I recently recieved a request for professional help with a piercing bump on a "false snug" piercing, which is two different piercings made to look like a single puncture of the cartilage. It consists of one piercing through the conch and another through the rim of the ear (juncture of the helix and scapha). 

"I have had a slightly red bump on the top side of the outer piercing of my "faux snug" piercing for months, and I had the piercing for a year and a half. The bump appeared almost five months after getting the piercing when I experienced swelling after flying. The bump appeared once the swelling from the flight went down. I've had the bump for 6-7 months.
 
I have used saline solution as cleaner and originally left it alone for a few months seeing if it would go away on its own. My dermatologist mistook it for a keloid and I had injections three times before getting another piercer’s opinion about it being irritation, not a keloid. I’ve tried heat compresses, saline/salt water soaks, and Mudscupper’s Bump Treatment (what I’m currently using)."

My reply:
After blowing up the image you sent, I actually agree with what your doctor had to say about the piercing. They're often not familiar with the range of piercing complications and often diagnose keloids in cases where the bumps are other issues such as excess granulation tissue or hypertrophic scarring.  

My opinion is based on the appearance of capillaries in the bump. This is highly characteristic of keloid formation, and that type of visible red capillary lines within a bump is not seen in hypertrophic scars, nor in irritation bumps, nor piercing pimples (other types of common piercing bumps).

I think I may have been able to determine what caused the problem. It looks like the jewelry does not rest unimpeded behind your ear. The two pieces look like they clash, and this could be putting excessive pressure against the jewelry, which could result in complications.

Based on everything I’ve seen, I do think the doctor diagnosed you correctly. You can try the suggestions below. But if you don’t see improvement in a matter of weeks, you should return to the doctor to pursue another course of action. Keloids can keep growing and reach very huge sizes. So don’t let it go for too long!

If you want to try to keep both piercings, you should get smaller discs or balls on the back.

You may want to try the small medical-grade silicone disc called the "NoPull Piercing Disc.”

You simply wear it continuously with the disc pressed up against the tissue. It may take a few weeks or longer to work, but I’ve seen incredible results and success with this simple remedy for hypertrophic scars. I do not know if it would be effective on keloid tissue, but it is certainly non-invasive, and not expensive. If you wish to preserve your piercing, it could be worth a try.

They may have them at the studio you were pierced at (or at another local shop). If not, you can get them online here or here.

I'm not familiar with the product you mentioned, but based on the description I doubt it would have any effect on a keloid.

Let me know if you have any other questions, and keep me posted!

She asked some important follow-up questions: 

"So even though I have piercings in other places without keloid formation, this one indicates it’s likely to occur on further piercings?

If I took the piercings out, would the bump go away?

And if I were to have the piercing redone on my other ear, how would you recommend the piercer do it to prevent the same thing from happening again, or is the type of piercing th cause of the problem?"

My reply:

Once someone has had a keloid formation, that does indicate it could happen again. There is no way to prevent it. That’s simply the body’s (disordered) response to injury. I would suggest you discuss future piercings with your doctor for his or her opinion on the risks. Unfortunately, keloids can be extremely difficult to get rid of, so it probably isn't worth the chance. 

For my part, I feel that anyone with a history of keloid formation is not a good candidate for further piercings. I decline any time I’m approached to pierce someone with such a history because I consider it simply too risky…. 

Unfortunately, with a keloid, even removing the jewelry may not result in a resolution of the problem. You may best be served by the original medical treatment that was suggested by your doctor. Note that if your doctor advises you to remove it, I would heed his counsel.

So sorry I don’t have better news for you.

EDIT: Update several days later:

after doing your consult, I was inspired to do additional research. I had seen this study, which talked about how keloids are more vascular than hypertrophic scars. But then today I found this other study, which indicates that hypertrophic scars can have that vascularization pattern too.

Also, based on the size of the excess tissue you have there, that appears more like hypertrophic scarring than keloid (though, of course, if it is a keloid, it would keep growing…)

Bottom line, I think it is very much worth trying the suggestions for hypertrophic scarring, including the "NoPull Piercing Disc” as explained above, and see if you get some positive results.

Also, if it is determined that you do not have an actual keloid, that bodes much better for you for future piercings!