Keloids versus HT scarring

This will be my last post before the official Christmas holiday, and I’ll have more up shortly after the New Year. Merry Holidays, everyone!

There has been some debate recently over what is a keloid and what is hypertrophic scarring on piercings. So, let’s find out the difference, shall we? It’s very important that you recognize the difference between the two and know how to treat them because, unfortunately, many piercers don’t even know.

First, the definition of each. In the sense of body piercings:

Keliod: an abnormal scar that grows beyond the boundaries of the original site of skin injury.
Hypertrophic scarring: a widened or unsightly scar that does not extend beyond the original boundaries of the wound.

Contrary to popular belief, not every lump or bump on a piercing is a keloid, it is not a general term for piercing growth abnormalities of any kind. Keloid scars are actually very rare, while hypertrophic scarring, or HT scarring for short, is much more common. Keloids extend far beyond the initial injury site, becoming a raised amorphous growth, and are usually painful. These will be huge growths taking over the area well beyond the area that was pierced to begin with. They are also much more common in dark skinned people than they are in light skinned people.

These are keloid scars:

Keloid scars can form the same way other scars can, but what exactly causes a keloid isn’t really known. Trauma to the area, infections, foreign bodies in the wound, or excessive tension and movement can all contribute to the formation of keloid scars. Certain areas of the body such as the sternum and chest, the upper arm, the ears, and upper back have an increased chance to develop keloid scars. These areas also go through a lot of muscle and skin tension and movement, which can encourage the growth of keliod scars.

The best way to treat an actual keloid is to have it cut off and removed by a doctor or dermatologist, since they can be recurring without proper treatment, removal and aftercare. Some may also recommend steroid injection treatments, which can only be prescribed and performed by a doctor or dermatologist. There are no home remedies to cure a full blown keloid.

Hypertrophic scarring, or HT scarring for short, is actually much more common. It is also called the “piercing bump, piercing pimple, or piercing lump”. Unlike keloids, HT scarring doesn’t continue to grow beyond the initial wound site, and once it reaches a certain level or height it will usually stop and just remain there. They can sometimes be painful, but are more sore than actually painful. Hypertropic scars are usually raised a bit, usually reddish in color, but don’t go beyond the original wound.

This is Hypertrophic, or HT, scarring:

These scars, at least on piercings, are caused by trauma to the piercing, sleeping on it, pulling on it, constant movement of jewelry, etc. They can also be caused by metal allergies. The first step in treating HT scarring is to figure out what’s causing it, and rectify that. If you’re wearing rings in your piercing, switch them out for barbells instead since barbells do not allow for movement the way rings do. Do not sleep on the side that your piercing is on, be very aware that you are not catching the jewelry on a hairbrush, earphones, you’re not playing with it, etc. If you think you may be having metal allergy reactions, switch the jewelry for something non-metallic, or opt for titanium or niobium, if you must wear metal, since both contain no nickel.

There are two most effective treatments for HT scarring, and both are very easy to do. The first one is Tea Tree oil. This amazing oil does everything; it’s antiviral, antibacterial, antifungal, and antiseptic. It can even help treat acne. However, some find that direct undiluted applications of Tea Tree oil can cause allergic reactions on their skin. So, before treating HT scarring on piercings, do a test patch on your skin. Dab straight oil onto the underside of your wrist or elbow, and leave for 24-48 hours. If no reaction occurs, you should be just fine to use it.

For the purposes of treating HT scarring, dab Tea Tree oil onto the scar after every sea salt soak you perform each day. If you would like to dilute the oil, you may do so with another carrier oil, do not mix with water (remember 3rd grade science, everyone, you can’t mix oil and water!). A great oil to mix with Tea Tree is Jojoba or Vitamin E, both of which will also help keep your skin from drying out from the Tea Tree oil. Continue to apply the oil until the scarring disappates, this can take weeks or even months depending on the severity of the scarring, how long it’s been there, and what you’re doing to stop it from recurring. As the oil starts to take effect, it will dry out the scarring cause it to peel away. Do not pick at the peeling skin. Continue salt soaks and Tea Tree oil treatments until the scarring is completely gone. Mixing the Tea Tree with a carrier oil, like Jojoba or Vitamin E, can help prevent the drying out of the skin, but can also make treatment take longer. Once the oil is on, do not wipe it off, do not wash it off, just leave it alone to air dry.

A few words of warning about Tea Tree oil, however. It is considered toxic if consumed, so do not use this method for inside of the mouth treatments. It is also deadly to cats, so keep it locked away from your furry friends. Do not purchase Tea Tree oil if it is not in a black or dark brown glass bottle, since sunlight can degrade the oil. The best way to get it is in its organic, pure, essential oil formula, and it is available nearly everywhere. You can get it from grocery stores, drug stores, health food and supply stores; I have never not found it when I’ve been looking.

