Keloid in a nose piercing: what to know

A keloid is excess scar tissue that grows beyond the original piercing channel. It may feel firm, smooth, itchy, sore, or tight, and it can enlarge gradually. A smaller bump limited to the piercing opening may instead reflect irritation or a hypertrophic scar. Redness, heat, throbbing pain, pus, or spreading swelling raise concern for infection rather than simply scar growth.

Avoid twisting jewellery, picking crusts, or applying harsh antiseptics. These actions can keep the channel inflamed and make the bump harder to interpret. Note when it started, whether it is changing, and whether the jewellery catches on clothing or bedding.

Have a dermatologist or qualified clinician examine the bump before removing jewellery or starting treatment, particularly if the piercing is fresh or the area is draining. Management can include an intralesional steroid injection, cryotherapy, laser treatment, or surgery. The choice depends on the tissue, symptoms, piercing site, and whether a keloid has returned before.

Keep hands clean, reduce pressure and friction, and follow the piercer's or clinician's aftercare advice. Do not cut or pop the lump. Relevant options to discuss include Steroid Injection Into The Skin, Pulsed Dye Laser Treatment, Cryotherapy (Lesion Removal), and Keloid Removal Surgery.

Seek prompt care for spreading redness, warmth, pus, fever, rapidly increasing swelling, severe pain, or jewellery becoming embedded. Arrange a non-urgent assessment if the bump keeps enlarging, bleeds, repeatedly crusts, or remains unexplained after the piercing has settled.

Ask whether the bump is a keloid, an irritated piercing, or infection; whether jewellery should stay in place; which treatment is safest near the nostril; and what follow-up is needed if it returns.