Keloid & Hypertrophic Scar Guide: User Guide Documentation

Overview

The Keloid, Hypertrophic Scar & Bump Guide is an educational clinical guide published by Poli International for piercing studios, tattoo artists, and clients. It provides evidence-informed guidance on raised skin reactions, distinguishing between reversible irritation bumps, self-limiting hypertrophic scars, and invasive keloids.

The Three Raised Tissue Formations

Irritation Bump (Inflammatory Granuloma / Focal Swelling):

Boundary: Confined strictly to the immediate puncture exit orifice.
Onset: Typically appears 2 to 8 weeks post-procedure.
Cause: Sustained mechanical shear, pressure from sleeping or helmets, improper jewelry angle, or excessive post length.
Resolution: Reversible. Settles within weeks once the physical irritant or movement is resolved.

Hypertrophic Scar (Non-Spreading Collagen Fibrosis):

Boundary: Elevated above the skin plane but remains strictly within original wound boundaries.
Onset: Develops 4 to 12 weeks after trauma during collagen remodeling.
Cause: Excessive wound tension, prolonged inflammation, or minor tears.
Resolution: Frequently stabilizes and flattens over 6 to 18 months without surgical intervention.

Keloid Scar (Invasive Benign Fibroproliferative Lesion):

Boundary: Expands outward and invades surrounding healthy skin beyond the original wound perimeter.
Onset: Often delayed; can appear 3 months to years after trauma.
Cause: Genetic cellular regulation anomaly causing continuous, unchecked collagen deposition.
Resolution: Does not resolve spontaneously; requires medical management (such as intralesional corticosteroids or specialized dermatological care). Carries a high recurrence rate if surgically excised without multimodal therapy.

How to Use the Guide

1. Pre-Procedure Discussion Factors

Before booking a piercing or tattoo:

Select your history for the 5 clinical factors: personal scar history, family history, Fitzpatrick skin type, planned anatomical site, and prior reaction.
Click "Evaluate Discussion Points".
The tool generates a concrete list of questions and risk considerations to discuss directly with your piercer, artist, or physician.
No arbitrary scores are assigned: Healing outcomes depend on biology, jewelry gauge, anatomical tension, and technique, not a point score.
If you report a history of surgically removed keloids, the tool alerts you that surgical excision carries a documented 50% to 80%+ recurrence rate and mandates a dermatology consult before proceeding.

2. Settling an Existing Bump

If a bump has appeared on a healing piercing:

Remove Pressure & Movement: Review the named culprits (over-ear headphones, motorcycle helmets, sleeping on the pierced side, high waistbands, and eyeglass arms).
Downsize with a Professional: If swelling has subsided, long initial bars tilt and snag. Have your piercer fit a snug post.
Practice LITHA (Leave It Alone): Rinse with sterile 0.9% saline spray; do not twist, pick, or manipulate jewelry.
Banned Home Treatments: Never apply crushed aspirin paste, undiluted tea tree oil, coarse salt scrubs, or hydrogen peroxide. These destroy delicate new epithelial cells and worsen granulation tissue.

3. Anatomical Site Considerations

Review healing timelines and tissue characteristics across:

Ear Cartilage: 6 to 12+ months. Avascular repair; highly susceptible to pressure bumps.
Earlobe: 6 to 10 weeks. High blood supply; low bump incidence.
Nostril / Septum: 3 to 6 months (Nostril) / 6 to 8 weeks (Septum). Prone to snagging and movement.
Navel: 6 to 12 months. Subject to waistband friction and torso bending.
Chest, Sternum, Shoulders & Jawline: Highest natural skin tension vectors on the body; keloid formation incidence is highest here.

4. When to See a Doctor

Review the red flags checklist:

Spreading past the original wound margin.
Continuous growth after 3 months.
Severe pain, radiating heat, or purulent drainage (signs of serious perichondritis or infection).
Click "Print Clinical Red Flags Checklist" for a portable reference.

5. Doctor Consultation Worksheet

Prepare for a physician or dermatology visit:

Fill out the procedure type, site, date, onset timeframe, and observed behavior in your own words.
Click "Copy Findings to Doctor Worksheet →" from the factors questionnaire to prefill relevant history.
Click "Print Doctor Consultation Page" to produce a clean, one-page intake summary to hand to your physician.

Language Selection

A language selector is located in the upper header:

Choose from English, Español, Deutsch, Français, Italiano, Português, Nederlands, or ไทย.
Your selection is automatically saved in poli_tools_language for future sessions.

Privacy & Data Handling

100% In-Browser Execution: All logic runs locally in your browser.
Zero Network Transmission: Your personal notes and selections stay on your device and are never sent to external servers.

Support & Feedback

Website: <https://poliinternational.com>
Tools Directory: <https://poliinternational.com/tools/>
Inquiries: <[email protected]>

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