Nose Piercing Bumps: Causes and Treatments

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Getting a bump on a new nose is extremely common — and in most cases it is part of the normal healing process rather than a complication. Nose piercings disrupt skin, cartilage and small blood vessels in an anatomically tricky area, and the body’s healing response can produce visible swelling, bumps, or small pieces of tissue around the piercing site. The great majority of these resolve with simple home care over weeks to a few months. A smaller — particularly true keloid scars and persistent inflammatory bumps — need professional assessment and treatment.

This guide covers the different types of nose piercing bump, how to tell them apart, what to do for each, and when to seek specialist help at Centre for Surgery’s Baker Street private hospital.

The different types of nose piercing bump

In the first few weeks after a new piercing, some and redness around the piercing site is entirely expected. The skin and underlying tissue have been broken and the body’s natural inflammatory response is active. This kind of bump is diffuse rather than discrete, usually pink or red, and gradually settles over 2–4 weeks as the wound heals. No specific treatment is needed beyond good piercing aftercare.

A hypertrophic scar is a raised, firm bump confined to the original piercing site. It develops over the early weeks to months of healing, often peaks at 3–6 months, then slowly improves over 1–2 years. The bump is typically pink or red, firm to the touch, and may itch or feel tender. The key distinguishing feature: it stays within the boundaries of the original piercing hole rather than growing beyond.

Hypertrophic scars respond well to silicone gel or sheeting, intralesional steroid injection, and sometimes laser treatment. For more on the natural history and treatment of these scars, see

A keloid is similar to a hypertrophic scar but more aggressive — it extends beyond the boundaries of the original piercing site, growing into previously healthy skin. Keloids do not improve spontaneously the way hypertrophic scars do; they tend to persist or continue for months to years. They are more common in patients with darker skin types (Fitzpatrick IV–VI), and there is often a family history.

Keloids need active rather than watchful waiting. Options include intralesional injection (the first-line treatment, given as a course of injections every 4–6 weeks), silicone gel or sheeting, surgical excision combined with post-operative steroid injection or radiotherapy in severe cases, and adjunctive laser. For more detail on keloid management on the ear and face, see and .

A pyogenic granuloma is a rapidly growing, bright red, vascular lesion that can develop at a piercing site. It bleeds easily — sometimes alarmingly — and tends to grow over weeks to months. Despite the name, it is not infected; the “pyogenic” part is a misnomer. It is a benign vascular overgrowth that responds to excision, sometimes with or laser. For full discussion, see .

An infected piercing is red, hot, swollen, painful, and may discharge pus. There is sometimes systemic upset — fever, malaise. This needs prompt treatment rather than home management: antibiotics, sometimes formal drainage, and removal of the piercing if the infection is severe. Don’t mistake a routinely inflamed piercing for an infected one; the key features of infection are pus, significant pain, and rapid over days.

Nickel allergy is common, and a piercing with a nickel-containing post can produce persistent itching, redness, swelling and sometimes weeping at the piercing site. The bump in this case is more diffuse and often itches more than it hurts. Switching to a hypoallergenic post (titanium, niobium, surgical steel, or solid gold) usually resolves the issue. Patients with piercing problems should consider an allergy as a possible cause.

Make-up, skincare, perfumes, certain soaps, and even some piercing aftercare products can irritate the wound and produce localised . This typically improves quickly once the irritant is identified and removed.

If the piercing post is too short for the swelling, or if the jewellery has been pushed too far in, the skin can heal over the post — embedding it. This produces a persistent bump that does not resolve until the jewellery is removed and the wound managed appropriately.

How to tell which type of bump you have

The first questions to ask yourself are:

For any bump that is unusual, persistent beyond a few months, growing, or causing concern, assessment is appropriate.

Home care that helps

For routine and early bumps, simple home care usually settles the issue:

Sterile saline (or homemade salt water using a quarter teaspoon of sea salt to a cup of warm boiled water that has cooled) applied as a brief soak with a clean cotton pad twice daily helps clean the area and supports healing. This is the foundation of most piercing aftercare protocols.

Don’t twist or rotate the jewellery — modern piercing guidance has moved away from this practice. Twisting disrupts the healing tissue and prolongs the . Leave the piercing alone except for cleaning.

