What You Should Know Before Getting a Dermal Piercing

Although dermal jewelry sits on the top layer of your skin, dermals aren’t surface piercings.

Surface piercings have a separate entry and exit point. They’re anchored using barbells shaped like open staples. This barbell is inserted underneath the skin. Decorative tops rest on the skin’s surface.

A dermal piercing can be placed anywhere on the body, so long as the area of skin is flat.

Popular areas include the:

• cheekbones
• nape of the neck
• chest
• lower back
• abdomen
• thighs

Although no area is necessarily off-limits, the skin has to be thick enough to hold the dermal anchor in place.

A dermal piercing can be done with a needle or with a skin (dermal) punch. The type of jewelry used depends on the way the piercing is done.

Here are your options:

• Anchor. A traditional dermal piercing starts with an anchor that’s inserted underneath your skin. Your anchor may have either a rounded base or flat “feet” on each side of the post.
• Top. Once the anchor is in place, your piercer will top off the anchor with the type of jewelry you’ve picked out. Examples include metal studs or magnetic gems.
• Diver. Divers have pointed-end bases with preset jewelry on top. Your piercer will use a skin puncher to insert this type of jewelry. Unlike the typical anchor and topper style, divers aren’t interchangeable.

Talk to your piercer about the following options:

• Surgical titanium. If you have sensitive skin, titanium may be the least likely to cause irritation.
• Surgical stainless steel. This is the most popular material, notes TatRing. Although it’s considered hypoallergenic, irritation is still a possibility.
• Niobium. This is another hypoallergenic material that’s unlikely to corrode.
• Gold. Quality is important with gold. Stick to 14-karat yellow or white gold during the healing process. Gold higher than 18 karats isn’t as durable. Gold-plated jewelry can lead to infections and allergic reactions.

A dermal piercing typically costs between $70 and $100, estimates Cost Helper. Some shops charge separately for the jewelry, too. This may add another $10 to $20 to the overall cost.

You’ll also need to factor in a tip for your piercer. At least 20 percent is standard.

Also ask your piercer about upfront costs related to aftercare, such as saline solution.

Dermal piercings are done with either needles or skin punches. Each approach involves placing an anchor underneath the skin.

For a dermal piercing with needles:

1. Your piercer will clean your skin, making sure it’s completely sterile.
2. After the area is dry, they’ll mark your skin with a pen or marker to ensure the piercing is created in the right spot.
3. They’ll puncture the skin with the needle and pull it back out. This creates a “pocket” for the anchor to sit in.
4. Your piercer will likely use forceps to insert the base of the anchor into the hole. They’ll push the jewelry in until it’s completely situated under the surface of your skin.
5. Once the anchor is set, your piercer will screw the jewelry top on.

For a dermal piercing with a skin punch, your piercer will follow the same steps as above, except the hole is made with a punch instead of a needle. The skin punch removes a small bit of tissue to create the pocket that the anchor will sit in.

A bit of pain is possible with all piercings. Dermals are no exception.

How you feel during the piercing process depends on several factors, such as:

• the placement (the fleshier the area, the less likely it’ll hurt)
• the type of procedure (dermal punches are considered less painful)
• your individual pain tolerance
• your piercer’s level of experience and reputability

Although dermal piercings are popular and highly versatile, they also carry a high risk of complications. Be sure to discuss the following risks with your piercer beforehand:

• Infection. If the piercing isn’t done in a sterile environment — or aftercare is neglected — bacteria can spread deep within the dermis.
• Displacement. If the anchor isn’t inserted deep enough, it may become dislodged within the dermis and move to another area of skin.
• Rejection. Rejection occurs when skin tissues expand in the dermis until the jewelry is completely pushed out. Although it’s common with anchor displacement, your body may simply register it as an unwelcome foreign object and reject it.
• Tissue damage. If the anchor is inserted too deeply, it may damage the surrounding blood vessels or nerves.
• Hypergranulation. Marked by a red bump around the piercing site, hypergranulation occurs when the jewelry is too tight or if the piercing is otherwise irritated. Covering the surrounding skin with makeup or tight fabric, constantly messing with the jewelry, and improper cleaning can all lead to hypergranulation.
• Scarring. If you experience rejection or otherwise retire the piercing, a small scar will form as the hole heals shut.

