Causes and Proper Treatment for Piercing Pus and Infection

The three main causes of a piercing becoming infected are "bacterial infection," "metal allergy," and "poor aftercare." If an infected piercing is left untreated, the infection can spread, requiring antibiotics, or developing into serious complications such as perichondritis.

This article explains the "reasons why piercings are prone to infection" and "how to treat an already infected piercing" based on symptoms.

Even if it starts as a mild inflammation, if left untreated, a bacterial infection can spread deeper, prolonging healing or leaving a keloid (raised scar). It is common for people to think that disinfecting will heal it, only to find that the pus increases and the pain worsens. If you experience pus discharge, throbbing pain, warmth, or hardened pus, it is recommended to see a dermatologist as soon as possible.

• Accurate identification of cause and severity through anamnesis, visual examination, and bacterial culture testing
• Treatment tailored to symptoms, including oral antibiotics, topical treatments, and disinfection
• Troubleshooting for self-piercing is also available
• No appointment needed, same-day visits welcome | Open daily from 9 AM

👉 Same-day visits are possible without an appointment. Please feel free to contact us first.

What is pus/infection in a piercing?

Pus or infection in a piercing means that bacteria have entered the piercing hole and caused an infection. A piercing hole is a "wound" that penetrates the skin, and until it is completely stable (healed), there is a risk of bacterial infection. For earlobes, it takes about 1-2 months to heal, and for cartilage, it takes about 3-6 months.

Mild inflammation is a common reaction right after a piercing or when changing jewelry. If there is redness, slight swelling, and a small amount of clear to yellowish discharge, it should improve within a few days with proper care.

Suppuration (bacterial infection) occurs when bacteria (such as Staphylococcus aureus and Streptococcus) multiply in the piercing hole, causing symptoms such as white to yellowish-green pus, severe pain, warmth, redness, and swelling. If left untreated, the infection can spread to deeper cartilage and subcutaneous tissue, leading to severe infections such as chondritis and cellulitis.

⚠️ See a doctor early if any of the following apply:

• Continuous discharge of white, yellow, or green pus
• Throbbing pain or warmth around the piercing
• Spreading swelling or a hard lump
• Systemic symptoms such as fever, chills, or swollen lymph nodes
• Severe pain or bleeding when moving the piercing
• No improvement or worsening after more than a week of care
• Severe swelling or pain in cartilage or body piercing areas
• Problems after self-piercing

Causes of Piercing Infection – Why it Gets Infected

A piercing hole is a wound in the skin. While the wound is healing (during the initial piercing period), it is especially prone to bacterial infection.

Cause ① Bacterial Infection

Bacteria such as Staphylococcus aureus enter the piercing hole, causing inflammation and suppuration. This can be caused by touching with dirty hands, using unsanitary piercings, or insufficient cleaning.

Cause ② Metal Allergy

This is common with piercings made of materials containing nickel, cobalt, and chromium. Metal components ionized by sweat combine with skin proteins to cause an allergic reaction, leading to inflammation and then secondary infection with pus. Changing to materials like titanium, pure gold, or surgical stainless steel is effective.

Cause ③ Excessive Disinfection/Irritation

Frequent use of disinfectants "to keep clean" can kill even the skin's beneficial bacteria, which can hinder healing. Excessive use of alcohol-based disinfectants is counterproductive.

Cause ④ Over-tightening the Earring Back

Tightening the earring back too much can impair blood flow, causing tissue necrosis and increasing the risk of infection. Leave a gap of about 1-2mm between the earring and the earlobe.

Cause ⑤ Weakened Immune System

When you are sleep-deprived, fatigued, or unwell, your immune system weakens, making you more susceptible to infections from bacteria that would normally not cause problems.

Distinguishing between mild inflammation and suppuration (bacterial infection)

Item	Mild Inflammation	Suppuration (Bacterial Infection)
Discharge color	Clear to slightly yellowish (lymph fluid)	White, yellow, or green pus
Amount of discharge	Small amount, forms a scab	Continuous discharge, reappears after wiping
Pain	Slight pain when touched	Throbbing pain
Swelling	Only around the piercing, mild	Spreading widely, hard lump
Redness	Pink to light red	Bright red to purplish-red
Warmth	Almost none	Clearly warm to the touch
Time to improvement	2-5 days with care	Requires medical consultation and treatment
Action	Continue cleaning and disinfection at home	Consult a dermatologist early

Severity Classification of Suppuration

The treatment plan for suppuration varies depending on its severity. If addressed when mild, it can heal quickly, but if it becomes severe, intravenous antibiotics or incision and drainage may be necessary.

