Thinking About a Septum Piercing? Here’s What to Expect

Pretty much, but keep in mind that all noses are different. Not everyone’s septum has a columella, which is the thin strip of fleshy tissue that sits in front of the cartilage.

Ideally, that bit of flesh is the “sweet spot” that piercers use for septum piercings. If yours is especially thin or nonexistent, a piercer could go through the cartilage, but that hurts more and takes longer to heal.

If you’re a stickler for symmetry but have a deviated septum, your piercing won’t be centered. Not a big deal, but it can be to some.

Once you’ve chosen your body artist (aka your piercer), you’ll be asked to show your ID and fill in some paperwork, including a waiver.

When you’re ready, you’ll lie back in a recliner or on a table while they disinfect the area inside your nostrils.

The technique used for the procedure can vary depending on the piercer.

They might use:

• only a needle (referred to as freehand)
• forceps to hold your nostrils open and a needle
• a receiving tube, which is a hollow tube that supports the tissue on one side and receives the needle as it’s passed through

The jewelry is then slipped into the opening as the needle is pulled out.

The technique can vary, but sanitary and safety procedures should be consistent and include:

• the piercer putting on clean disposable gloves
• the inside of both nostrils being disinfected thoroughly
• the piercer removing the needles and other equipment from sterile containers or packaging

The entire procedure is pretty quick (hallelujah!) and only takes a minute or two from start to finish.

Some discomfort when having a hole poked in your body’s pretty much a given. That said, septum piercings aren’t generally up there with other piercings when it comes to pain.

Assuming your piercer hits the sweet spot, most people describe the sensation as more “weird” or “unusual” than painful and compare it to the feeling of needing to sneeze.

The pain from the needle going into the tissue only lasts a split second. Some people find that the application of the jewelry actually hurts more than the puncturing of the skin.

If you want to keep pain a minimum, try to relax. The consensus among piercers and pierce-ees (not a word, but you get the gist) is that being tense seems to increase pain.

You can expect some mild tenderness at the tip of your nose over the first week or so, but nothing major. More than that could be a sign of an infection or other complication.

The price of a septum piercing typically falls between around $40 and $90.

There are a few factors that impact how much you pay for a piercing, like:

• the experience of the piercer
• the studio and where it’s located
• the type of jewelry used, which you’ll want to confirm is included in the price

If cost is a factor (when isn’t it?), you’ll also want to consider extras like aftercare products and a tip.

Most piercers use initial piercings made of surgical stainless steel (SSS) because they’re generally safe and inexpensive.

The Association of Professional Piercers (APP) recommends initial piercings made of any of the following metals:

Surgical stainless steel

If it’s good enough to be implanted in your body during surgery, then it should be fine for your septum!

Surgical stainless steel is durable, nonporous, and non-absorbable, and has a low rate of nickel release. So, though it contains some nickel, the way it’s processed makes it safe even for people with a nickel allergy.

That said, SSS could cause a reaction in someone with a very severe nickel allergy, in which case titanium would be the way to go.

Titanium

Titanium is another metal that’s used for medical implants.

Piercers often recommend it, especially for initial piercings, because it’s completely hypoallergenic and safe for everyone. It’s the best choice for people with a severe nickel allergy.

The only downside is that it’s more expensive.

Niobium

Niobium is similar to titanium and safe for pretty much everyone.

The key differences are that it doesn’t have the implant-grade designation, meaning it’s not been approved for surgical implantation, which isn’t a huge deal in this case. It’s also heavier than titanium.

As far as cost, it costs more than SSS but less than titanium.

Solid 14-karat or higher gold

If you opt for a gold septum piercing, it needs to be 14 karat or higher.

It can be yellow, white, or rose gold — just be sure that it’s solid as opposed to gold-plated or gold-filled. Not only do these contain alloys, including nickel, but the plating can also peel off over time.

Not surprisingly, solid gold piercings are more expensive than other metals.

Once you’re fully healed, you can take your pick of all the cool jewelry out there. Before that, though, you’ll have to keep the initial piercing, which is usually a 14- or 16-gauge ring or circular barbell or horseshoe.

