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Cartilage is a connective tissue that is harder than skin but softer than the bones. An ear cartilage piercing goes straight through the “harder” tissue (cartilage) in the ear and out the back. Cartilage piercings are very popular because of how versatile they are. The ear has different spots that can be pierced. For example, some of these piercings are: the snug, upper helix, anti-helix, conch, orbital, daith, and tragus. The most common and basic cartilage piercing is the helix piercing, this is a piercing at the tip of the upper ear. When you go in for your piercing appointment your piercer will help find jewelry to fit your ear and sterilize your chosen jewelry. After setting up their piercing station your piercer will clean your ear and mark the spot that will be pierced. When you agree on the exact placement of the piercing the piercer will use a hollow needle to pierce the cartilage and they will insert the jewelry immediately after. The process takes a few minutes to complete from start to finish.
Cartilage piercings are prone to swelling, especially towards the back so they are started with larger and longer jewelry. For the first two to three months of healing they are started with a captive bead ring or a barbell. The most common size of the captive ring and the barbell are an 18 gauge, 16 gauge and 14 gauge (if you are looking for a larger size). The length of the jewelry will accommodate for any swelling, it is important that the starter jewelry is not done with anything smaller then 5/16". A basic barbell and captive ring as used to start with because of how easy they are to clean. More intricate cartilage rings with many different cabochons can have a lot of nooks and cranny’s that will harbor bacteria. After the first two or three months your piercer can change out the jewelry to something smaller, that fits snug to the ear.
After the piercing is done healing there are thousands of more ornate jewelry options. Barbells have the most unique jewelry options because the front of the barbell can be many different shapes and hold multiple cabochons with different colors or stones. They can give the illusion that there is more than one piercing on the helix by using cluster jewelry. This is a barbell that has a front with multiple cabochons attached together, making a bigger design.
The other unique part about cartilage piercings is that you can have multiple piercings in a small area. These piercings can be done for a custom project and will create an overall design. For example, some people will do three or four piercings to create the shape of a cascading flower. The different designs and “ball” for the front of the piercing make the cartilage a great way to create different designs and looks that are unique to you.
As mentioned, the cartilage is where your ear feels "harder" or "tougher" than normal skin, which is everything above the ear lobe! Each cartilage piercing has a different name based on the area of cartilage that is being pierced. Read below to find out where each piercing is located and which kinds of jewelry you can wear in each.
Conch piercings go through the middle of the shell of the ear, which is also the largest and thickest piece of cartilage in the ear. It’s called a conch because this part of the ear looks like a conch seashell. The outer conch is in the lower part of the middle of the ear. The inner conch piercing goes through the upper middle shell (conch) of the ear, which would be above the outer conch piercing and slightly closer to the ear canal.
Jewelry with a straight post like a barbell, flatback barbell (also called labret jewelry), or threadless or pushpin posts are worn in conch piercings. Circular barbells and captive rings are often uncomfortable to sleep on in conch piercings and aren’t usually recommended for long-term wear.
The initial piercing can be done from an 18G to a 14G, depending on the look you want. (Note: Cartilage piercings don’t stretch like ear lobe piercings do, so if you want a large-gauge conch piercing, you will have to pierce it at that size.)
A tragus piercing goes through the center of the small flap of cartilage directly in front of the ear canal, which is called the tragus. This piercing isn’t recommend for a first cartilage piercing since the piercing process can be a little more difficult to do if your tragus is small or thick, and the proximity to your ear canal means you can hear a pop when the needle goes through, which can be unsettling.
The initial piercing is usually done at 16G with a straight barbell, flatback barbell, or threadless post, so there is room for swelling during healing. After healing, you can change the jewelry to a captive ring, hoop, circular barbell, or curved barbell.
Antitragus piercings go through the flap or ridge of cartilage that is between your tragus and your ear lobe. The antitragus has to be very prominent for this piercing to work. The antitragus is typically pierced at a 16G with a curved or flat barbell to allow for swelling. Once the piercing is healed, you can change to a captive ring or circular barbell.