Category	Condition	Main Symptoms	Treatment Guideline
Mild	Shallow infection on the hole's surface	Small amount of pus, mild swelling, pain when pressed	Topical antibiotics, cleaning instruction for 1-2 weeks
Moderate	Infection of tissue around the piercing	Pus, severe swelling, warmth, throbbing pain	Oral antibiotics + topical for 2-3 weeks
Severe	Chondritis, cellulitis, abscess formation	Widespread swelling, fever, swollen lymph nodes, accumulation of pus	Oral medication + incision and drainage, rarely IV treatment

Cause of Odor from Piercing Holes

If there is an unpleasant odor from a piercing hole, the main cause is the accumulation of sebum, sweat, and old secretions. Dried and hardened pus (pus plugs) can also be the source of the odor.

If there is only an odor without pain or swelling, it often improves with frequent cleaning, but if accompanied by pus, swelling, or pain, it is a sign of infection. Please see a dermatologist as soon as possible.

Correct Treatment for an Infected Piercing (by Symptom)

Mild (small amount of white pus, slightly red around the area)

1. Do not remove the piercing: If removed during the initial piercing period, the hole may close.
2. Clean with shower: Lather a mild soap well and gently wash the piercing shaft.
3. Rinse shampoo and conditioner thoroughly: Leftover oils can be a breeding ground for infection.
4. Use disinfectants minimally: Avoid alcohol; if using, opt for saline solution or a special gel.
5. Avoid touching too much: 1-2 cleanings per day are sufficient.

Moderate (swelling, pain, yellow to green pus)

Apply a small amount of over-the-counter antibiotic ointment (such as Terramycin or Dolmycin) to the affected area. If it does not improve in 2-3 days, consult a dermatologist.

Severe/Signs to seek medical attention (if any of the following apply)

• The affected area is severely swollen, warm, and intensely painful.
• You have a fever.
• A large amount of pus is discharging, or the pus discharge is continuous.
• The swollen area has become hard (suspected keloid or hypertrophic scar).
• Your entire ear has become red and swollen (suspected perichondritis).
• Symptoms have not improved after more than one week.

Perichondritis can lead to ear deformity if left untreated. Early medical attention is crucial.

By Location | When Cartilage, Navel, or Initial Piercings Get Infected

In cases of mild inflammation, home care may lead to improvement. The first 48 hours of response are key to preventing worsening conditions.

When a cartilage piercing gets infected

Cartilage piercings (helix, tragus, industrial, etc.) have less blood flow compared to earlobes, making them harder to heal if an infection occurs. If a cartilage piercing gets infected, it is more likely to become severe than an earlobe piercing, so it is strongly recommended to see a dermatologist as soon as possible.
It takes 3-6 months for a cartilage piercing to heal completely (compared to 1-2 months for an earlobe). During this time, do not remove the initial piercing and be careful to avoid pressure or snagging.

Cartilage Piercing Infection - Characteristics	Purpose/Content
Difference from earlobe	Less blood flow, harder to heal. Can lead to chondritis or cartilage necrosis if severe.
When to see a doctor	See a doctor immediately if swelling spreads, warmth, or throbbing pain occurs.
Treatment policy	Oral antibiotics are fundamental. Incision and drainage or IV treatment for severe cases.
Important note	Ignoring it and hoping it will "heal naturally" is the most dangerous. Cartilage necrosis is irreversible.

When a navel piercing (belly button piercing) gets infected

Navel piercings are prone to friction from clothing, sweat, body movements, and exposure to environments with many germs (such as pools and soil), making them a high-risk area for infection. Many people are concerned about "navel piercing infection" or "belly button piercing suppuration."

Navel Piercing Infection - Characteristics	Purpose/Content
Reasons for susceptibility to infection	Frequent irritation from clothing friction, sweat, and body movement. Takes 6 months to 1 year to heal.
When to see a doctor	See a doctor early if pus persists, redness spreads widely, or fever is present.
Daily care	Choose breathable clothing, avoid pressure, thorough cleaning after bathing.
Important note	Removing the piercing can close the opening, trapping pus inside and worsening the condition.