Talk to your piercer about the options available and any concerns you have, since some styles may be better suited to your situation than others. For instance, if you want to be able to hide your piercing while you’re at work, the horseshoe shape works best.

A few, actually. Having your septum pierced by an experienced and reputable professional greatly lowers your risk.

Here are potential risks to consider:

• Allergic reactions. Some piercing jewelry — mainly those containing nickel — can cause allergic reactions in some people. Be sure to disclose any allergies to the piercer beforehand.
• Infections. Openings in the skin can allow bacteria into your body and lead to infection. This can cause redness, swelling, pain, and pus or discharge. This is why keeping the area clean and following aftercare instructions is a must (more on this later).
• Septal hematoma. A septal hematoma can develop if the piercing damages blood vessels and the tissue lining the cartilage, causing blood to collect between the two. This can cause pain, swelling, pressure, and congestion.
• Bloodborne diseases. There’s a risk of contracting bloodborne diseases, including HIV, hepatitis B and C, and tetanus from unsterilized needles. Insist that your piercer use only a fresh, sterile needle.
• Scarring. Aesthetically speaking, scarring is NBD when it comes to septum piercings because they’re not visible. Still, the formation of scars and excess scar tissue — or keloids — can be uncomfortable.
• Tearing. Depending on the jewelry used, your bling could get caught or ~ouch~ torn out.

Aftercare is key to help your piercing heal and prevent infection and other complications.

Your piercer will provide you with specific aftercare instructions to follow, but here are a few major do’s and don’ts to keep in mind:

• DON’T touch it because the more you do, the longer it’ll take to heal.
• DO wash your hands first if you’re going to touch it and before cleaning it to avoid introducing bacteria.
• DON’T flip it up if it can be avoided until it’s fully healed.
• DO rinse it with warm water first if you do need to flip it to help loosen any crust and avoid bleeding or injury.
• DON’T use products containing alcohol or hydrogen peroxide and avoid soaps that contain harsh ingredients like iodine or triclosan.
• DO use a saline solution — packaged or homemade — to rinse the area.
• DON’T overclean your piercing and limit cleaning to two or three times per day or as needed.
• DO be careful when getting dressed, blowing your nose, or doing anything that could result in catching or pulling the piercing.

A septum piercing does most of its healing in 2 or 3 months, though it can take as long as 6 to 8 months to heal completely for some people.

How quickly and how well you heal depend on factors like:

• how well you follow aftercare instructions
• how much or how little you touch the piercing while it’s healing
• your overall health
• any complications, such as infection

It depends on who you ask, but the general rule of thumb is to wait until:

• it’s no longer tender
• the minimum healing time has passed, usually at least 2 to 3 months
• it’s no longer weepy or crusty

Unless you have a problem with the jewelry, leave it in for the entire healing period. If you need to change it for some reason during the healing period, a piercer should perform the jewelry change.

Some people with septum piercings report noticing a distinctive smell, even after the healing period.

Unless you have signs of an infection, the stink is most likely due to an accumulation of oils and dead skin cells around the jewelry. The fact that it’s right under your nose only makes it more noticeable.

Regular cleaning should be enough to tame the stank.

Oh, you’ll know!

Here are the signs and symptoms to watch out for:

• severe or worsening pain, redness, or swelling
• itching
• pressure
• thick green, yellow, or gray discharge or pus that smells bad
• fever or chills
• a lump or thickened tissue around the piercing
• skin eruptions or bumps
• thinning, flaking, or peeling of the tissue around the piercing

See your healthcare provider if you experience any of these.

Waiting until it heals and changing the style of the jewelry is preferable. If you’re absolutely positive you don’t want it anymore, you can just remove it or have your piercer do it for you.

The hole will close up eventually — usually within a couple of months.

Keep in mind that if you remove it during the healing period, you’ll still need to continue keep up with your aftercare routine until it’s totally closed

If a septum piercing’s your jam, find a reputable piercer, take a deep breath, and go for it.

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 paddle board.