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The conch, which gets its name from the ear’s resemblance to a conch shell, is the inner cup part of your ear. When it comes to piercing, you can pierce your inner or outer conch, or both:

  • The inner conch is higher up, parallel to the daith (the fold of cartilage above your ear canal).
  • The outer conch is lower and closer to your antihelix, which is the first of the two ridges making up the outer contours of your ear.

Before you head to the piercing parlor, there are a few more things you should know about conch piercings.

There are two different methods for piercing your conch, regardless of whether you choose to do your outer or inner conch:

  • Piercing needle. This is the most common procedure for a conch piercing. Your piercer will clean the area, mark a point on both sides, then insert the needle and jewelry. The whole process takes only a few minutes.
  • Dermal punch. If you’re interested in wearing larger jewelry, your piercer may recommend doing a dermal punch. This involves using a small device to remove a small circle of cartilage (kind of like a small cookie cutter).

Regardless of which method you choose, the procedure should involve many of the same steps:

  1. Cleaning. Your piercer will clean your ear to prevent infection.
  2. Marking. The piercer will use a marker to indicate where they plan to make the piercing. You should be given a chance to double-check the location at this step. If you aren’t, don’t hesitate to ask to take a peek.
  3. Piercing. Once they’ve confirmed the placement with you, they’ll use either a needle or dermal punch to make the piercing.
  4. Placing jewelry. Your piercer will fit the piercing with the jewelry you chose beforehand.
  5. Applying pressure. They may apply pressure to the area for a few minutes to reduce bleeding.
  6. Cleaning (again). Finally, they’ll give the area one more cleaning to remove any lingering blood and reduce your risk of infection.

Pain is subjective, so it’s difficult to say how painful your conch piercing will be. It will hurt — but it will hurt some people more than others.

When you get your conch pierced, the needle has to move through a hard plate of cartilage.

Feel your ear and move it around. You can tell that the cartilage in the conch is thicker and harder than most other parts of your ear. This means the piercing is going to be more painful than one in most other areas, including your earlobe.

Here’s a closer look at the pain associated with conch piercings:

  • During the procedure. You can expect to feel sharp pain and pressure, but this only lasts for seconds.
  • Immediately after. After getting a conch piercing, you’ll likely feel a hot, throbbing pain. This might last for several hours or even a few days.
  • As it heals. You’ll likely continue to feel some pain for several months, especially when you clean the piercing. Some people report that the pain wakes them up if they accidentally roll onto their side with the piercing while sleeping, especially during the first month or so. In some cases, this pain might last for a year or more, especially if you opt for a dermal punch.

If the pain suddenly becomes more intense during the healing process, you’ll want to reach out to your piercer or a healthcare professional right away to check for signs of infection.

Conch piercings can be painful, but some people actually get them in order to relieve acute or chronic pain. This practice is based on the same underlying idea of acupuncture and acupressure.

It’s thought that stimulating certain points on the body — many of them on the ears — can provide relief. The daith piercing, for example, may offer some relief from migraine.

While some people report that getting a conch piercing provides relief from various types of pain, including migraine and chronic pain, there’s no research to back up these claims.

However, looking at research around ear acupuncture for pain relief offers some insight.

A 2017 review suggested that auricular acupuncture (acupuncture focused on the ear) may offer some pain relief when administered within 48 hours of pain onset. But the authors noted that much more research is needed. Plus, the 48-hour timeframe isn’t ideal for getting an appointment with a reputable piercer.

Other research has looked at something called battlefield acupuncture, which involves targeting five different points in each ear.

While research suggests it provides pain relief for some people, none of the targeted points are near the conch, so these findings likely aren’t applicable to conch piercings.