When a new piercing gets infected

A new piercing is worn continuously from immediately after piercing until the hole is fully healed. This period is when the hole is still a "wound" and carries the highest risk of infection. If you suspect your new piercing is infected, check the following:

• Clear to slightly yellowish discharge (lymph fluid) is a normal part of the healing process. If there is white, yellow, or green pus, severe pain, or warmth, it is a sign of infection.
• Do not remove the initial piercing on your own — if removed, the hole may close, trapping pus inside and worsening the condition.
• Do not use alcohol disinfectants or hydrogen peroxide — they can damage healthy tissue and delay healing.
• Gentle cleaning with soap and lukewarm water is the basic care.
• If symptoms do not improve after 3 days of care or worsen, consult a dermatologist.
  

"A red bump formed around the piercing hole," "I don't know if it's pus or granuloma" — a piercing granuloma is a different kind of problem than pus. It's important to differentiate them and treat them appropriately.

Piercing Granuloma - Causes, How to Identify, and Treatment

What is a granuloma?

A granuloma is a red to pinkish lump (granuloma) that forms around a piercing hole. It is a condition where the body overreacts to foreign body irritation (the piercing) and attempts to repair itself by proliferating tissue. It is different from suppuration caused by bacterial infection.

How to Distinguish from Suppuration (Pus)

Causes of Granuloma Formation

• Piercing shaft is too thin or too thick (incorrect size)

• Metal allergy (piercings containing nickel)

• Piercing's inner diameter is too short, causing pressure on the skin

• Moving the piercing too much before the hole is healed

• Repeated irritation from injury or snagging

• Body type (people prone to keloids may form granulomas/keloids)

Treatment

⚠️ Granulomas and keloids are different. Granulomas often improve once the cause is removed, but keloids require specific treatment. If it continues to grow, feels hard, or is painful, please consult a dermatologist.

Frequently Asked Questions

Will a piercing granuloma heal on its own?

Mild granulomas may improve within several weeks to months if the cause (material, size, pressure) is removed. If it continues to grow, causes severe pain, or doesn't improve after more than 3 months, please consult a dermatologist.

Should I remove my piercing if a granuloma forms?

It is not recommended to remove it on your own. Removing the piercing can cause the hole to close, trapping the granuloma inside and worsening the condition. Whether it should be removed depends on the symptoms, so please consult a dermatologist first.

Warning Signs (When to See a Doctor)

We answer the question, "What happens if a piercing gets infected?" If pus is left untreated, it can worsen from a mild case as follows:

Stage	Symptoms	Risk if Left Untreated
Initial (Mild)	Small amount of pus, mild swelling, pain when pressed	Recovers in 1-2 weeks with proper care, but progresses to moderate if left untreated
Moderate	Persistent white to yellow pus, widespread swelling, warmth, throbbing pain	Will not heal without antibiotics. Can cause keloids if prolonged
Severe (Chondritis, Cellulitis)	Widespread redness, fever, swollen lymph nodes, accumulation of pus (abscess)	May require hospitalization, IV treatment, or incision and drainage. Risk of cartilage necrosis

If any of the following apply, please see a dermatologist as soon as possible:

• Continuous discharge of white, yellow, or green pus
• Throbbing pain or warmth around the piercing
• Spreading swelling or a hard lump
• Systemic symptoms such as fever, chills, or swollen lymph nodes
• Severe swelling or pain in cartilage or body piercing areas
• No improvement or worsening after more than a week of care
• Problems after self-piercing

First Aid for Piercing Infections

In cases of mild inflammation, home care may lead to improvement. The first 48 hours of response are key to preventing worsening conditions.

Treatment	Content/Precautions
Clean your hands	Always wash hands thoroughly with soap before touching the piercing. Dirty hands are the biggest source of infection.
Gentle cleaning with foam	Lather a mild soap well and wash around the piercing 1-2 times a day. Do not rub; gently envelop with foam.
Rinse with lukewarm water	Rinse off all soap residue. Use lukewarm water gently. Hot water is not recommended.
Dry thoroughly and cleanly	Pat dry with a clean cotton pad or tissue. Do not rub vigorously. Low-heat hairdryer can also be used.
Do not remove the piercing	Even if infected, removing it on your own can block the pus exit, causing it to accumulate internally and worsen. Seek a doctor's advice.
Avoid strong disinfectants	Alcohol and hydrogen peroxide are irritating and can damage healthy tissue, delaying healing.

