Can you get rid of a keloid without removing the piercing?

Keloids are overgrowths of scar tissue that occur at the site of an injury, such as a piercing. They are benign skin growths that often continue to grow beyond the boundaries of the original wound and do not regress over time. Keloids can form after any type of skin trauma but are more common after piercings, particularly in areas like the earlobes and cartilage.

Keloids tend to be firmer and rubberier than normal scars and may itch or become painful. They can cause significant cosmetic concerns due to their enlargement over time. Keloids after piercings often form within a few weeks to months after the piercing.

Quick Answers

Here are some quick answers to common questions about removing keloids without taking out piercings:

  • It is possible in some cases to remove or reduce the appearance of keloids without removing the piercing.
  • Treatment options include steroid injections, cryotherapy, laser therapy, radiation, and silicone gel sheeting.
  • The most effective treatment is often excision (surgical removal) followed by radiation or other therapies to prevent recurrence.
  • Leaving the piercing in place during treatment may make some options more difficult.
  • Consulting a dermatologist experienced in keloid treatment can help determine the best approach.
  • Patience and persistence are key, as it often takes multiple treatments over weeks or months.
  • Preventing new keloids after treatment involves protecting the area from further trauma.

What are keloids?

Keloids are fibrous overgrowths that occur at the site of a skin injury. They form when collagen and other skin proteins are overproduced during the healing process, causing a raised, thick scar that grows beyond the original wound borders.

Keloids can occur after any type of skin trauma but are more common after surgeries, burns, piercings, cuts, insect bites, vaccinations, tattoos, and acne. They are not cancerous or contagious but are a benign skin condition.

People with darker skin tones are at higher risk of developing keloids. There also seems to be a genetic predisposition, so having a family history increases susceptibility. Keloids do not regress over time and often continue to slowly enlarge.

Signs and symptoms

Signs and symptoms of keloids include:

  • A raised, thick, rubbery scar that grows beyond the boundaries of the original injury
  • May be pink, red, skin-colored, or hyperpigmented
  • Often itchy, painful, or cause a burning sensation
  • Gets larger over time, even after the initial injury has healed
  • May cause functional problems if grows over a joint or in certain locations

What causes keloids after piercings?

Piercings are one of the most common causes of keloids, especially in the earlobes but also areas like the nose, navel, nipples, and cartilage piercings. The mechanism behind keloid formation after piercings is not fully understood but likely involves:

  • Genetic predisposition – genetic differences affect how prone skin is to excessive scarring.
  • Skin injury – piercings create a wound, inciting increased collagen production during healing.
  • Foreign material – metals or plastic from the piercing jewelry may cause chronic irritation.
  • Mechanical tension – force on the skin from the weight of jewelry may stimulate growth.
  • Inflammation – ongoing inflammation in the wound can drive scar proliferation.

Keloids begin forming within weeks to months after the piercing. The chance of developing a keloid is higher with cartilage or other body piercings versus simple earlobe piercing. Proper piercing technique and jewelry also affect risk.

Can you treat a keloid scar without removing the piercing?

It is sometimes possible to treat keloid scars from piercings without needing to remove the piercing itself. However, there are pros and cons to consider when deciding on this approach.

Pros

  • May allow the piercing hole to remain open if desired
  • Avoids pain, cost, and healing time for repiercing if removed
  • Eliminates stimulus of new injury that could worsen scar

Cons

  • Presence of jewelry may hinder effectiveness of some treatments
  • Risk of irritation or re-injury from jewelry during treatment
  • More difficult to fully remove scar tissue with jewelry in place
  • Higher chance of recurrence without removing all scarred tissue

Whether it is appropriate to treat a piercing-related keloid without jewelry removal depends on factors like:

  • Location and size of the keloid
  • Type of jewelry worn (metals can cause problems)
  • Pliability of the scar tissue
  • Treatment methods being considered
  • Skill of the practitioner

In some cases, like a very small, smooth earlobe keloid, treatment while leaving jewelry intact may be reasonable to try. For large or irregular keloids, removal is often advised. Consulting a dermatologist knowledgeable in keloids is recommended to assess options.

