Quick Reference

Hypertrophic Scarring

Bump Description | Bump Creation | Bump Prevention | Bump Treatment | Further Reading

This page discusses a type of piercing bump known as Hypertrophic scarring. It is a very common piercing bump, can be quite stubborn and is often mistaken for Keloiding.


Hypertrophic Scarring

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Description

  • A hypertrophic scar is a pink or purple-red bump.
  • They can also appear skin coloured and even change colour over time.
  • The bumps are often quite itchy and can suffer from peeling skin.
  • Hypertrophic scars also stay fairly close to the wound  and are quite solid like a pimple.
  • Hypertrophic scars are prone to bleeding when knocked or upset.


Creation

  • A hypertrophic scar is created by an overgrowth of granulation tissue cells or proteins while a piercing is healing.
  • It is thought to be created by more granulation tissue being produced than can be broken down or reabsorbed. Instead it in all directions, creating the bump.
  • Hypertrophic scarring generally occurs 4-8weeks after infection or trauma, grows for up to 6 months and then naturally starts to go away by itself.
  • It can take several years for a hypertrophic scar to go away naturally without aid.

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Prevention

Hypertrophic bumps are common on wounds which heal by secondary intention and  that have foreign bodies in them which is what a piercing is. So seriously consider if getting a piercing is worth the risk.


Pressure therapy is thought to help gently press back into place the membrane that helps feed cartilage so it is likely to help healing cells get to where they need to be.

Preventing knocking the piercing can help not to trigger potential over-production of tissues.

Looking after you body is important. Wounds need certain vitamins and minerals to close up properly. Omega 3, Vitamin A & C and the mineral zinc should help with this. Smoking and alcohol can inhibit the immune system. Eating healthy may help limit the bad fats needed to build the scar.

The biggest factor in causing hypertrophic scarring seems to be irritation (stress). This probably causes the body to send out more wound healing signals than it needs, creating excess tissue. Common stresses for body piercing include:

        • Wearing jewellery made from  poor materials during healing – especially if you are allergic to ‘cheap metals.’
        • Having jewellery that is an unsuitable length, width or shape.
        • Wearing a ring in the piercing during healing.
        • Cleaning using harsh chemicals or antibacterial agents.
        • Sleeping on the piercing
        • Wearing clothing, hats or large earphones that rest or rub on the piercing.
        • Wearing long hair down as it can get caught or wrapped and contains oil and dirt.
        • Knocking , playing with or moving the piercing jewellery frequently.
        • Removing or replacing the jewellery. Using the salt soak cleaning method you do not need to move the jewellery to clean well.

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Treatment

Essential Treatment  |   Home Treatments   |   Medical Treatments   |   Unsuitable Treatments

Essential Treatment

The most important step in treating hypertrophic scarring in body piercings is to remove any stress which could be stimulating an overproduction of tissue. Without this step the bump simply will not go away and could even increase in size for up to 6 months.

  1. Change your jewellery if it is too long, too short, a ring or not made of titanium.
  2. In some cases, changing to PTFE or Bioplast plastic jewellery can help.
  3. Clean your piercing using salt water soaks and avoid chemicals or antibacterial agents. Learn why here.
  4. Don’t play, twist, fiddle or remove the piercing jewellery. Learn why here.
  5. Use a doughnut shaped, ‘U’ shaped or travel pillow or learn to sleep with your bent arm, pillow or cupped hand cradling the piercing.
  6. Be careful to keep hair, clothing and accessories away from the piercing.
  7. Do not use moisutriser, foundation, face powder, talc or other cosmetics too near the piercing.
  8. Do not treat the bump with harsh chemicals, or antiseptics.
  9. Do not try to pop or squeeze the bump. It is solid inside and there is nothing to squeeze out!
  10. Take care of yourself. Eat well, sleep well, drink water, take a multivitamin and cut down on smoking and drinking.

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Treatment

Home Treatments

Each of our recommendations are gentle enough to use on healing piercings and have a scientific basis, but shouldn’t be considered a substitute for professional medical advice. To find out what these treatments actually do, read here.

The best thing to try first is chamomile tea.

        • Pure chamomile tea can be found in fruit tea section of most supermarkets.
        • Add boiling water to the tea bag as normal and leave it to cool until it’s still hot but bearable to the touch. Add in 1/4 teaspoon of sea salt and use as a soak or use the hot tea bag itself as a compress (dip it back into the tea when it gets cold) for several minutes, twice a day.
        • If you have a ragweed or celery allergy do a skin test before using chamomile. Also test if you have very bad hayfever or nut allergy and do not know what causes it.

Quercetin is a natural supplement found from most health food stores or online.

        • Break down one tablet to a powder to use either in a hot salty / chamomile soak or to mix with an oil as a paste to apply directly to the bump. Use twice a day.
        • Do not use Quercetin if you are taking anti-biotics or certain medications (see here.)

