Keloid on septum piercing: what to know

A keloid is scar tissue that grows beyond the original piercing injury. It can feel firm, smooth, itchy, tender, or darker than nearby skin, and it may enlarge gradually. A smaller bump limited to the piercing channel may instead reflect irritation, trapped discharge, or a hypertrophic scar. A painful, hot, increasingly red area with pus points more toward infection. Do not squeeze, cut, twist, or repeatedly remove and replace the jewellery while the area is unsettled. A clinician can inspect the tissue and the inside and outside of the septum.

Use gentle cleansing recommended for a healing piercing and keep hands, cosmetics, and friction away from the site. Avoid home burning, strong acids, and unprescribed steroid creams. If the diagnosis is a keloid, treatment may involve an intralesional steroid injection, cryotherapy, laser treatment, or carefully selected surgery; recurrence prevention is part of the discussion. Read about [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) and [Keloid Removal Surgery](/treatments/surgical-dermatology/keloid-excision/).

Arrange a dermatology assessment if the bump keeps enlarging, catches on jewellery, bleeds, or remains itchy or painful. Seek urgent care for spreading redness, fever, severe swelling, foul drainage, uncontrolled bleeding, or trouble breathing through the nose. Nasal swelling with breathing difficulty needs prompt attention regardless of whether the lump is a scar.

Ask whether the tissue looks like a keloid, hypertrophic scar, irritation, or infection; whether jewellery should stay in place; which treatment fits the septum; and how recurrence would be reduced after treatment.