You have a few choices when it comes to jewelry for your conch piercing:

  • Bars. A lot of piercers recommend starting with some kind of bar jewelry. These are longer posts with small balls on either end, kind of like (very) small dumbbells. Bars are a good option for the initial piercing, because they allow for some swelling and are easy to keep clean. Depending on the location of the piercing, you can use a straight or curved barbell.
  • Studs. Studs used for conch piercing typically have flat backs instead of the traditional backings on studs used in your ear lobes. This prevents the end of the stud from poking into the side of your head, especially when you use a phone or lie on your side. However, they don’t allow for much swelling, so they can be uncomfortable early in the healing process.
  • Hoops. Small hoops can be a good pick for outer conch piercings, but you’ll want to skip them for the initial piercing, because they allow for too much movement that can disrupt the healing process.

Regardless of the jewelry you choose, you’ll want to pay close attention to the material of the jewelry. To avoid irritation or any complications, opt for one of the following:

  • Surgical stainless steel. This is a safe option for most people. However, it does contain a small amount of nickel. This low amount is tolerable to most people, even those who are sensitive to nickel. But if you have a severe nickel allergy, you may want to skip this one.
  • Titanium. Titanium is completely hypoallergenic, making it a good option for super sensitive skin. The only drawback is that it costs more than surgical stainless steel does.
  • Solid 14- or 16-karat gold. Just make sure it’s not gold-plated, which can flake and expose you to nickel and other alloys used under the plating.
  • Niobium. This elemental metal is another safe option for almost anyone, even those with very sensitive skin. Plus, it’s often less expensive than titanium.

A good piercer will help you pick out jewelry that’s best suited for your particular piercing — don’t hesitate to ask for their advice if you aren’t sure what you want.

Cartilage is thick avascular tissue that doesn’t take kindly to puncture wounds. Because the cartilage does not have a good blood supply, it can take longer to heal.

Conch piercings done by needle typically heal in 6 to 9 months, while those done by dermal punch can take a year or more to fully heal.

Aftercare is essential to prevent infection during the long healing time. You should always follow the aftercare directions given by your piercer.

This will usually consist of the following advice:

  • Clean your piercing at least twice per day for at least 3 months.
  • Wash your hands thoroughly before touching or washing your piercing.
  • Find a store-bought saline solution or dissolve 1/8 to 1/4 teaspoon of non-ionized sea salt into one cup of distilled or bottled water.
  • Give your piercing a sea salt bath once per day by putting warm saline in a mug or shallow bowl and tilting your head to dip your ear in the solution for 3 to 5 minutes.
  • Gently wipe the area around the area with clean gauze or paper towels saturated with saline.
  • Don’t rotate your piercing during cleaning or at any other time.
  • Do not remove your jewelry until the piercing is fully healed or if your piercer says it’s OK.
  • Avoid placing anything over the piercing, including in-ear headphones, headbands, or hats.

As with any piercing, conch piercings can lead to some complications.

Infection

Older research suggests that cartilage piercings carry a higher risk of infection than ear lobe piercings. An infected ear can be extremely painful and may require antibiotics.

Signs of an infection include:

  • red and swollen skin around the piercing
  • pain or tenderness
  • yellow or green discharge coming from the piercing
  • fever, chills, or nausea
  • red streaks
  • symptoms that are getting worse or that last longer than one week

If you suspect an infection, do not remove your jewelry unless a healthcare professional tells you to. Removing your jewelry could cause an infected abscess to grow.

Swelling

Swelling, or inflammation, is the body’s natural response to trauma. Your ear may look puffy and red. Swelling should go down within a few days.

Piercing bumps

Different bumps that may affect the conch include:

  • keloid scars, which is a painless buildup of collagen that looks like scar tissue
  • an abscess, which may be full of pus
  • a piercing pimple, which is a small pustule next to the hole
  • contact dermatitis caused by a metal allergy to your jewelry

See a healthcare professional if you have any signs of infection.

You’ll also want to seek immediate care if you notice these signs of a serious infection:

  • fever
  • sweating
  • chills
  • nausea or vomiting
  • streaks of red coming out of the piercing

A conch piercing may hurt a bit more than other piercings, but with proper aftercare you should heal without problems.

Just be sure to do a bit of research beforehand, and make sure you have the procedure done by a licensed, reputable piercer.