Do not forcibly remove your piercing, apply Makiron continuously, or squeeze out pus before your appointment. This can worsen the infection or spread pus into the subcutaneous tissue, leading to a more severe condition. "Fiddling with it because you're worried" is the action we most want you to avoid.

NG Actions to Avoid

NG Action	Reason
Forcibly squeezing pus	Pushes bacteria deeper and worsens the condition
Frequent alcohol disinfection	Damages healthy tissue and hinders healing
Twisting the piercing	Repeatedly damages healing tissue
Excessive use of over-the-counter Makiron	Highly irritating and kills beneficial skin bacteria
Swimming in a pool while festering	Worsens condition due to double irritation from bacteria and chlorine

How to distinguish between lymph fluid and pus

Fluid	Color/Characteristics	Meaning
Lymph fluid	Clear to pale yellow, watery	Normal healing response. No problem.
Pus	White to yellow-green, sticky	Sign of bacterial infection
Bloody fluid	Red to pink	Normal in small amounts. Large or continuous amounts require attention.

Causes and Treatments for Odor from Piercing Holes

Accumulation of sebum, sweat, and old secretions: Sebum and secretions can build up inside the piercing hole, leading to bacterial growth and odor.・Pus plugs: Dried pus can accumulate as white clumps, emitting a strong odor.・Inflammation due to metal allergy: If inflammation persists due to an incompatible piercing material, it can cause an odor.

Q. My cartilage piercing is festering. Is the care the same as for an earlobe piercing?

Cartilage piercings have less blood flow than earlobe piercings, and infections can worsen more easily. Self-care similar to an earlobe piercing may delay appropriate treatment. If your cartilage piercing is festering, we strongly recommend seeing a dermatologist as soon as possible to receive antibiotic treatment. Leaving it untreated can lead to chondritis or cartilage necrosis.

Q. Are there any signs that a first piercing is about to fester?

After getting a first piercing, if you experience any of the following signs, be careful of it developing into an infection: the area around the piercing feels hot and throbbing, you feel sharp pain when touched, the color of the discharge changes from clear to yellow or white, or the swelling doesn't subside. These are signs that a bacterial infection has started. At this stage, perform appropriate care (wash with soap, do not touch the affected area), and if it doesn't improve, see a doctor as soon as possible.

Q. I got my piercing a week ago. Some pus-like discharge is coming out, is it an infection?

For 1 to 2 weeks immediately after getting a piercing, it is common to have a small amount of clear to slightly yellowish lymph fluid, which is a normal part of the healing process. If you have thick white, yellow, or green pus, severe pain, warmth, or spreading swelling, it is highly likely an infection, and we recommend seeing a doctor.

Q. Should I remove my piercing when it's infected?

Please avoid removing it on your own. If you remove the piercing, the exit of the hole may close, and pus may accumulate inside, worsening the condition. Whether or not to remove it depends on the symptoms, so please consult a doctor.

Q. Can I disinfect with Makiron or hydrogen peroxide?

Alcohol-based disinfectants and hydrogen peroxide (Oxy-Doll) are highly irritating and can damage healthy tissue, delaying healing. Gentle cleaning with soap and lukewarm water is generally recommended. If disinfection is necessary, please use a disinfectant prescribed by a doctor.

Q. I have an infection, but I want to keep my piercing hole. Is that possible?

In mild to moderate cases, it is often possible to preserve the piercing hole with antibiotic treatment. However, if the infection becomes severe and requires incision and drainage, or if it recurs repeatedly, we may consider closing the hole and repiercing later. Please discuss this with us during your examination.

Q. I pierced it myself and it's infected. Can you examine it?

Of course. We handle problems after self-piercing at our clinic. After treatment, we will also advise you on future care methods if you wish to keep your piercing hole.

Q. I don't know if I have a metal allergy. How can I tell?

If you repeatedly get infections in the same area, if your condition worsens every time you change your piercing, or if you experience severe itching, you may have a metal allergy. We can perform patch tests at our clinic, so please consult us.

Q. I have developed a keloid (raised scar). Can it be treated?

If detected early, keloids may improve with topical steroids or local injections. If left untreated, they can grow larger, so please see a doctor as soon as you notice one. For severe cases, we can also refer you to a specialized plastic surgery hospital.

Q. What department should I see?

Dermatology is appropriate. Our clinic handles all types of piercing problems as part of our dermatology practice. Please visit us first if you have an infection, pain, or if your piercing has come out.

