How do I know if my ear swelling is from piercing or cauliflower ear?

Ear swelling. Piercing an ear, by itself, does not cause much swelling, usually just a mild, low grade inflammation. In persons with increased susceptibility to keloid formation (eg., some persons with darker skin), ear piercing can cause a keloid, which may look like a cauliflower growth. The term "cauliflower ear" usually refers to someone, like a boxer, who has had repetitive blunt trauma to the ear.