The helix piercing is the official name for the upper ear piercing that we know and love from the 80s! One of the more common cartilage piercings, helix piercings are usually pierced with a captive ring, circular barbell, or straight barbell at a small gauge, anywhere from 18G to 14G, depending on your ear and the jewelry you want to wear.
The forward helix piercing is on the same ridge of cartilage on the upper ear as the helix piercing, but it is placed so that the piercing is facing forward, above the tragus. Many people opt to 2 or 3 piercings aligned vertically up the ear, and this called a double or triple forward helix.
Straight barbells, flatback barbells, and threadless/pushpin posts are used for healing forward helix piercings. There are a lot of options for endpieces for that accentuate the ear, but you should wait until the piercing is healed to swap to a captive ring, circular barbell, or seamless ring. Forward helix piercings are much trickier than standard helix piercings because they need to be lined up to your anatomy to sit well.
The industrial piercing is technically two piercings, an outer helix piercing and a forward helix piercing, that are connected with a long straight barbell. The industrial piercing was created first pierced in the 90s as an edgier cartilage piercing, because it is not as delicate as the other cartilage piercings can look. It’s usually pierced at a 14G for this reason too. It’s usually not possible to take an existing cartilage piercing and turn it into an industrial because both piercings need to align correctly. Industrials used to just be limited to the stainless steel barbell, but there are now customized barbells made specifically for industrials that have decorative accents or bends to the bar and more decorative ends.
The orbital piercing is another piercing that is technically two piercings in one, with a captive ring or seamless ring connecting both piercings. This gives the look that the jewelry is orbiting the ear, so it is called the orbital piercing. A few of the cartilage piercings can be turned into an orbital: the helix, the inner conch, and the rook. Orbitals are pierced at a 16G or 14G with a captive ring.
The rook piercing is a vertical piercing through the cartilage fold above the tragus that rests in the conch, also called the anti-helix, and are initially pierced at a 16G with a curved barbell for healing. After healing, the barbell can be change to a captive ring, but this placement is great for curved barbells because it rests with both ends visible from the front of the ear.
The snug piercing is a horizontal piercing through the cartilage fold above the antitragus that lines the conch towards the edge of the ear. Snug piercings are usually pierced with a curved barbell at 16G. The curved barbell is an ideal shape for this piercing as the ends of the barbell sit neatly against the ear.
The daith piercing goes through the smallest fold of cartilage in the ear, right above the ear canal. The piercing sits behind and above the tragus, sort of floating in front of the conch. It’s pierced at a 16G with a captive ring, seamless ring or clicker ring. The daith piercing is one of the only cartilage piercings that a captive ring or other ring jewelry is encouraged for healing. There are also rings that are shaped like hearts, stars, crescent moons, etc. and these kinds of jewelry also work in a daith piercing.
Fun fact: Have you ever heard about treating migraines with piercings? The daith piercing aligns with an acupuncture pressure point that is typically used to treat migraines, so some migraine sufferers have found relief through getting it pierced.
Navel piercings are one of the most popular piercings that piercers offer. When they first gained popularity, it was mostly teenage girls aiming to look like the top female popstars of the 90s. However, people of all ages and genders get their navels pierced.
A navel piercing is an anatomy dependent piercing. This means that you must have suitable anatomy to get this piercing done; the piercer needs to ensure that they can pierce through the inside of the navel so the piercing will heal properly. If the piercing is just through the skin of the stomach, it will not be able to heal correctly.
Each belly button is unique and some people have what are considered “advanced navels,” or those that have a variance in anatomy and require a high skill level to perform so that they’re well placed and can heal well. This does not mean that they’re more difficult to do, just that they need a piercer with the professional know-how and experience to do them correctly.
Advanced navels consist of:
The bottom line is that when you sit, stand, and lay down, the bottom of the piercing needs to rest safely and comfortably inside your navel.