These products can irritate the wound. Apply skincare to the rest of the face but avoid the immediate piercing area until fully healed.

Avoid directly on the piercing site. Pressure during sleep can increase swelling and prolong healing.

If the piercing has been done with a metal that may contain nickel, switching to titanium, niobium, surgical steel, or solid gold can resolve allergy-related irritation.

Once the wound has fully closed (typically several weeks after the piercing was done), silicone gel can be applied to small hypertrophic scars. Silicone is the only topical treatment with strong evidence for improving the final scar; it can be continued for 3 months or more. For full discussion, see

When to seek professional assessment

Several scenarios warrant professional review rather than continued home management:

For specialist assessment of persistent or problematic piercing bumps, particularly those affecting cosmetic appearance, surgical input is . The plan depends on what the bump turns out to be.

Treatment options for problematic piercing bumps

For scars and keloids, steroid injection delivered directly into the bump is the first-line treatment. Given as a course of injections at 4–6 week intervals, it gradually reduces the scar by suppressing collagen overproduction. Multiple injections are usually needed. The procedure is performed under topical anaesthesia and takes only a few minutes per session.

Silicone gel or sheeting applied to the bump for 12 hours or more per day, continued for 3 or more months, has the strongest evidence base of any topical treatment for hypertrophic scars and keloids.

For persistent keloids that do not respond to injection, or for granulomas, surgical excision can be performed. Keloid surgery alone has a high recurrence rate — it is usually combined with steroid injection or, for severe cases, post-operative radiotherapy. excision is more straightforward and typically definitive.

laser can reduce redness in vascular scars and granulomas. Fractional CO2 or erbium laser can help with textural improvement. Laser is usually adjunctive rather than primary treatment.

In some cases — particularly with recurrent infection, persistent allergy, or large — the most effective treatment is removal of the piercing itself. Once the piercing is gone, the bump usually settles substantially, though the original scar may persist.

Prevention — minimising the risk in the first place

If you are planning a nose piercing:

If you have already had multiple problematic piercings, particularly with keloid formation, further piercings in the same anatomical area are likely to cause similar problems.

What we don’t recommend

Frequently asked questions

Often yes — some swelling and redness is part of normal healing in the first few weeks. Persistent or growing bumps after 2–3 months are more likely to need specific treatment.

A keloid extends beyond the boundary of the original piercing into the surrounding skin and tends to grow over time. A hypertrophic scar stays within the piercing site and typically settles over months to a year or two. Family history and skin type are useful clues.

Hypertrophic scars usually do, slowly, over 1–2 years. Keloids rarely do. Granulomas usually need active treatment. Normal inflammation settles within weeks.

Often yes — many bumps can be treated while the piercing remains in place. For some cases, particularly large keloids or recurrent infections, removal of the piercing may be needed.

Treatment cost depends on what is needed — steroid injection courses, excision, laser treatment. We discuss this at consultation with a written quotation.

Steroid injections sting briefly but are otherwise well . Surgical procedures are under local anaesthetic and are painless. Most treatments are well managed with paracetamol for any post-procedure discomfort.

In some cases yes, in others no. Repeat piercing after a keloid carries a high risk of recurrent keloid formation. Repeat piercing after a non-keloid bump can sometimes be considered after a period of healing, but should be discussed .

No — Centre for Surgery is a plastic surgery clinic. We treat complications of piercings (keloids, granulomas, bumps, scarring) but do not perform piercings themselves.

Centre for Surgery is a CQC-regulated plastic surgery clinic at 95–97 Baker Street, Marylebone. Treatment of problematic piercing bumps — keloids, granulomas, hypertrophic scars, and other persistent issues — is performed by GMC-registered consultant plastic surgeons. Steroid injection, surgical excision, laser treatment, and combination are all available. No GP referral is required.

For related guides, see , , , , and .

Centre for Surgery · CQC-regulated · GMC specialist-registered surgeons · · · ·

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Centre for is a CQC-regulated hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including and , , for men, and body contouring procedures such as and . safety, surgical excellence and natural-looking results sit at the heart of everything we do.

Centre for Surgery is a CQC-regulated private hospital on London’s iconic , offering plastic and surgery led by GMC-registered consultant surgeons.