What are the treatment options?

There are variety of methods that may be used to remove or reduce keloids without taking out piercings. Effectiveness and risks vary with each approach:

Steroid Injections

  • Corticosteroid medication injected directly into scar tissue
  • Helps reduce inflammation and collagen overproduction
  • Usually requires multiple injections over weeks or months
  • Risk of atrophy, color changes, and recurrence after stopping

Cryotherapy

  • Freezing scar tissue with liquid nitrogen to damage abnormal cells
  • Repeated freezing and thawing helps break down keloids
  • Can use freeze-thaw-freeze approach in one session
  • Risks include pain, blistering, and pigment changes

Laser Therapy

  • Laser light targets blood vessels and cellular activity in the scar
  • Helps shrink keloids by creating localized heating
  • Usually requires multiple treatments
  • Can sometimes cause increased pigmentation as a side effect

Radiation

  • Focused radiation aimed at the scar several times weekly
  • Helps prevent recurrence of keloids after surgical removal
  • Given externally or by implanted wires for longer courses
  • Risks include skin redness, fatigue, other side effects

Silicone Gel Sheeting

  • Self-drying silicone sheets applied over the keloid
  • May help soften scar tissue and reduce collagen buildup
  • Usually worn for 12+ hours per day for months
  • Can cause skin irritation with long-term use

Many doctors recommend a combination approach, such as surgical removal followed by corticosteroid injections or radiation to prevent recurrence of the keloid. Leaving piercing jewelry in place may make some of these options more difficult.

What is the most effective treatment method?

Excisional surgery to remove the keloid scar, followed by radiation or other adjunctive therapies, is typically the most effective approach and provides the best chance for permanent resolution. However, this does require fully taking out the piercing.

With excision, the entire keloid is surgically removed or cut away. This eliminates the overgrown scar tissue down to normal skin underneath. Radiation is often started shortly after surgery to prevent regrowth of the keloid.

Corticosteroid injections, cryotherapy, pressure dressings, or laser treatment may also be used following excision to further minimize recurrence. Excision with post-operative radiation provides around a 70-90% chance of permanent keloid removal.

Non-surgical options like steroid injections, cryotherapy, or lasers used alone have significantly higher rates of keloid recurrence compared to excision. However, they may still be reasonable alternatives in some situations where excision is not possible or desired.

What are the risks of removing a keloid scar without removing the piercing?

Attempting to remove or reduce a keloid scar while leaving the original piercing intact does carry some risks and downsides, including:

  • Incomplete removal of scar tissue – May not be possible to fully eliminate keloid with jewelry in place
  • Higher recurrence rates – Greater chance scar will return without excisional removal
  • Ongoing irritation – Metals or movement of jewelry may cause persistent inflammation
  • Infection risk – Open wound during treatment can allow bacteria entry
  • Treatment limitations – Some options like radiation may be restricted
  • Scar enlargement – Trauma during procedures can worsen keloid
  • Aesthetic results – More difficult to achieve smooth, flat scar without excision

There is also the possibility that removal of the keloid ultimately fails, necessitating taking out the piercing anyways. This can mean added costs, time, and discomfort from two procedures instead of one.

What aftercare is needed?

Proper aftercare following keloid scar treatment is vital for reducing complications and improving results. Post-treatment recommendations may include:

  • Wound care – Keeping site clean, using antibiotic ointment, changing dressings
  • Activity restrictions – Avoiding exercise, heavy lifting to prevent re-injury
  • Compression – Using silicone sheets, pressure dressings
  • Sun protection – Shielding scar from UV rays can help reduce pigmentation
  • Massage – Helps soften and flatten scar tissue
  • Follow-up appointments – For repeat steroid injections, radiation, etc
  • Avoiding re-injury – No new piercings, trauma to area

Following provider instructions closely, especially in the first few months after treatment, gives the best chance of minimizing recurrence and achieving optimal scar improvement.

