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Hip piercings give you a little bling that runs diagonally along one or both sides of your hips.

As cool as it looks, it’s a good idea to be in the know about the different types of hip piercings and what’s involved with each before committing.

Surface hip piercings have an entry and exit point through the surface layer of the skin — or epidermis if you want to be medically correct.

A surface bar runs under the skin with two ornamental ends exposed.

Dermal hip piercings look an awful lot like surface hip piercings, but they’re actually quite different.

Unlike a surface piercing that has two points — an entry and exit — a dermal piercing is a single-point piercing with only one adornment per piece of jewelry.

The adornment sits flat on the skin so it almost looks as if it’s been glued in place, while the other remains embedded in the dermis, which is the layer of skin below the epidermis.

The process depends on what kind of piercing you get.

For surface hip piercings, a needle is used to pierce the skin. A surface bar — also called a barbell or curved barbell — is threaded through the piercing and out the other end, leaving both ornamental ends exposed while the rest of the bar remains just under the surface.

Dermal hip piercings can be done using a needle or a dermal punch and each uses different jewelry.

When done with a needle, a dermal anchor and top are used.

This involves:

  • pushing the needle through the skin to create a tiny pocket
  • inserting an anchor into the opening so that it runs parallel to the skin’s surface
  • topping off the anchor with the jewelry you’ve picked out, such as a stud or gem

The tops are interchangeable so you can change out the jewelry (more on this later).

If done with a skin punch, your piercer will use a type of jewelry called a diver. Divers have pointed bases with jewelry already attached on top. The diver is inserted using the skin punch. This method tends to bleed less but is a bit limiting because it’s not interchangeable.

Your options for jewelry will depend on whether you get a surface or dermal piercing.

No matter which you prefer, choosing jewelry made from quality materials recommended by the Association of Professional Piercers (APP) is important to help prevent allergic reactions and exposure to toxins.

Examples of these are:

  • implant-grade stainless steel
  • implant-grade titanium
  • 14-karat gold or higher

Hip piercings typically cost between $40 and $100 for a single piercing, depending on the type you get.

The cost of the jewelry isn’t always included and can add another $10 to $20 to the overall cost, depending on the material.

Other factors that influence the cost are the studio, your location, and the experience of the piercer.

Remember to factor in a tip when pricing out your piercing — 20 percent is customary.

Probably, but how much it hurts depends on a few things, like your pain tolerance, your piercer’s experience level, and how fleshy the area is.

Some pain is to be expected with any piercing, but it’s usually over pretty quick.

Dermal hip piercings done with a skin punch are typically less painful than surface hip piercings.

Migration and rejection are the main risks of hip piercings, and surface piercings in particular have a higher risk of rejection because of how close they are to the skin’s surface.

That said, your body can reject a dermal piercing, too, if it’s not deep enough. Rejection also happens when your body sees the jewelry as an invader and tries to push it out.

Hip piercings in general are notorious for not lasting simply due to their location. The area is prone to excess friction, pressure, and snagging, which can interfere with healing and lead to irritation and even tearing.

Other risks associated with hip piercings include:

  • Bleeding. A bit of blood is expected with any piercing, but dermal piercings tend to bleed more. Regular rubbing in the area from jeans and other clothing also makes bleeding more likely.
  • Infection. There’s a risk of infection anytime you have an open wound, which is what a fresh piercing is. Bloodborne infections like tetanus and HIV are also possible if unclean equipment is used. This is why a reputable piercer is a must.
  • Allergic reaction. You can have an allergic reaction to jewelry containing nickel or other metals. This can cause a red, itchy rash on the skin around the piercing.
  • Scarring. If you experience rejection or decide to retire the piercing, a small scar will form over the hole once it heals shut.
  • Tissue damage. Though not likely when performed by an experienced piercer, a dermal anchor that’s inserted too deeply can damage the tissue and blood vessels around it.

Dermal piercings typically heal within 1 to 3 months. Surface piercings take considerably longer — roughly 6 to 18 months.

Hip piercings tend to fall on the longer side of the healing range because of their location and the pressure on the area.

Proper aftercare is crucial to help your piercing heal and lower the risk of infection and other complications.

It’s totally normal to have some tenderness, redness, and clear discharge in the first few days after getting a piercing. Anything else, however, could indicate a problem like infection or rejection.

See your healthcare provider right away if of you notice any of the following signs or symptoms:

  • severe pain or swelling
  • fever
  • chills
  • skin that’s hot to the touch
  • discharge that’s yellow, green, or thick
  • a foul odor coming from the piercing
  • rash
  • jewelry displacement
  • skin growing over the jewelry

Wait until you’re fully healed to change your jewelry.

If you have a dermal hip piercing, it’s best to have your piercer change the top for you to avoid dislodging the anchor or other complications.

You should be able to change a surface piercing yourself, as long as you’re completely healed. Just be sure to wash your hands thoroughly with soap and warm water first, and clean the area with saline solution.

If the jewelry is stubborn or you have a hard time seeing what you’re doing, have your piercer do it for you.

Wait until you’re completely healed to retire the piercing to avoid infection or trauma that could lead to more scarring.

Once you remove it, keep the area clean until the hole closes over. You’ll be left with some scarring, but it should fade somewhat over time.

If you’ve decided to get a hip piercing, finding a reputable piercer is the next order of business.

You can ask your pierced friends or family for referrals or use the APP member’s directory to find someone in your area.

When considering a piercer, be sure to:

  • Visit the studio in person to check for cleanliness and professionalism.
  • Ask for credentials, such as proof of their APP membership.
  • Ask to see photos of their work, including clients’ healed piercings.
  • Ask about their equipment sterilization process.
  • Check the quality of the jewelry they stock.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddleboard.