A piercing lets you wear jewelry in your skin. It’s basically a small wound, so piercings heal like other wounds. Your skin repairs itself by making collagen, a protein that gives your skin structure and strength. Collagen is often called the “building block” of the body.

Sometimes, a bump can form while the piercing heals. It could be a scar called a hypertrophic scar. Hypertrophic scars, or raised scars, are one response during the healing process.

You might wonder if you have a hypertrophic scar. Keep reading to find out what they look like and how you can treat them.

A hypertrophic scar is thicker than a normal scar. It doesn’t go past the wound that caused it.

Hypertrophic scars are usually:

  • raised less than 4 millimeters above the surrounding skin
  • firm
  • pink or red

They can also be itchy or painful. After an initial growth period, hypertrophic scars can flatten and shrink over time.

The scars can form anywhere on your body, but they’re most common with nose and ear cartilage piercings. Cartilage doesn’t heal as well as other tissues.

Hypertrophic scars are also common on your chest, upper back, and shoulders. Dermal piercings in these areas might be more prone to scarring.

Typically, hypertrophic scars are harmless. They’re more of a cosmetic issue that goes away in time. Some people take extra steps to make them less noticeable.

Hypertrophic scars aren’t the same as keloid scars. Both are caused by excess scar tissue, but keloids grow past the wound and into the surrounding skin.

In general, keloid scars:

  • are raised more than 4 millimeters above the skin
  • are firm
  • are pink, purple, or flesh-colored
  • can be itchy
  • grow over time
  • can come back after treatment

If you get a keloid on an earlobe piercing, it’ll probably be a round hard mass.

Anyone can get keloids, but they’re common in people under 30 years old. People with deeper skin tones are also 15 times more likely to get keloids.

If you think you have a keloid, see your piercer. They can offer expert advice and tell you what to do next. Your piercer might have you go to the doctor for a second opinion.

Scars are a natural response to wound healing. Normally, cells make collagen to repair your skin. Sometimes, cells make too much collagen and a raised scar can form.

Some people are more prone to scarring because of their skin type, genetics, or age.

A hypertrophic scar on piercings can happen for two reasons:

  • Physical trauma. Inflammation, infections, and tension can make your skin overproduce collagen. This may happen if you keep touching the piercing while it’s healing. Or it may happen because of the placement of the piercing and the body area that it’s in.
  • Chemical irritation. Cosmetic and personal care products might have chemicals that irritate a healing piercing. Examples include makeup, sprays, and scrubs. Products with harsh fragrances and dyes are also big no-nos.

Hypertrophic scars usually develop with new piercings. Generally, a hypertrophic scar shows up within four to eight weeks. The scar may grow quickly for up to six months before shrinking slowly over time. It can take months or years to get smaller.

Before treating a hypertrophic scar, visit your piercer. They can suggest the best option based on your symptoms and piercing.

If the scar is young, your piercer might recommend waiting first. Until the initial piercing wound heals, trying to treat a scar could make things worse.

Scars can take one year to fully mature. This is about how long your skin needs to repair itself.

Salt or saline soaks

Soaks speed up wound healing. To make a salt soak, add 1/4 teaspoon of iodine-free salt to 8 ounces of warm water. Dip a clean paper towel into the mixture and apply to the piercing for 5 to 10 minutes. Do this twice a day. You can also use sterile saline instead of salt water.

Chamomile soak

Bang Bang Body Arts, a custom body art studio in Massachusetts, recommends chamomile soaks in their piercing aftercare guidance. And research over the years supports the use of chamomile to encourage skin repair.

To use it, steep a chamomile tea bag in a warm cup of water for 3 to 5 minutes. Soak a clean paper towel or clean cloth and apply to your piercing for 5 to 10 minutes.

If you’re allergic to ragweed, avoid chamomile.

Pressure

This is the easiest and cheapest way to break down scar tissue. You can use massages, bandages, or tape. Pressure discs like NoPull Piercing Discs can help compress the scar.

Jewelry swap

Low-quality jewelry can irritate the skin. You’ll need new jewelry. If your piercing is still healing, don’t change it yourself. Your piercer can safely do it for you.

Silicone gel

Silicone gel can soften and flatten scars. It’s an over-the-counter (OTC) product, so you don’t need a prescription. You’ll need to apply it on the piercing twice a day. Silicone is also available as patches and sheets.

Corticosteroid injections

Corticosteroid injections may reduce scar tissue by fighting inflammation and breaking down collagen. You’ll need to get an injection every four to six weeks. Steroids can weaken the nearby skin, so you shouldn’t get more than five injections total.

Laser therapy

Laser treatment can lighten and shrink scars by dissolving blood vessels in the scar tissue. Other types of laser therapy remove the top layers of the skin.

Topical creams

Topical corticosteroid treatments are available as OTC and prescription creams. Another OTC treatment is onion extract cream, but more research is needed to prove how well it works.

Things to avoid

While your piercing is healing, you shouldn’t:

  • apply oils and products that your piercer hasn’t recommended
  • apply soaks with reusable towels, which can breed bacteria
  • apply soaks with tissue, cotton swabs, or cotton balls since they can get stuck
  • change the jewelry unless your piercer says it’s fine
  • touch or play with your jewelry

These habits can irritate and bother the area around your new piercing.

Generally, hypertrophic scars don’t cause complications. They usually fade and flatten over time, even without treatment.

Keloid scars are different. They can grow and feel uncomfortable. If you’re not sure what you have, or if you have other symptoms, visit your piercer or doctor.

Pay attention to your piercing. See your doctor if you have:

  • yellow or green pus or discharge
  • ongoing pain or throbbing
  • burning or itching
  • redness
  • swelling
  • bleeding
  • fast-growing scar

You might have an infection or something else that needs medical attention.

It may not be possible to avoid a hypertrophic scar’s formation, since some factors are simply genetic. Some of us will get them no matter what. But there are things you can do to lower your risk of getting hypertrophic scars on healing piercings. If you’re prone to scarring, be sure to:

  • regularly clean new piercings by following your piercer’s instructions
  • leave your jewelry alone while a piercing is healing
  • use only products recommended by your piercer
  • use silicone gel or sheets on new scars

Hypertrophic scars are often benign and harmless. If they bother you, ask your piercer or doctor about treatment options.

Always take care of new piercings. Clean them regularly and avoid touching your jewelry. This will minimize trauma, irritation, and other issues.

Follow your piercer’s aftercare routine. If you don’t understand something, ask them. It’s the best way to help your piercing heal properly.