The problem: the piercing is red, swollen or weeping
The new ear piercings are a few days old, the earlobe throbs, it is red and warm, and a yellowish crust clings to the stud. Or the holes have been fine for years, but since autumn one ear has been itching, the stud sits in a weeping, crusted patch of redness, and this only happens with certain earrings. Sometimes a firm lump forms at the hole and does not go away.
Local infections are among the common complications after piercing; contact allergies, for example to nickel, overgrown scars and tears also occur (Holbrook et al. 2012). The table helps you get your bearings. It does not replace a diagnosis; only a medical examination gives a clear answer.
| What you notice | When and where | What it may be |
|---|---|---|
| Red, swollen, warm, painful, pus or blood, you may feel unwell | Freshly pierced hole, in the first few weeks | Infection (NHS Wales: Infected piercings) |
| Painful, red swelling at the top of the ear, the earlobe often stays clear | Piercing in the cartilage, often within the first month | Inflammation of the cartilage lining (perichondritis) (Meltzer 2005): see a doctor promptly |
| Itching, redness, weeping, crusts, or later dry, thickened skin | Old hole, often only with certain earrings, keeps coming back | Nickel allergy (DermNet: Nickel allergy) |
| Firm, smooth lump that slowly grows and sometimes itches | Months to years after piercing | Keloid or thickened scar (DermNet: Keloid and hypertrophic scar) |
| Stud or back disappears into the swollen lobe | Usually with a fresh hole and a thick earlobe | Embedded stud (Meltzer 2005): do not try to remove it yourself |
| Dry, flaky skin on the outer ear, unrelated to the hole | Often in winter | Dry skin, see Dry, flaky skin on the ears: causes and care |
Why it happens: fresh wound, metal and friction
A fresh ear piercing is a wound. According to one review, it takes about six to eight weeks for the channel in the earlobe to close up fully. Cartilage has a poor blood supply; piercings there take longer and can become seriously inflamed. Typical pathogens of cartilage inflammation include Pseudomonas, staphylococci and streptococci; once an abscess has formed, the shape of the ear often cannot be preserved well (Meltzer 2005). In a hospital analysis of 217 people with inflammation of the ear cartilage, 120 cases went back to a piercing; this group had more abscesses and more Pseudomonas, and symptoms began on average about 19 days after piercing (Ungar et al. 2025).
Nickel is a common contact allergen. In a study of 3,119 randomly selected adults from five European countries, including Germany, 14.5 % reacted to nickel in allergy testing. Women were affected much more often, as were people who have or had piercings: with three or more piercings, the odds of a nickel allergy were more than five times higher (Schuttelaar et al. 2018). The earlobes are the most common site of a nickel allergy; once developed, it often lasts for life (DermNet: Nickel allergy). This is why the EU has limited nickel release since 2009: ear studs and other posts inserted into pierced skin may release at most 0.2 micrograms per square centimetre per week, jewellery in prolonged contact with the skin at most 0.5. How sensitive a person is varies greatly, however (LGL Bayern 2021); earrings made of 9-carat gold and white gold contain nickel (DermNet: Nickel allergy), and people with a nickel allergy often react to gold-plated jewellery (Meltzer 2005).
Why it shows more often in winter. Hats, headbands, scarves and roll necks rub against the earlobe, catch on the back of the stud and pull on it; under a hat it gets warm and damp. That is an observation from everyday practice, not a studied cause. On top of that, cold and heated indoor air dry out the skin of the outer ear. And because earrings are changed more often in autumn and around the holidays, the ear comes into contact with unfamiliar metal more often.
The lump. The ears are among the places where overgrown scars form easily. A keloid grows beyond the original wound edge and can appear months to years after the injury; a thickened scar stays within the wound area and is more likely to regress on its own. People with darker skin are affected more often (DermNet: Keloid and hypertrophic scar). Why scars can itch is explained in Itchy scar: why it happens even years later and what helps.
