If there is no debris still in the tire, then add pressure back to what you regularly run. If it holds, which it most likely will, then consider it fixed! Sometimes if the sealant hasn't had sufficient time to cure (or there is still debris) the hole will re form. In this case spin the wheel a bit so sealant meets the hole and wait for the sealant to do its thing. Let it cure a bit longer, then try adding more pressure.
If there is something still in the hole, you should remove it (to prevent further tire damage), then go through the above described steps to get the sealant to reseal.
The only time you really need to patch is when the hole is too large for the sealant to plug.
What do I do if it won't seal?
- Check that you have sufficient sealant in the tire.
- Is your sealant old (e.g., over 6 months)? It may have degraded to the point where it won't seal properly. In this case you will need to change your sealant.
- Is the hole is too big? If (1) and (2) do not fix the puncture then the hole may be too big.
- Try adding a particulate (e.g., glitter) to your sealant, this can help plug larger holes. Some sealants include particulate as part of their "formula."
- The hole may simply be too large for any sealant to successfully plug. In this case you repair with tubeless tire repair kit. These are either a cord that you use to physically plug the hole or a special patch for the inside of the tire.
Note: Avoid using a regular inner tube patch as these are not designed to provide the structural reinforcement needed for a tire carcass.
Will the hole reform?
Maybe, but you will probably never know because the sealant in the tire will simply reseal. The only time I have ever had an issue with previous punctures is when I tore down and scrubbed out the sealant from my winter tires which had a number of punctures. The scrubbing removed the sealant plugs. When I re-seat that tire I simply need to take a minute or two to reseal the old punctures. That is about as hard as it gets.
How do I know I still have enough sealant?
If you set up the tires with sufficient sealant (e.g., 40-50 ml for 700x25) then there should be enough sealant to handle multiple punctures which should get you through the 6 month window when you should refresh or change the sealant. Otherwise if you get additional punctures, that do not seal, that may be an indication you do not have enough sealant remaining. If your setup is mission critical (i.e., upcoming events or races). It is a good idea to open up the tires and ensure everything is set up properly.