You’re looking in the mirror, tilting your head at an awkward angle, and there it is. A weird, fleshy, maybe slightly red bump staring back at you from the inside of your nostril. It’s annoying. It might even hurt a little. Your first instinct, because the internet is a terrifying place, is probably: "Oh great, I have a keloid inside nose piercing."
But honestly? You probably don't.
Keloids are actually pretty rare, even though everyone on TikTok seems to think any bump on a piercing is one. Most of the time, what you’re seeing is an irritation bump or maybe a bit of hypertrophic scarring. True keloids are a specific genetic glitch where your body doesn't know when to stop healing. It keeps churning out collagen long after the wound is closed, creating a growth that eventually becomes larger than the original piercing site. If that bump stays small, or if it goes away when you change your jewelry, it wasn't a keloid.
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What’s Really Happening With That Keloid Inside Nose Piercing?
Real keloids are stubborn. Unlike a standard pimple or a localized infection, a keloid won't just "pop" or drain. If you try to squeeze it, you’re just going to make it angry. Dr. Shari Sperling, a board-certified dermatologist, often points out that keloids are firm, rubbery, and can sometimes be itchy or painful. They are more common in people with darker skin tones—specifically those of African, Hispanic, or Asian descent—but they can happen to anyone.
The science is basically a communication breakdown. Your fibroblasts, which are the cells responsible for making collagen to knit a wound back together, just stay "on." They keep building. And building.
Is it a keloid or an irritation bump?
It's easy to mix them up. An irritation bump (granuloma or hypertrophic scar) is usually caused by something specific. Maybe you snagged your ring on a towel. Maybe you’re using harsh chemicals like hydrogen peroxide—please stop doing that, by the way. Or maybe the jewelry is made of cheap "surgical steel" which is often just a fancy name for "mystery metal containing nickel."
- Irritation bumps: These usually stay right at the edge of the piercing hole. They might be soft, they might bleed, and they usually shrink if you fix the source of the irritation.
- Keloids: These grow beyond the piercing. They can look like a smooth, shiny dome. They don't care if you change your jewelry; they’re doing their own thing.
Why the Inside of the Nose is a Chaos Zone
The inside of your nose is a mucosal membrane. It’s damp. It’s full of bacteria (naturally). It’s also subject to constant movement every time you flare your nostrils, sneeze, or smile. This makes it a prime location for healing complications. When you get a keloid inside nose piercing, the tight space makes it feel much larger than it actually is.
If you’ve been wearing a hoop too early in the healing process, that’s a classic trigger. Hoops move. They slide back and forth, dragging bacteria into the fistula (the hole). They also put "curved" pressure on a "straight" wound. If your piercer used a piercing gun instead of a needle, you've basically experienced blunt force trauma to your nostril. That kind of tissue damage is a fast track to scarring issues.
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Real Talk on Treatment Options
If you actually have a keloid, sea salt soaks aren't going to cut it. Sorry.
Dermatologists usually start with corticosteroid injections. Brands like Kenalog are the standard here. The steroid helps break down the excess collagen fibers and shrinks the mass. It usually takes a few rounds, spaced about a month apart. It’s not fun—getting a needle inside your nostril is exactly as uncomfortable as it sounds—but it works better than anything you’ll buy at a drugstore.
In more extreme cases, doctors might suggest:
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- Cryotherapy: Literally freezing the tissue with liquid nitrogen. This can be tricky inside the nose because you don't want to damage the surrounding healthy mucosa.
- Laser Therapy: Pulsed-dye lasers can help flatten the keloid and take the redness out.
- Surgical Removal: This is the nuclear option. The irony is that cutting a keloid off creates a new wound, which can just trigger a new keloid. Most surgeons will do a steroid injection immediately after the surgery to prevent this.
The Myth of Tea Tree Oil
You'll see people online swearing by tea tree oil for a keloid inside nose piercing. Use extreme caution here. Tea tree oil is an antifungal and antibacterial, but it is incredibly harsh. It can cause chemical burns on sensitive nasal tissue, which just creates more inflammation. If you must use it, dilute it heavily. But honestly? If it's a real keloid, tea tree oil will do absolutely nothing. If it's an irritation bump, it might help by drying it out, but a saline soak is much safer.
Prevention is Actually Possible
If you know you are prone to keloids—like, if you have them on your ears or from previous surgeries—you should think twice about a nose piercing. Or at least go in with a plan.
- Titanium is king. Use implant-grade titanium (ASTM F136). It’s biocompatible and lacks the nickel that causes most allergic reactions.
- The "L-Bar" vs. "Flat Back" debate. Many piercers now prefer flat-back labrets for the inside of the nose. They don't move as much as L-bars or screws, which reduces the constant friction that triggers scar tissue.
- Hands off. Stop touching it. Seriously. Every time you "check" if it's still there with your finger, you’re introducing bacteria and causing micro-tears.
According to the Association of Professional Piercers (APP), the most common cause of "piercing bumps" is simply poor aftercare or poor jewelry quality. If you see a bump forming, go back to a high-end, reputable piercer before you run to the doctor. They can often tell at a glance if it's just a "snag" bump or something more serious.
When to Actually Worry
How do you know when it’s time to see a doctor? If the bump is growing rapidly, if it’s interfering with your breathing, or if it starts to look "cauliflower-like," you need a professional. Also, look for signs of infection: yellow/green discharge, heat radiating from the nose, or a fever. A keloid is a scar; an infection is a medical emergency.
Don't panic. Most people who think they have a keloid inside nose piercing actually just have a stubborn irritation that needs a jewelry change and some patience. Give it a few weeks of "leave it the hell alone" (LITHA) therapy.
Actionable Next Steps
- Swap the metal: If you are wearing a hoop or mystery metal, go to a pro piercer and have them install an implant-grade titanium flat-back stud. This settles the tissue faster than anything else.
- Saline only: Use a pressurized saline spray (like NeilMed) twice a day. Stop the soaps, the oils, and the pastes.
- Document it: Take a clear photo of the bump today. Check again in two weeks. If it’s getting bigger despite better care and better jewelry, book an appointment with a dermatologist.
- Check your history: Look at old scars on your body. Are they raised and thick? If yes, tell your doctor, as this confirms a genetic predisposition to keloids.