Hypertrophic scarring occurs when an irritation lump is left untreated, or the body produces too much collagen in response to trauma - this can be seen in ear and facial piercings and also in stretched piercings when performed incorrectly or too quickly.
In fresh piercings it appears as a skin tone ring around the fistula or as a circle of raised tissue with a slight textured surface over the area a retired piercing used to be.
Hypertrophic scarring occurs in earlobe, nostril and navel piercings mostly, but can occur anywhere on the body & will grow according to the wound shape – for example, a torn earlobe.
Hypertrophic scarring can also be caused by trauma to the fistula site, for example catching a nose stud or navel curve, or after suffering a blowout while stretching a piercing.
While other types of scar tissue usually tend to appear around 4-8 weeks into the life of a fistula, hypertrophic scarring takes a lot longer to develop.
Hypertrophic scarring differs from keloid scarring as it remains immediately around the fistula site, where as keloids will grow far beyond the initial trauma location.
A dermatologist can help with the treatment of hypertrophic scarring but can also be treated at home. The most popular type of home treatment is self drying silicone scar therapy gel, such as those available from Dermatix or Kelocote.
If your scarring has appeared in the early stages of healing you must wait until the piercing is fully healed before treating the scar – applying any ointments while the fistula is still open encourages bacteria and dirt to become trapped inside, which could lead to infection.
Most silicone scar treatments simply require massaging a small amount of silicone gel into a scar twice a day until you’re satisfied with your progress, which may take anywhere from a few weeks to several months or more.
These treatments work by slowly reopening cell communication that the scar tissue previously blocked so that the skin below a scar regenerates in the same way as the skin around the scar, replacing the scar tissue layer by layer over time.