To prevent recurring infections

A piercing hole that has been infected once tends to recur. Reviewing the root cause is key to preventing recurrence.

• Choose medical-grade piercings: Use pure titanium, pure gold (18K or higher), medical-grade stainless steel, or medical-grade plastic.
• Keep piercings clean: Disinfect the piercing itself regularly. Avoid long-term use of inexpensive piercings.
• Get tested for metal allergies: If the causative metal can be identified, you can choose appropriate materials.
• Be cautious if you are prone to keloids: If you have had a keloid before, avoid piercing the same area.
• Do not remove the first piercing until healed: 1-2 months for earlobes, 3-6 months or more for cartilage.
• Move the piercing regularly: After healing, move it back and forth once a week to prevent adhesion.
• Maintain good health: Maintain immunity through sleep, nutrition, and stress management.

And, piercing in a clean environment is the first step in prevention. For safe piercing methods at a clinic, see the article below ▼

[Doctor's Explanation] For those considering getting a piercing | Safe piercing guide at a dermatology clinic

Our Clinic's Examinations and Treatments

Examination/Procedure	Purpose/Content
History taking, visual inspection, palpation	Confirm onset, care status, piercing material used, pain, swelling, discharge, and determine severity.
Bacterial culture test	Collect bacteria from pus to identify the causative organism and effective antibiotics (if necessary).
Metal allergy patch test	Diagnose whether recurring infections are caused by metal allergy (upon request).
Antibiotic prescription	Topical medications (e.g., Gentamicin, Aquacalm), oral medications (e.g., cephalosporins) for moderate to severe cases.
Disinfection/Cleaning procedure	Remove pus and scabs, clean the affected area.
Incision and drainage	If an abscess (pocket of pus) has formed, incise under local anesthesia to drain the pus.
Piercing removal/replacement guidance	Guidance on piercing removal or replacement with medical-grade materials, depending on symptoms and recovery stage.
Keloid treatment	If a raised scar (keloid) remains, treat with topical steroids or injections.

Visit Flow

1. WEB reservation or direct visit
   If you have severe pain or fever, please call us. We will guide you through the appointment process.
2. Reception and filling out the medical questionnaire
   Please indicate when, where, what symptoms, the material of the piercing used, and any past piercing troubles.
3. Doctor's examination
   The doctor will visually inspect and palpate to determine the extent and severity of the inflammation. A bacterial culture test will be performed if necessary.
4. Procedure and prescription
   Depending on the severity, procedures such as topical or oral antibiotics, disinfection, or incision and drainage will be performed.
5. Guidance on home care
   We will carefully explain cleaning methods, disinfection methods, whether to remove the piercing, and precautions in daily life.
6. Payment and departure
   We will inform you of the estimated next visit and provide advice on preventing recurrence.

Visit Flow

1. WEB reservation or direct visit
   If you have severe pain or fever, please call us. We will guide you through the appointment process.
2. Reception and filling out the medical questionnaire
   Please indicate when, where, what symptoms, the material of the piercing used, and any past piercing troubles.
3. Doctor's examination
   The doctor will visually inspect and palpate to determine the extent and severity of the inflammation. A bacterial culture test will be performed if necessary.
4. Procedure and prescription
   Depending on the severity, procedures such as topical or oral antibiotics, disinfection, or incision and drainage will be performed.
5. Guidance on home care
   We will carefully explain cleaning methods, disinfection methods, whether to remove the piercing, and precautions in daily life.
6. Payment and departure
   We will inform you of the estimated next visit and provide advice on preventing recurrence.

Clinic Hours / Access

Item	Content
Clinic Name	Jujo Station Haru Internal Medicine and Dermatology Clinic
Consultation Hours	Monday - Sunday, open from 9 AM. Wednesdays until 8 PM, Fridays and Saturdays until 9 PM, and Sundays until 7 PM.
Closed	None (irregular holidays)
Location	1F J&MALL, 2-27-1 Kami-Jujo, Kita-ku, Tokyo 114-0034
By Train/On Foot	Approx. 1-2 minutes walk from Jujo Station on the JR Saikyo Line, 1st floor of J&MALL.
By Bus	Directly in front of the Kokusai Kogyo Bus "Jujo Station" bus stop.
By Car	Please use a nearby coin parking lot.
Contact Us	TEL: 03-6698-2509　／　Official LINE:https://lin.ee/AL0fp3z