The second method is the aspirin paste method. Crush one plain, uncoated aspirin tablet as finely as you can. You can also sometimes find aspirin powder in small packets, this works just as well, just use one packet as you would for one pill. Add a single drop of water at a time to the powder or crushed pill until it forms a paste. Apply this paste to the scarring, allow it to air dry for about 5 to 7 minutes, and then rinse off. This method is safe for inside of the mouth treatments, it just doesn’t taste very good. This is also known as an effective spot treatment for pimples and acne.

And so with that out of the way, I wish everyone safe and sane Holidays to come. Eat lots, drink lots (if you’re of age), and be very merry, indeed. I wish everyone a safe and happy New Year, and hope everyone gets everything they want this gift-giving season.


Microdermal Anchors

Microdermals are very popular piercings right now, but I think there is a lot of misconception about them. So, let’s clear it up a bit.

A microdermal anchor, known by many names such as microdermal, micro, anchor, dermal, surface anchor, among others, is a piece of metal jewelry implanted under the skin with a decorative piece of jewelry visible above the skin. They’re the latest incarnation of the transdermal implantation techniques and jewelry, in the same general category as other anchoring techniques and pocketing. They are designed to replicate the aesthetic look of other, more dangerous, risky, or difficult surface piercings without the invasive procedure and painful healing process.

There are several varying styles of microdermal jewelry, but they all work in essentially the same way. They are flat plates of metal with holes in the bottom, called the foot or anchor. A stem extends up from the foot, the end of which sits flush against the skin, and where decorative jewelry is screwed in. They get their name because once the jewelry is inserted, the flesh grows through the holes in the foot, anchoring it into the skin.

They are usually very small pieces, many I’ve seen being about 4mm long, and about 2mm high, not including decorative jewelry. The gauge of jewelry that can be inserted is 14ga, on average. They are also primarily made of titanium rather than any form of steel.

These piercings are designed to be what’s called a single point piercing, meaning there is only one visible end that looks as though the jewelry was screwed directly into the skin. They also have only one insertion hole, which is also the exit hole, while other piercings are more “through and through”, having a separate entry and exit hole.

There are no special tools required to implant microdermals. There are two ways they can be implanted, either via the needle or the dermal punch.

With the needle process, the skin is lifted and the needle is inserted at an angle to create a pocket. The needle is then retracted and removed the same way it went in. The long end of the foot is then inserted into the newly created fistula, it’s maneuvered to make sure it’s deep enough and sits level and flush to the skin, and you’re done!

The dermal punch method works in a similar way. The dermal punch is around cutter that cores out a bit of flesh. So, for microdermal purposes, the dermal punch is inserted straight down into the area. The bit of flesh is removed as the dermal punch is removed as well. The jewelry is then inserted, maneuvered to make sure it’s deep enough and sits level, and you’re done!

No matter the insertion method, it’s very typical that a bandage will be placed over the new piercings. This helps absorb any residual bleeding, mostly, and protects the new piercing from outside elements, jewelry, coats and shirts, etc. It also helps to make sure the dermal stays sitting as deeply as it should, allowing it to heal as deeply as possible. You may also get a little bit of folded gauze under medical tape, same thing as an adhesive bandage. It’s important that you leave this on for as long as you can.

Look! A handy dandy diagram!

Aftercare is pretty simple. Sea Salt Soaks are standard, but depending on location of the microdermal, direct soaking can be difficult. If this is the case, just take a bit of folded paper towel and soak it with the sea salt solution, then compress instead. Do this 2-3 times a day, for about 5-10 minutes each time. Beyond that, not much more needs to be done. Remember that a proper sea salt soak is 1/4 teaspoon of pure organic sea salt (not iodized salt or table salt), dissolved in 8oz of pure water, made as hot as you’d make your bath water.

Some people have noticed that microdermals will raise up a bit on their own as the skin beneath moves and shifts. This is fairly common, and a few days compressed under gauze and tape, or an adhesive bandage, can help quite a bit to reverse this.

Healing times can vary greatly, based on location of the microdermal, the style of jewelry used, how you take care of it, and your body’s own healing rate. But on average, you can expect to have a healed microdermal in about one to three months.

Do not try to change the jewelry on the end of the microdermal yourself. It’s best if you go to your piercer and have them change it for you. Try to find jewelry you like and stick with it, rather than changing it all the time.

Since microdermals only have one exit hole, and it’s stopped up with jewelry all the time, they tend to not drain as well during the healing process as normal through and through piercings do. This can cause a buildup of lymph and other healing fluids underneath the jewelry, which can cause pain, swelling, redness and irritation. This is why warm salt water soaking is SO incredibly important, because it loosens up these fluids and allows them to come out, relieving the pressure underneath. In my experience with microdermals, as well as several others’, the first sign you’re getting sick or getting a cold is your microdermals will get swollen and sore and angry for seemingly no reason.