What’s the likelihood of success?

The likelihood of successfully removing or improving the appearance of a keloid scar without extracting the piercing depends on:

  • Size and location of keloid – Smaller, more superficial keloids have higher success rates
  • Scar characteristics – Smooth, narrow keloids respond better than large, irregular ones
  • Treatment method – Excision has highest success probability
  • Use of adjuvant therapies – Combination approaches work better than single modalities
  • Patient factors – Age, genetics, adherence to aftercare affect outcomes
  • Provider skill – An experienced dermatologic surgeon often has better results

Overall success rates with non-excisional methods like steroid injections are highly variable but often in the 50-70% range after multiple treatments. Leaving piercings in place may decrease success rates by 10-20% or more.

Small, uncomplicated earlobe keloids have better outcomes compared to large cartilage keloids, which are challenging to eliminate even with excision. Realistic expectations are important, as keloids can often only be improved rather than removed entirely.

Are there ways to prevent keloids from forming?

Preventing keloids from developing in the first place is ideal. Recommendations to help avoid keloids after piercings include:

  • Proper piercing technique – Using a needle rather than piercing gun; experienced professional
  • Quality jewelry – Implant grade materials like titanium or niobium
  • Avoiding trauma – No playing with or bumping piercing during healing
  • Aftercare – Keeping site clean; saline spray or water only
  • Avoiding infection – Practicing good hygiene; prompt treatment with signs of infection
  • genetics – Being aware of personal/family tendencies to over-scar
  • No repiercing – Piercing same site again risks triggering keloid
  • Cautious site selection – Earlobes safer than cartilage or other areas

There are also some medications and topical treatments that may help reduce keloid risk when applied after a piercing, such as topical silicone gel sheets and creams containing hydrocortisone, onions extract, or imiquimod. However, these are not guaranteed to prevent keloids from developing.

When to seek medical treatment

It is recommended see a dermatologist or doctor experienced in treating keloids if:

  • A new growth appears at the piercing site that seems to enlarge or extend beyond the piercing site
  • The scar becomes painful, itchy, or changes color
  • The scar continues growing larger than the piercing site months after healing
  • You have a history of keloids and want to discuss prevention after a new piercing
  • The keloid is interfering with daily activities or causing significant discomfort
  • You want to discuss treatment options to remove or improve the appearance of a keloid

While some people choose to live with keloids, especially small ones, treatment is often desired for symptom relief, functional improvement, or cosmetic reasons. Early intervention also provides the best results.

Questions to ask your doctor

When consulting a physician about a keloid scar, important questions to ask include:

  • What treatment options do you recommend for my type and size of keloid?
  • Is it possible to treat my keloid without removing the piercing?
  • What is the likelihood of my keloid coming back after treatment?
  • How many sessions will treatment require?
  • What type of aftercare is needed?
  • How much improvement can I expect in the appearance of my keloid?
  • What risks or side effects could treatment cause?
  • Is there anything I can do to help prevent keloids from coming back in the future?

Conclusion

Keloids sometimes form as an overgrowth of scar tissue around piercings. While challenging to treat, various options exist that may help remove keloids or improve their appearance without necessarily removing the original piercing.

Smaller, less established keloids have the best prognosis with non-surgical techniques like steroid injections or cryotherapy. However, recurrence rates are higher compared to surgical excision of the entire keloid followed by radiation or adjuvant therapies.

Leaving piercings in place somewhat limits treatment options and effectiveness. Patients must weigh the benefits of keeping the piercing against potentially achieving better results by fully extracting the jewelry and elimating all scar tissue.

With a knowledgeable provider and careful follow-up care, it may be possible to significantly improve keloid scars from piercings while leaving the piercing intact. However, the most prudent approach in many cases is surgical excision and closure of the piercing site.

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