A dermal piercing typically heals within one to three months. If you don’t follow your piercer’s aftercare recommendations, the piercing may take longer to heal.

Crusting around the jewelry top and minor swelling is typical during the first couple of weeks. These symptoms will gradually decrease as the healing process continues.

They usually aren’t cause for concern unless the piercing is also leaking yellow or green pus, hot to the touch, or showing other signs of infection.

Proper cleaning and care are crucial to the success of your dermal piercing.

During the healing process, do:

• Keep the area covered with a bandage for a few days.
• Wash your hands with antibacterial soap before touching the area.
• Use a new paper towel each time you clean the piercing.
• Clean twice daily with a sea salt or saline solution.
• Gently wipe away any crust that’s formed between cleansings.
• Cover the piercing to protect it from getting wet during showering, if possible.
• Pat the area dry after each cleansing or after taking a shower.

At the same time, don’t:

• Wear tight clothing around the piercing.
• Allow your hair to get tangled in the jewelry.
• Play high-impact sports or engage in other activities where collision is possible.
• Submerge the pierced area in a bath, pool, or other body of water.
• Use antiseptics or antibacterial soap to clean the piercing.
• Rub the surrounding area with a towel. Pat dry instead.
• Pick off any crust that forms around the piercing.
• Change the jewelry for at least three months, or until the piercing has healed.
• Play with or remove the jewelry.

While mild swelling and crustiness is normal for any new piercing, other symptoms could indicate more severe health concerns.

See your piercer if you experience any of the following signs of infection or rejection:

• severe pain
• severe swelling
• skin that’s hot to the touch
• yellow or green discharge
• foul odor
• rash

With rejection, you may also experience:

• jewelry displacement
• jewelry that hangs or droops instead of sitting flat on the surface of the skin
• transparent or calloused skin around the jewelry top
• complete anchor dislodgement

There’s no real timeline for a dermal piercing. However, your skin will eventually grow and push the anchor up to the surface until it falls out. Whether this happens within the next three months or three years depends on how well you care for the piercing.

Once your dermal piercing has completely healed (about three months), you’ll be in the clear to change the external jewelry top. It’s best to have your piercer do this so you can avoid complications, such as accidental anchor dislodgement.

If you do decide to change the jewelry top yourself, carefully follow these steps:

1. Wash your hands with antibacterial soap before touching the area.
2. Clean the area with a sea salt or saline solution.
3. Pat the area dry.
4. Unscrew the existing jewelry top in a counterclockwise direction. If the top is stubborn, you may need to see your piercer. Your piercer can use forceps to help unscrew the jewelry.
5. Screw on the new jewelry top in a clockwise direction.
6. Clean the area again and carefully pat dry.

If you need to retire the dermal piercing, see your piercer for professional removal. You should never attempt to remove this type of piercing on your own.

Your piercer will likely:

• Clean the area with a sterile solution and pat the area dry.
• Unscrew the jewelry top.
• Massage the surrounding skin to help dislodge the anchor.
• Use a scalpel to make a small incision relative to the size of the anchor base.
• Use the scalpel to remove any scar tissue that has formed around the anchor.
• Use forceps to pull the anchor out of the skin.
• Apply a suture or bandage to the area.

Although a general practitioner or cosmetic surgeon may be able to remove the dermal, you should talk to your piercer before moving forward with removal. They can discuss the pros and cons of having an outside party remove the anchor and may be able to make a referral, if needed.

A prospective piercer from a reputable shop is your go-to authority for dermal piercings. They can also answer specific questions related to your desired placement and associated risks. A reputable piercer will also be honest about whether the desired area is good or not for a dermal piercing.