For centuries, people have expressed themselves through body piercings. Piercings that were once considered tribal or barbaric are now part of mainstream culture. Nipple piercing, for one, has grown tremendously in popularity among men and women, young and old, but they carry with them the risk of hypertrophic scars. Understand this risk prior to obtaining a nipple piercing.

History of Nipple Piercing

According to the experts at Painful Pleasures, a body jewelry Web site, nipple piercing can be traced back as far as the Roman Centurions. It wasn’t until the late 1890s, however, that piercing the nipples truly came into fashion. Wealthy women in Paris and London had both nipples pierced with Bosom Rings that enlarged the nipples, made them more sensitive, and provided a constant stimulation and increased sexual stimulation.

Post-Piercing Nipple Development

Elayne Angel, author of "The Piercing Bible: The Definitive Guide to Safe Body Piercing," explains that pierced nipples are prone to development, which is a semi-permanent or permanent change in the shape, dimensions, and texture of the nipple and areola. The nipple grows in response to the piercing and jewelry stimulation. This development is most common in male nipples and young, underdeveloped female nipples, and overall change can be quite dramatic. Development should not be confused with the temporary swelling other body parts may experience after piercing.

When placed in the natural creases of the body, nipple piercing results in development that is well-formed and attractive. If the piercing is made in the wrong spot, the tissue can develop an awkward, unattractive appearance that may remain even after jewelry is removed.

Defining Hypertrophic Scars

The hypertrophic scar is a variation of normal wound healing. Hypertrophic scars are raised fibrous lesions that result from trauma to the skin, such as piercings. While hypertrophic scars are generally of cosmetic concern, their presence can result in disfigurement and a loss of function. Furthermore, hypertrophic scars can be tender or painful.

Hypertrophic Scarring Risk Factors

Dr. D.J. Verret is the founder of Innovative Facial Plastic Surgery and Wellness Center in Plano, Texas. Verret explains that nipples are no more prone than other areas of the body to hypertrophic scars, but certain populations are more at risk.

Hypertrophic scarring can occur in any person, but individuals who are African-American, Asian, or Hispanic, or those with a previous history of abnormal scarring, have the highest risk of developing a hypertrophic scar from nipple piercing 1.

Preventing and Repairing Hypertrophic Scars Caused by Nipple Piercing

According to Verret, the development of hypertrophic scars is not completely understood. For this reason, it’s difficult to determine whether the piercing, the jewelry, or both is the cause.

Verret explains that any injury to the skin—whether whether surgical, intentional, or accidental—causes wound healing, which can go awry and result in a hypertrophic scar.

Hypertrophic scars may also result from the presence of a foreign material, such as nipple jewelry, but removal of the jewelry does not affect the growth or regression of the hypertrophic scar. The jewelry must be removed, however, to remove the scar with surgical treatment and closure of the piercing.

Hypertrophic scars will grow only in the area of the original scar and will often improve over time. According to Verret, injecting the scar with steroids can help.

Re-Piercing after Hypertrophic Scar Removal

After the hypertrophic scar has been removed, the nipple can be re-pierced; however, the risk of development of another abnormal scar is high.