Sometimes, no matter how well you take care of yourself or your piercings, microdermals do have to be removed. Just as there is with insertion, there are a few different ways of removing microdermals as well.

The most painful way is probably the twist and yank method. Basically the piercer will grab the jewelry and twist it, to dislodge and break any flesh holding onto the anchor. It is then pulled out of the skin.

A similar method is the massage method. The piercer will massage the area to try to loosen any flesh attached to the foot, then it can be gently pulled out of the skin. This can also be painful and time consuming.

A better way is the needle removal method. The tip of a regular piercing needle is used to slice open the skin above the anchor. It is then used to cut away any flesh that still may be attached through the holes. The needle then scoops out the anchor like a spoon, or it can just be lifted away.

Sometimes no professional removal is required, the anchor removes itself. This is called rejection. Rejection means your body doesn’t want this foreign object you’ve put into it, and it forces it out completely. This is pretty common with microdermals, and any other form of surface piercing. Trauma to the piercing can also cause rejection to start, like pulling on it, sleeping on it, hitting it, anything like that. And once rejection starts, you cannot stop it no matter what you do.

The most obvious sign of rejection is more of the jewelry being visible than there was originally. With microermals, this may be hard to notice since the stem that comes up is already very short, but it’s also something to keep an eye on. You can also pay attention to where the foot end is, if you can see the foot end beneath the skin, almost a shadow of it, then it’s too shallow and either is rejecting and should be removed, or it wasn’t implanted deeply enough in the beginning and should be removed and re-implanted once you’ve healed up completely.

What makes microdermals a better option than other surface piercing options is that these are actually designed to give you the best possible outcome for healing. Other methods, like surface bars or regular barbells, aren’t designed for this. Microdermals are small and their implantation process is as minimally invasive as possible, while the barbells and surface bars are much more traumatic processes and are larger pieces of jewelry. Microdermals heal faster and easier, with holes in the foot designed for the skin and flesh to latch onto quickly, easily, and securely. Surface bars and barbells have to create a tunnel of flesh around a foreign body, which is hard for your body to do, and doesn’t give the skin anything to latch on to. And even if they do need to be removed or reject on their own, the scars microdermals leave behind are MUCH smaller and easier treated.

Not to rain on anyone’s parade, but my personal word of warning is that these piercings are very much not for someone new to the piercing world. Meaning, do not make this your first piercing. They are very different than more traditional piercings, requiring special care, special treatment, and even special training by the piercing professional in order to implant. My recommendation is to get some other piercing first, develop good piercing care habits, learn to recognize irritation from infection, learn how to treat irritation and infection, and further educate yourself on piercings, both through reading and experience, before getting one of these done.

Microdermals are very delicate little piercings. A common misconception is that they are very stable and have a very low rejection rate; some have even called them the “cure-all” piercing, when in reality this isn’t true at all. The slightest trauma can set them on the path to rejection, and there is no stopping it once it’s started. These things are very small, with very little surface area for the flesh to grab on to, making them very easy to rip out. They don’t sit very deeply below the skin, the tallest ones being around 2-3mm tall (not including decorative jewelry screwed in).

Depending on the location of the microdermal, how you take care of it, and your body’s acceptance to the jewelry, certain areas are more willing to take the jewelry than others. Before you get one of these, consider the location you want. Place a finger on the area you’d want the jewelry. Now, move the muscles around, flex them, bend and twist and move. If the skin and flesh under your finger moves a lot, it’s probably a bad area to get a microdermal there. Any area with thin skin, close to bone, or that undergoes a lot of movement, shifting, bending or pressure probably isn’t a good idea.

Consider your clothing and accessory choices. If you wear a lot of necklaces, scarves or other neck accessories, or wear a lot of crew-neck shirts, getting microdermals around the collarbone isn’t a good idea since those items will catch on them easily and the neck seam of shirts can catch on them as well. Seatbelts, purse or bag straps as well can get caught on them. If you wear glasses, getting a microdermal around the eye or temple might get in the way. If you wear a lot of makeup facial microdermals might not be a good idea because the makeup can get inside and cause irritation. Certain areas in general are just terrible ideas, like the hands, butt, back, and hips being near the top of the list.

Microdermals are beautiful piercings, and they are becoming more and more common as demand for them increases. This means more piercers are getting the necessary training to implant them. But remember, just because you can pierce something, doesn’t mean it’s a good idea or that you should pierce it. But all in all, if you want a microdermal, get one. Just do your research first.