Postpartum

That Bump at Your Tear Site: Granulation Tissue

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A soft, red, easily bleeding bump where your birth stitches were is usually granulation tissue — extra healing tissue that can snag, spot blood, or make sex tender. Often noticed around 6 weeks, at the postpartum check, it is usually harmless and can be treated in about 10 minutes.

Last updated: July 2026

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What is granulation tissue after a tear?

Granulation tissue is the soft, bumpy, blood-vessel-rich tissue the body builds to fill and close a healing wound. As a perineal tear or episiotomy heals over the first 2 to 4 weeks, the body sometimes grows a little more of this repair tissue than it needs, leaving a small raised bump right at the old stitch line 1. It tends to look bright red or pink, feels moist and fragile, and bleeds easily when touched because it is full of tiny new blood vessels. According to postnatal care guidance, overgrowth like this is a common, benign part of wound healing rather than a sign that something went wrong 2. Many people first find it around 6 weeks, at the postpartum check, once the sorest phase has passed and they look more closely.

How do you know if a bump is granulation tissue?

A few features help distinguish granulation tissue from ordinary scar tissue or a retained stitch. Granulation tissue usually sits exactly where the repair was, looks red and glistening rather than pale, and spots small amounts of bright blood after wiping, sitting, or sex. Scar tissue, by contrast, is firmer and paler and does not bleed on light contact. Light spotting from a granulation bump can look alarming but is typically minor, unlike heavier flow or bleeding after sex that has other causes 2. Only a clinician can confirm the diagnosis with a brief look, so guessing at home has real limits. Persistent spotting past 6 weeks is a common reason people finally ask about a bump they have been watching.

How is granulation tissue treated?

Treatment is usually quick and done right in the clinic. Small, symptom-free granulation tissue often shrinks and resolves on its own within a few weeks as healing finishes, so watchful waiting is reasonable 2. When a bump bleeds, snags, or hurts, a clinician can treat it in about 10 minutes — commonly by touching it with silver nitrate to shrink the tissue, or occasionally removing it in a minor procedure. The area may sting briefly and spot for 2 to 3 days, then settle. Keeping it clean and dry with a peri bottle, and easing pressure from hemorrhoids or constipation, supports comfort while it heals. Most bumps need only a single visit, and full relief usually follows within 1 to 2 weeks.

Could the bump be something other than granulation?

Most postpartum bumps at the repair are granulation tissue, but a few other things can look similar. A retained or knotted stitch, a small skin tag, a hemorrhoid, or a cyst near the repair can each be mistaken for granulation tissue, and each is managed differently 1. Firm, fixed, growing, or ulcerated lumps, or any that do not fit the usual soft-and-bleeding pattern, warrant a closer look. Life stage matters too: recovery capacity differs for first-time and younger birthing people, and years later the estrogen decline of the perimenopausal transition can leave older perineal tissue thinner and slower to heal. Because look-alikes exist, a clinician's exam is the reliable way to sort them out 2.

When granulation tissue needs a clinician

Granulation tissue is usually minor, but confirming it and easing symptoms is worth a clinician's visit. Persistent spotting, a bump that snags or bleeds with sitting or sex, or discomfort that lingers past about 6 weeks are all good reasons to seek clinician review, even though the problem is typically benign 2. Heavy bleeding that soaks a pad in under 1 hour, spreading redness, foul discharge, or fever point to something other than granulation and are reasons to seek urgent, same-day care 1. If tender sex continues after healing, pelvic floor physical therapy can help, often over 6 to 8 weeks. According to postpartum care guidance, the comprehensive postpartum visit within 12 weeks is an ideal time to raise it 3. Gale can help you note what you are seeing.

Common questions

It is usually harmless overgrowth of normal healing tissue, not a tumor or infection. The main problems it causes are nuisance spotting, snagging, and tenderness. A clinician should confirm it, and any firm, fixed, growing, or ulcerated lump should be looked at rather than assumed to be granulation.

Small, symptom-free granulation tissue often shrinks and resolves as healing finishes, so watchful waiting is reasonable. When a bump keeps bleeding, snagging, or hurting, a quick in-clinic treatment usually settles it, often in a single visit.

Treatment such as touching the bump with silver nitrate is quick and usually causes only brief stinging, followed by some light spotting for a few days. A larger or stubborn bump may need a minor procedure. Your clinician can explain what to expect for your specific bump.

Early on, general soreness and swelling make it hard to notice a small bump, and you may not be looking closely. As the area heals and settles by around six weeks, a persistent spot or spotting becomes more obvious, which is why many people first raise it then.

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A bump at your tear site: when to check in

  • —Persistent spotting or a bump that bleeds or snags with sitting or sex is a reason to seek clinician review, even though it is usually benign
  • —A firm, fixed, growing, or ulcerated lump that does not fit the soft, easily bleeding pattern is a reason to have it examined
  • —Heavy bleeding that soaks a pad in under an hour, spreading redness, foul discharge, or fever is a reason to seek urgent, same-day care
  • —Discomfort or pain with sex that lingers past healing is a reason to seek clinician review

Heavy bleeding that soaks a pad in under an hour, spreading redness with fever, or a rapidly growing painful lump needs urgent evaluation — seek same-day care right away, or call 911 if you feel faint or cannot control heavy bleeding.

This article is general health education, not medical advice. Only an exam can confirm whether a bump is granulation tissue or something else, so a persistent or unusual bump is best assessed by your obstetric clinician, midwife, or primary care clinician.

References

  1. 1.American College of Obstetricians and Gynecologists (2018). ACOG Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000002841 ✓Perineal wound healing after laceration repair and the range of local findings and complications at a repair site, including features that warrant examination rather than assumption
  2. 2.National Institute for Health and Care Excellence (2026). Postnatal care (NG194). National Institute for Health and Care Excellence (NICE). link ✓Postnatal perineal wound healing, that overgrowth of healing tissue can be a benign finding, and the warning signs of infection or persistent problems that warrant clinical assessment
  3. 3.American College of Obstetricians and Gynecologists (2018). ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000002633 ✓The comprehensive postpartum visit within 12 weeks as the appropriate setting to raise lingering perineal concerns such as a persistent bump or spotting

3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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