From the Guidelines
The treatment for a patient with an umbilical piercing who presents with a pea-sized, light pink, round growth without tenderness is likely management of a pyogenic granuloma or granulation tissue, and the first step is to discontinue the OTC antibiotic ointment, as this may be contributing to the problem, as recommended by guidelines to prevent promoting fungal infections and antimicrobial resistance 1. The patient should clean the area twice daily with sterile saline solution and avoid manipulating the jewelry.
- The growth is likely granulation tissue that formed as an excessive healing response to the piercing trauma.
- This is a benign condition and not an infection, which explains why antibiotic ointment was ineffective and may have worsened the condition by keeping the area too moist.
- The absence of fever, chills, and tenderness supports that this is not an infected site. Silver nitrate cauterization is the recommended treatment, which can be performed in an office setting by a healthcare provider, as there is no strong evidence to support the use of other treatments for this condition 1.
- This typically requires 1-3 applications, spaced 1-2 weeks apart.
- If silver nitrate is unsuccessful, surgical excision may be necessary. The patient should continue proper piercing care during and after treatment to prevent recurrence, and it's essential to note that the healing time for navel piercings can be up to 9 months, as indicated in the approximate healing times for body piercing sites 1.
From the FDA Drug Label
Directions clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage The patient can be treated with topical antibiotic ointment such as Neosporin (2) or Bacitracin (3), by applying a small amount to the affected area 1 to 3 times daily.
- Clean the affected area before application
- Apply a small amount of the product
- The area may be covered with a sterile bandage The patient should be instructed to monitor for signs of infection such as increased redness, swelling, or tenderness, and to seek medical attention if symptoms worsen or do not improve.
From the Research
Treatment for Umbilical Piercing with Pea-Sized Growth
- The patient presents with a pea-sized, light pink, round growth at the site of an umbilical piercing, without tenderness, after applying over-the-counter (OTC) antibiotic ointment, and denies fever or chills.
- The provided studies do not directly address the treatment of umbilical piercings with pea-sized growths 4, 5, 6, 7, 8.
- However, the studies suggest that oral antibiotics can be non-inferior to intravenous antibiotics in treating certain infections, such as bone and joint infections 4, 6, 8 and bacteraemia and sepsis 5.
- The bioavailability of orally administered antibiotics during the initial phase of a systemic infection in non-ICU patients is not well understood, and more research is needed to determine the effectiveness of oral antibiotics in this context 7.
- Given the lack of direct evidence, it is unclear what the best course of treatment would be for this patient's specific condition.
Possible Treatment Options
- Continue to monitor the patient's condition and adjust treatment as necessary.
- Consider consulting with a specialist, such as a dermatologist or an infectious disease specialist, for further guidance on treatment.
- Keep in mind that the provided studies suggest that oral antibiotics may be a viable option for treating certain infections, but more research is needed to determine their effectiveness in this specific context 4, 5, 6, 7, 8.