When getting your belly button pierced, the standard size jewelry is a 14 gauge. This is an industry standard; there is rarely 12 gauge jewelry for this piercing. The gauge number is referring to the thickness of the bar. If the bar were any thinner, it could cause irritation to the piercing. For example, it could cause the barbell to cut at the piercing or be pulled out. The length of the bar is typically 7/16”; it is a little long to accommodate for any swelling, drainage, and healing. After your navel piercing is fully healed, you can visit a professional piercer to change the barbell out to what is comfortable and the right size for you. For example, some people use a 5/16”, while other people prefer 7/16”. It depends on the style and type of belly button jewelry you’re looking for.
Because a belly button piercing is anatomy dependent, your professional piercer will begin by looking at your navel anatomy and ensuring it is suitable for the piercing. Next, your piercer will clean and sterilize your navel with antiseptic to make sure there are no bacteria on the surface area. Your piercer will then mark the piercing placement to ensure it is lined up properly and you are happy with where it will sit. Your piercer will use a hollow needle to pierce the navel and then insert the jewelry moments after. When the piercing is complete, your piercer will discuss proper aftercare with you.
It is not recommended that you get pierced with a piercing gun because it can cause more trauma to the area, damage the tissue, and increase the chances of infection. Unlike needles, piercing guns cannot be fully sanitized using an autoclave, which means there’s greater risk for spreading bacteria.
If you notice a bump forming on or around a new piercing, you have good reason to be concerned. As dainty as the piercing may be, it is possible that your body views the piercing as an injury. Piercing growths (big or small) are never "normal," although they do occur fairly often. Most people assume right away that their growth is a keloid, but the majority actually aren't.
Keloids are overgrowths of scar tissue caused by trauma to your skin. They’re common after ear piercings and can form on both the lobe and cartilage of your ear. Keloids can range in color from light pink to dark brown. Getting your ears pierced might not feel like a serious injury, but that’s sometimes how your body sees it. As wounds heal, fibrous scar tissue starts to replace old skin tissue. Sometimes your body makes too much scar tissue, leading to keloids. This extra tissue starts to spread out from the original wound, causing a bump or small mass that’s larger than the original piercing. On the ear, keloids typically begin as small round bumps around the piercing site. Sometimes they develop quickly, but usually they appear several months after you pierce your ear. Your keloid may continue growing slowly for the next few months.
While anyone can develop keloids, some people do seem to have a higher risk based on certain factors, such as:
If you are looking to prevent keloids from developing in the first place, it's suggested you look into your family history or personal history of keloids, to prevent skin trauma or injury. If you are prone to keloids, piercings and tattoos are strongly discouraged. There's no real limit as to where keloids can form, as they can also grow on the tongue and other mucus membranes. If you decide to risk a tattoo or piercing, be aware that you may end up with excessive scarring and/or keloids.
Irritants like oil, sweat, dirt, perfume, hairspray, and other things can aggravate a piercing and cause an infection. Unfortunately, it also won't respond very well to normal cleaning, (although it's important to keep it clean so it doesn't get worse).
Sea Salt Soak - In general, to prevent any and all issues. Sea salt soaks, which any responsible piercer will tell you to do, are meant to draw out any pus and blood, which will release the pressure and aid healing. They also tend to be soothing. It is recommended to cleanse the area twice a day with a piercer-recommended saline solution or sea salt soak. Sticking to that simple process will increase your chances of healing the infection without causing further irritation.
At the first sign of thickening, firm bumps, redness, tender or raised areas within a scar—see a PCP, dermatologist or your surgeon. Do not delay treatment.
These guidelines are based on a combination of vast professional experience, common sense, research and extensive clinical practice. This is not to be considered a substitute for medical advice from a doctor. If you suspect an infection, seek medical attention. Be aware that many doctors have not received specific training regarding piercing. Your local piercer may be able to refer you to a piercing-friendly medical professional.
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