Onion Extract.  Allium Cepa is an onion extract found online or in the homeopathy section of health food shops. You can also find it as gel called merderma which tends to be more expensive.

      • Break down the tablet to a powder to use either in a hot salty soak or to mix with an oil as a paste to apply directly to the bump. Alternatively apply merderma after a soak. Use twice a day.
      • Allium Cepa does not seem to interact with drugs in the same way as Quercetin does but caution is advised. If you are unsure get the advice of a doctor or pharmacist.

Garlic supplements are found online or in most health food shops and some supermarket health supplement aisles.

      • We recommend using odourless garlic capsules broken down to powder and used in a hot salty soak or mixed with oil for a paste and applied directly on to the bump. Use twice a day.
      • You may need to be careful with this herb if you use certain medications (see list here).

Rosehip oil can be found online or in most health food shops.

      • Apply a little to the bump twice a day after soaking. It is recommended that you massage it into the skin in a circular motion.
      • Be careful using this oil

Fish oils such as cod liver oil can be found online or in most health food shops and supermarket health supplement aisles.

      • Apply a little to the bump twice a day after soaking. It is recommended that you massage it into the skin in a circular motion.
      • Unfortunately there isn’t a decent vegetarian alternative to this oil.
      • This oil may interact with people who take medications to lower blood pressure or slow blood clotting. This includes ibuprofen, aspirin, naproxen and other anti-inflammatory painkillers.

You can mix these remedies together. Simply do so in equal amounts. We particularly recommend a chamomile salt soak with added quercetin and an application of cod liver oil to the bump after drying.

You should see some improvement after two weeks. It can take several weeks for bumps to go completely. If you do not see any improvement after two weeks then try another method where possible. Medical advice should be sought if you are worried or concerned in any way.

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Treatment

Medical Treatments

      • Usually doctors suggest treating the bump as a possible infection first and may suggest an antibiotic cream like Fucidin cream.
      • The best ‘self’ medical treatment for more stubborn bumps are products like hydro gel and silicone scar gels. Silicone sheets may irritate. Always read the leaflet before use or ask a pharmacist for advice.
      • You can also try to self medicate with a low dose steroid cream like hydrocortisone. Alternatively your doctor can prescribe you a triamcinolone cream which is generally more effective. Always read the leaflet before use or ask a pharmacist for advice.
      • Very stubborn or very large hypertrophic scars can be treated by doctors in the same way as keloids (steroid injections, laser treatments or freezing) or surgically removed. Interferon injections have also been quite successful.

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Treatment

Unsuitable Treatments

It is important not to treat hypertrophic scars on still-healing piercings with anything too strong. Harsh treatments can cause a lot of damage (and thus irritation) to a healing piercing, increasing the bump.

      • Aspirin Paste. Chemically burns away the top layer of skin and dries out the bump which makes it appear smaller. Doesn’t treat root cause of the bump. Can burn skin and damage gums.
      • Hydrogen Peroxide (H202). Burns away a top layer of skin from the bump and dries it out, making it appear smaller. It can cause serious damage to a still healing piercing and deafness if it gets inside the ear. Doctors do not recommend it for wound care. Doesn’t treat root cause of the bump.
      • Compression Therapy. Very successful when used on a bump without jewellery in the way. Needs specialist made-to-measure equipment for enough equal pressure on the bump. It is unlikely that using tape to put pressure on a piercing bump will have the same effect. Compression garments need to be used for around 23 hours a day for 6 months or more without jewellery in the way to irritate and interfere, so this method is not recommended if you wish to keep the piercing.
      • Tea Tree Oil. Is strong and can damage a still healing piercing. Antibacterial properties also interfere with healing process. Many people find they have skin reactions to it. Can be very helpful for bumps on well healed piercings only.
      • Scar Oils. (Ie. Bio, Lavender, Emu &Vitamin E oil. Nut Oils.). Hypertrophic scars are different from regular scars and these oils do not attempt to treat the root cause of the bump. The oils we recommend above seem to be better.
      • Vinegar. Has anti-microbial properties that can upset piercing healing. Also damages healing cells in wounds unless very diluted (and then it doesnt work well). Can cause burns or skin reactions. Apple Cider Vinegar maybe helpful for some people but will only work on well healed piercings, otherwise it will just bring the bump back.
      • Exfoliation. (I.e. Bicarbonate of soda, scar ‘peels,’ facial scrubs and ground almonds.) Removes the top layer of skin and lessens discolouration but doesn’t treat the root cause of the bump. Only likely to be of use for blending in regular scars to the rest of the skin.
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Further Reading

For more information please read the full guide to hypertrophic scarring which includes a more in-depth look at how certain treatments work. Other common piercing bumps can be explored through the Piercing Bumps Guide. You also may be interested in reading how a piercing heals in order to better understand how and when these bumps form.


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