Piercing bumps — what they are, why they happen, and what to do

Irritation bumps are the most common complication we see in healing piercings. They arrive as a small raised area near the entry or exit point of a piercing — sometimes fluid-filled, sometimes firm, sometimes appearing quickly and other times developing over weeks. They cause alarm in almost everyone who gets them, primarily because the internet consistently tells people it might be a keloid.

It almost certainly is not a keloid. And in the majority of cases we see at Platinum Point in Parnell, the bump is caused by something identifiable and fixable. This guide explains the different types of bump, what causes each one, what to do, and — importantly — what not to do.

Three types of bump — and why they matter

Not all bumps are the same, and treating them the same way causes unnecessary complications. The three types you are most likely to encounter:

• Irritation bump (also called a pressure bump or trauma bump): A localised raised area of tissue caused by ongoing mechanical stress or chemical irritation to the healing piercing. Usually soft, sometimes slightly red or pink. May contain clear fluid. This is the most common type — it is the body's inflammatory response to something that is repeatedly disturbing the healing tissue. Almost always reversible once the cause is removed.
• Hypertrophic scar: A raised, firm scar that forms within the boundaries of the original wound. Different from an irritation bump in texture — it is denser, less fluid-filled, and more permanent in appearance. Often caused by prolonged jewellery movement, poor jewellery material, or repeated disruption during healing. Can improve significantly with the right intervention, though it takes longer to resolve than an irritation bump.
• True keloid: A pathological overgrowth of scar tissue that extends beyond the original wound boundary, does not regress spontaneously, and has a genetic component. True keloids are significantly less common than the internet suggests, are more common in people of African or Asian descent, and require medical intervention. They do not respond to the interventions that resolve irritation bumps.

The distinction matters because the treatment approach differs. What resolves an irritation bump (remove the irritant, clean consistently, wait) will not resolve a true keloid, and what people commonly do for keloids (remove the jewellery, apply pressure) often makes irritation bumps worse.

The most common causes of irritation bumps

When we see a client at Platinum Point with a piercing bump, we work through the likely causes systematically. The most common ones, in rough order of frequency:

• Sleeping on the piercing: For cartilage piercings — helix, daith, tragus, conch — sleeping on the pierced ear applies consistent pressure and creates micro-movement in the jewellery throughout the night. This is the single most common cause of irritation bumps in cartilage piercings. The piercing may seem fine during the day but the nightly pressure prevents it from settling. The fix: a travel pillow with a cut-out, or a camping pillow with a hole in it. Cheap, available online, and effective.
• Inappropriate jewellery material: Jewellery that leaches metal ions (nickel from unspecified surgical steel, or from white gold alloys) causes a contact allergic response in the tissue. The bump is the body's attempt to wall off the irritant. Switching to ASTM F136 titanium or solid gold typically resolves this type of bump within weeks.
• A post that is too long: If the downsize appointment was missed or delayed, the longer initial post creates leverage every time the jewellery is caught or moved — even slightly. This lever action applies stress to the healing fistula and commonly produces a bump on the exit side of the piercing. The fix is a downsize — replacing the long post with a shorter one suited to the healed tissue depth.
• Jewellery movement from a ring in a fresh piercing: A ring in an unhealed piercing moves every time you breathe, speak, or shift position. This constant movement prevents the fistula from forming cleanly. The correct starter for any fresh piercing is a flat-back labret, not a ring.
• Aftercare products: Tea tree oil, antiseptic creams, alcohol, and hydrogen peroxide all cause chemical irritation to healing tissue. We see clients regularly who have been applying tea tree oil to a bump for weeks — the oil is causing the bump, or at minimum sustaining it. Stop all products except saline.
• Snagging: Catching the jewellery on clothing, hair, or while washing can cause acute trauma that produces a bump. Usually resolves without intervention once the snagging stops.
• Headphones and earphones: In-ear earphones pressing against a healing tragus or conch, or over-ear headphone cups pressing against a healing helix, create sustained pressure during use. A common cause of persistent irritation in active or office-based clients.

What to do when you have a bump

The approach depends on the type and likely cause, but the general protocol when you notice a bump:

• Step 1: Stop all products except saline. If you are using anything other than sterile saline wound wash, stop immediately.
• Step 2: Identify the mechanical cause. Are you sleeping on the ear? Wearing earphones? Is the post too long? Did you recently snag it? Address the source.
• Step 3: Check the jewellery material. Do you know for certain that the jewellery is ASTM F136 titanium, solid gold, or 950 platinum? If not, a jewellery check with your piercer is warranted.
• Step 4: Continue saline cleaning twice daily. Clean consistently, leave the jewellery still, and give the body time to respond once the irritant is removed.
• Step 5: Come in if the bump persists or worsens. Most irritation bumps respond within 2–4 weeks of removing the cause. If yours does not, or if it is growing rather than reducing, contact us at Platinum Point on 09 949 0940 or visit the studio at 389 Parnell Road.

What NOT to do

The list of things that make bumps worse is longer than the list of things that help:

• Do not apply tea tree oil. This is the most persistent piece of bad advice in piercing aftercare. Tea tree oil is a chemical irritant on healing tissue. It may reduce surface bacteria slightly, but it causes more damage than it prevents and prolongs the bump in most cases.
• Do not apply aspirin paste, Savlon, antiseptic, or anything else. See above. Saline only.
• Do not remove the jewellery. If the piercing is still healing and you remove the jewellery, the fistula closes. If the bump was caused by jewellery material or movement and the jewellery is removed before the fistula is stable, the bump often persists in the scar tissue left behind. Leave the jewellery in and fix the cause.
• Do not squeeze or drain the bump. If the bump contains fluid, squeezing introduces bacteria and causes more trauma. Leave it.
• Do not tape the bump. Applying tape or pressure dressings to an irritation bump does not help and often traps moisture and bacteria against the tissue.
• Do not seek a steroid injection without a professional piercing assessment first. Steroid injections for piercing bumps are appropriate for true keloids — not for irritation bumps, where they can cause tissue atrophy. See your piercer before a dermatologist for any piercing bump.

The most common pattern we see: a client gets a bump, Googles it, concludes it is a keloid, and applies tea tree oil for six weeks. The tea tree oil sustains the bump. They come to us convinced the bump is permanent. We remove the tea tree, address the mechanical cause, and the bump resolves within a month. The piercing is fine.

When to see a doctor

Most piercing bumps do not require medical attention. See a doctor (or contact us to advise on a referral) if:

• The bump is accompanied by spreading redness, significant heat, and pus — suggesting infection rather than irritation
• You have systemic symptoms: fever, chills, or swollen lymph nodes
• The bump has been present for many months, is growing, and extends beyond the original piercing boundary — this may indicate a true keloid requiring medical management

For everything else — which is almost all piercing bumps — the answer is a piercer, not a GP. We understand healing piercings in a way that most general practitioners do not, and we will refer you if we see something that needs medical attention.

Getting help in Auckland

If you have a bump on a piercing done at Platinum Point or done elsewhere, we are happy to take a look. We offer piercing check-in appointments at 389 Parnell Road, Parnell, Auckland 1052 — call 09 949 0940 or book online. Clients come to us from Remuera, Newmarket, Ponsonby, the CBD, and from across Auckland when they are having trouble with healing piercings from other studios.