Brief: This is a page that talks about granulomas, a type of bump that can sometimes appear on body piercings. Luckily these bumps are easy to treat and often go away by themselves.
TL;DR – Too much information? For a shorter version try reading our quick reference guide here.
Granulomas are not very common on body piercings but they do sometimes appear as a result of trauma (such as being pierced or knocking the piercing hard). They are often mistaken for blood blisters because they can bleed a lot and sometimes look to be ready to pop.
Granulomas are usually small and bright red in colour. They can appear as a perfectly round looking raised spot (like a red ball stuck to the skin) or as a lump which looks similar to chopped meat and is very uneven, both the appearances can look also quite shiny or wet.
Granulomas tend to bleed quite a bit when knocked (or even spontaneously) which, as well as being annoying, could pose an infection risk since the lump keeps ‘opening’. Because of this bleeding these bumps are sometimes mistakenly thought to be blood blisters.
Granulomas form when the body’s immune system attempts to wall off substances that it thinks is foreign. The body releases‘first response’ inflammatory cells which are responsible for flushing out debris and other things trapped inside wounds and if these don’t work it may make a granuloma to protect itself instead.
This could be from certain infectious bacteria or (most probably) from the jewellery itself as its not natural to have a small chunk of metal in the middle of a wound (no matter how much we may like it to be there)! If the granuloma was stimulated by bacteria it can contain dead cells which, in some cases, may smell.
The term granuloma covers any ‘small nodule’ so it is not very specific. It is thought that the granulomas that occasionally appear near piercings may be Pyogenic granuloma which (despite the name) are only loosely linked with ‘true’ granulomas. However they are only definable by biopsy and lab testing so its unlikely to really matter with body piercings.
Little specific is known about granulomas or exactly what stimulates the inflammatory cells to create them and since they can even appear completely spontaneously it’s quite hard to say what may prevent them.
- On body piercings they tend to appear most often on the nose and navel but they can appear almost anywhere on the head, arms and torso.The nasal septum seems to be another common place to see them, and they are often found to be the source of repetitive nose bleeds.
- They are also more popular in children (particularly under 5s) and young adults and appear to be effected by female hormones; making women in general more susceptible to them.
- Certain medications such as hormonal contraceptives, protease inhibitors and retinoids seem to increase the risk of these bumps forming also.
If you fall into a risk group it is seriously worth considering if you think body piercing is worth the risk of these bumps forming.
Luckily most granulomas go away by themselves but in the mean time they can be annoying and prone to possible infection so it is important to keep an eye on them.
Keep it Dry. The best thing to do is to stop saline soaking your piercing, moist conditions don’t appear to be good for granulomas which tend to shrivel and dry out when the start to go away. To this end creams, oils, soaps and liquids may not be helpful either.
Use medicated powder. The best thing to use is a medicated or antibacterial talcum powder once or twice a day. You can find medicated talcum powder in most pharmacies or you can shop online for things like CX Powder. This should help to keep the area dry and free of bacteria.
Treat the bleeding. When the granuloma bleeds make sure to apply pressure to stop the flow as soon as possible and let the scab / dried blood stay several hours before gently cleaning it away, to make sure the granuloma has clotted properly and won’t just bleed again. Blood is best cleaned away with a gentle soap, being sure to dry the piercing thoroughly afterwards.
Over it over. If the bump is particularly bothersome it can be covering in a breathable dressing. Just make sure to change it regularly, especially if it gets wet or dirty and to clean and powder the area each day.
If the granuloma bleeds a lot or just generally distresses you it can be removed or treated by a medical professional.
Imiquimod Cream. Perhaps the easiest form of treatment is to be prescribed a topical imiquimod cream which activates immune cells and encourages them to come to the bump and heal it, so this may be what your doctor will try first.
Cauterisation. If this doesn’t work then granulomas do seem to respond well to curettage and cauterisation which is where the bump is scraped away using a sharp blade and the wound closed using heat – all done under local aesthetic.
Medical Intervention. They can also be frozen off, lasered away and surgically removed but usually before any of these treatments happen a biopsy (where they take a piece of tissue from the granuloma) may be preformed to try and discover the cause of the bump.
If you would like to know more about granulomas we suggest reading the following articles.
A Pyogenic Granuloma article by Skin Sight can be found here. This article discusses the bump in some detail but is clearly laid out and easy to read.
The patient.co.uk Pyogenic Granuloma article has fantastic close up photographs and pinpoints key issues in handy bullet points.