The solution step by step
Stud in or out? For a fresh hole with signs of infection, the advice of the Welsh NHS is: leave the jewellery in unless a doctor says otherwise, and get medical help urgently (NHS Wales: Infected piercings). With severe swelling it can be necessary to remove the jewellery; the practice decides that (Meltzer 2005). With an old, closed-up hole and an itchy rash, by contrast, the earrings come out, because a contact allergy settles once contact with the trigger ends.
| Step | What you do | Why |
|---|---|---|
| Fresh hole, every day | With clean hands, clean twice a day as your studio instructed, soften crusts with warm salt water, pat dry with a clean paper towel | This is how the Welsh NHS describes it (NHS Wales: Infected piercings) |
| Fresh hole, every day | Do not pick off crusts, do not turn the jewellery when it is dry, do not dry it with a towel | These points are listed there explicitly under “do not” (NHS Wales: Infected piercings) |
| Signs of infection | Leave the jewellery in and see a practice the same day; disinfectants or ointments only on the advice of a practice or pharmacy | Infected piercings should be seen by a doctor (NHS Wales: Infected piercings) |
| Old hole itches | Earrings out, leave the area alone, do not scratch; check the suspect earrings with a nickel test from the pharmacy | A drop of test liquid turns pink with nickel (DermNet: Nickel allergy) |
| In future | Studs made of titanium or niobium, solid gold of 12 carats or more, or silver; ask about stainless steel | Titanium and niobium rarely cause allergies; not all stainless steel is nickel-free (Meltzer 2005); gold of 12 carats or more and silver are considered unproblematic (DermNet: Nickel allergy) |
| In winter | Put hats, scarves and jumpers on and off carefully; flat backs for fresh holes | Less pull and friction on the channel (everyday practice) |
| With a lump | Do not squeeze or prick it, have it seen by a doctor; if you are prone to keloids, no further piercings | People prone to keloids should avoid unnecessary cosmetic procedures (DermNet: Keloid and hypertrophic scar) |
What helps – and what doesn’t
| Measure or assumption | Assessment |
|---|---|
| Taking the stud out immediately when there is pus | better not on your own: the advice is to leave it in until the practice decides (NHS Wales: Infected piercings) |
| Coating studs with clear nail varnish | better not: the varnish soon chips off (DermNet: Nickel allergy) |
| “Surgical steel is always nickel-free” | no: not all stainless steel is nickel-free (Meltzer 2005) |
| Gold-plated earrings with a nickel allergy | better not: people with a nickel allergy often react to them (Meltzer 2005) |
| “The EU limit protects everyone” | not quite: sensitivity varies greatly (LGL Bayern 2021) |
| Ointment or disinfectant from the cupboard | only on the advice of a practice or pharmacy; some ointment ingredients themselves trigger contact allergies, see Plaster allergy: a rash under the plaster – irritation or allergy? |
| Re-piercing a closed hole yourself | no: do not do your own piercings (NHS Wales: Infected piercings) |
Common mistakes
The most common mistake with a fresh hole: taking the stud out at the first sign of redness and letting the hole close, although there is an infection underneath. Second: picking off crusts and constantly turning the dry stud. Third: switching to fashion jewellery too early, before the channel has closed up fully. Fourth: putting the same earrings back into an old hole although it itches every time. Fifth: squeezing or pricking a lump. And finally: waiting with a painful swelling on the cartilage because it is “only a piercing”. Red skin under a watch strap or necklace can also be nickel, see Rash under your smartwatch: red, itchy skin on the wrist and Dry skin on the neck, nape and décolleté: causes and what helps.
When to seek medical advice?
The same day, see your GP or, outside surgery hours, the out-of-hours medical service (116117 in Germany) if
- the redness spreads, the ear gets hot, throbs or pus comes out,
- you have a fever, feel shivery or unwell (NHS Wales: Infected piercings),
- the cartilage at the top of the ear is painfully swollen and red; the lining of the cartilage can become inflamed there and an abscess can form that threatens the shape of the ear (Meltzer 2005), (Ungar et al. 2025),
- the stud has become embedded or the back disappears into the lobe (Meltzer 2005),
- a child is affected; the first port of call is then the paediatrician.
In the next few days, see your GP or a dermatologist if an old hole keeps itching and weeping; a patch test shows whether a nickel allergy is behind it (DermNet: Nickel allergy). The same applies if a lump at the piercing grows, hurts or itches, or if you have diabetes or take medication that weakens the immune system and a hole becomes inflamed. Similar warning signs apply to fresh tattoos, see Itchy tattoo: what is normal in the first weeks and what is not; how to proceed after a reaction to a cosmetic is explained in Reacting to a cosmetic: what to do, where to report, returns.
Frequently asked questions
Infected ear piercing: stud in or out?
With a fresh hole and signs of infection: leave it in until the practice says otherwise, and have it seen promptly. With an old hole reacting allergically to the jewellery: out.
What should I do if my ear piercing is inflamed?
Clean twice a day as your studio instructed, soften crusts with warm salt water, pat dry, do not turn or pick. If the redness spreads, you develop a fever or the cartilage is affected, see a doctor the same day.
Which ointment helps with an inflamed ear piercing?
That is for the practice or pharmacy to decide, depending on whether it is an infection or an allergy. Applying something on a hunch can mask an allergy or trigger a new one.
Why does my ear piercing keep getting inflamed?
With old holes, a nickel allergy is often behind it, especially if it only happens with certain earrings. A patch test clarifies this. Friction from hats and scarves or a back that is too tight can also play a role.
Inflamed ear piercing after years, how can that be?
A nickel allergy can develop even after years. New earrings that release more nickel, gold-plated jewellery or white gold are typical triggers.
What is the lump at my ear piercing?
Often a keloid or a thickened scar, less often a pus-filled swelling. A lump that grows, hurts or produces pus should be seen by a doctor; do not squeeze it.
Which earrings can I wear with a nickel allergy?
Studs made of titanium or niobium, solid gold of 12 carats or more, or silver. Ask about stainless steel, because not all of it is nickel-free. A nickel test from the pharmacy shows whether a piece of jewellery releases nickel.
My child’s ear piercing is inflamed. What should I do?
As with adults: clean, do not turn, leave the stud in, and see the paediatrician the same day if it produces pus, spreads or your child has a fever.
At forpeople
We do not sell jewellery or disinfectants, and we have no product for an inflamed ear piercing. Cosmetics do not belong on a wound, a fresh piercing channel or inflamed skin.
If the skin on your outer ear is dry and flaky in winter, you will find advice on caring for the outside of the ear in Dry, flaky skin on the ears: causes and care. If you also react to hair dye, this often shows first on the rims of the ears: Itchy scalp after colouring your hair: irritation or hair dye allergy?.
Sources
- Meltzer DI (2005): Complications of Body Piercing. American Family Physician 72(10): 2029–2034. https://www.aafp.org/pubs/afp/issues/2005/1115/p2029.html
- Holbrook J, Minocha J, Laumann A (2012): Body piercing: complications and prevention of health risks. American Journal of Clinical Dermatology 13(1): 1–17. https://doi.org/10.2165/11593220-000000000-00000
- Schuttelaar MLA, Ofenloch RF, Bruze M et al. (2018): Prevalence of contact allergy to metals in the European general population with a focus on nickel and piercings: The EDEN Fragrance Study. Contact Dermatitis 79(1): 1–9. https://doi.org/10.1111/cod.12983
- Bavarian Health and Food Safety Authority (LGL): Nickel in Bedarfsgegenständen mit Körperkontakt [Nickel in consumer goods with skin contact]. Updated 19.02.2021, accessed on 30.10.2026. https://www.lgl.bayern.de/produkte/bedarfsgegenstaende/bg_koerperkontakt/nickel_bg_koerperkontakt.htm
- DermNet: Nickel allergy. Oakley A (1997), reviewed by Coulson I, April 2023, accessed on 30.10.2026. https://dermnetnz.org/topics/nickel-allergy
- NHS Wales 111: Infected piercings. Last updated 10.10.2024, accessed on 30.10.2026. https://111.wales.nhs.uk/encyclopaedia/i/article/infectedpiercings
- Ungar OJ, Bursztyn N, Shilo S et al. (2025): Auricular Perichondritis in the Cartilage Piercing Era. The Laryngoscope 135(12): 4693–4702. https://doi.org/10.1002/lary.32409
- DermNet: Keloid and hypertrophic scar. Yoong NKM, Numan H, reviewed by Coulson I, September 2022, accessed on 30.10.2026. https://dermnetnz.org/topics/keloid-and-hypertrophic-scar
