Surface Piercing



Not long ago, piercing styles like eyebrow and septum piercings were considered edgy. With the piercing world gaining mainstream traction, these piercings aren’t as alternative as they used to be. As a result, those who seek to push the envelope when it comes to fashion have begun looking for new areas to pierce.


Enter: the surface piercing.


The surface piercing pierces flat areas of the body, like the chest or upper cheek. While other piercing types typically feature an entrance hole and an exit hole that’s usually directly behind the entrance hole, surface piercings feature entrance and exit holes next to each other on top of the skin. Typically, a piercer will pinch the skin and push the needle through. The result? A double-pierced look that sits flat against your skin.


Don’t get the surface piercing confused with the dermal piercing. While they both offer a similar aesthetic, a surface piercing hosts an entrance and exit piercing hole while the dermal piercing stays in place with a dermal anchor that’s placed beneath the skin and only has one piercing point.


If you’re looking for a new, unique look, then the surface piercing is an excellent option to consider; its style allows you to pierce almost anywhere. Before you start making your surface piercing plans, there are a few things to consider. Here’s everything you need to know about surface piercings.

How Much Does Surface Piercing Hurts?

The pain level of a surface piercing will greatly depend upon the location of the piercing and where the piercing is placed.


Often, to complete your surface piercing, your piercer will simply pinch the skin that you want pierced and stick the needle straight through. With this process, the surface piercing shouldn’t hurt more than other piercing types in fleshy areas.


If you get a nape piercing or a piercing closer to your eye, it will probably hurt more than a surface piercing on your chest or near your collarbone. If you get a surface piercing on or near your genital region, it’s probably going to hurt quite a bit more.


Depending on your piercer and the location of your surface piercing, your piercer might choose to place the surface piercing using a scalpel rather than a needle. This method often allows them to pierce deeply enough to lower the risk of rejection, but it could be more painful than using a needle.


The pain level of the surface piercing will greatly vary from person to person. If you’re nervous, talk to your piercer about the experience beforehand.

What You Should Know Before Getting a Surface Piercing

Unlike ear piercings and other double-sided piercings, surface piercings go through parts of the body that have no natural entry and exit points. They’re inserted either by pinching up the skin and inserting a needle followed by a surface bar, as shown in the image below, or by cutting the skin with a scalpel in order to embed a surface barbell in the dermis. The way they’re placed makes surface piercings more prone to rejection and migration than double-sided piercings, so it’s important to carefully choose where you get one. For instance, if you like to wear super-tight skinny jeans and you’re not keen on the idea of wearing looser clothing for a few months after getting pierced, you may not want to get hip surface piercings or a Christina piercing (a type of female pubic piercing). You might also want to ask your piercer if s/he thinks the scalpel method is appropriate for the type of surface piercing you want and if it could help minimize the chances of migration. (Read the “How Are Surface Piercings Placed?” section of our Surface Piercing FAQs for more info about your placement options and other answers to frequently asked surface piercing questions.)

Surface Piercing Jewelry Styles

Jewelry styles for the surface piercing greatly depend upon the location of the piercing and your anatomy. When you get your surface piercing, talk to your piercer about your jewelry options and stick to those options. The wrong jewelry type will see rejection, so it’s important to choose the type of jewelry that will make your surface piercing happy.

Surface barbells, also called staple barbells, are made specifically for surface piercings in flatter areas. Although the name implies that this jewelry type is made specifically for all surface piercings, some locations should sport a curved or straight barbell instead. Your piercer will let you know which jewelry type you should use.

Curved barbells work in many surface piercing areas, too. The curvature of the barbell plays a similar role as the staple shape of the surface barbell. Be careful with this type, since the curvature could push the beads against the piercing holes in piercings in flatter areas.

Straight barbells can be used in specific surface piercings. However, it should never be used in many surface piercing types, so ask your piercer before choosing a straight barbell for your piercing.

Whether your piercing prefers surface barbells, circular barbells, or straight barbells, you can choose opal, pearl, or diamond ball styles, or have a little fun with charms.

Some surface piercings, like a corset piercing or genital piercings, can sport a captive bead ring or other hoop styles.

Why Shouldn’t I Get a Surface Piercing?

Since you can get a surface piercing almost anywhere, you can usually find a surface piercing that will work for you. However, there are lifestyle considerations to make before getting a surface piercing.


Healing time for surface piercings is substantial, and during that time, you’ll need to stay away from pools, hot tubs, and lakes, refrain from unhealthy habits like drinking and smoking, and make sure that you adhere to aftercare practices for the entire healing period. If you can’t commit to healing for at least one year, then you should choose a piercing with a shorter healing time.


Surface piercings are susceptible to snagging and rejection, which means that you’ll have to keep an eye on it for the duration of its life. If you’re looking for a piercing that requires little-to-no attention after healing, then this isn’t the piercing for you.


If you’d like a surface piercing somewhere that sees a lot of movement, like your hands or wrist, then you want to consider getting a dermal piercing instead. Surface piercings are easily rejected, and the movement will encourage migration.

How Much Will it Cost?

Cost will depend upon the piercer and the location of the surface piercing, but you can expect to pay around $50 – $100. Since surface piercings are so easily rejected, choose a piercer that has experience with surface piercings; the success of your piercing will depend greatly upon how deeply your piercer pierces it.

Surface Piericng Types

You can get a surface piercing almost anywhere. If you have an idea for a surface piercing, talk to your piercer about possibilities. Depending on where you’d like your surface piercing, they might say no or recommend a dermal instead. However, don’t be afraid to ask; after all, piercings are all about self expression.

Here are some common surface piercings.

  1. Anti-eyebrow piercings are placed on the cheekbone, usually at an angle beneath the eye
  2. Bridge piercings are placed horizontally at the bridge of your nose.
  3. Belly button piercings are technically surface piercings, even though their popularity has earned them a place as their own piercing type. Variations of the belly button piercing include surface piercings above, below, and alongside the actual belly button.
  4. Chest piercings appear on the collarbone or in the center of the chest. These are often paired with other surface piercings.
  5. Cleavage piercings are placed between the breasts, usually vertically.
  6. Corset piercings feature multiple surface piercings down the back that are usually connected with a ribbon to emulate the look of a corset back.
  7. Eyebrow piercings are technically considered surface piercings. You can also get pierced above and below the eyebrow.
  8. Genital piercings provide popular surface piercing options. For men, the Frenum, dorsal frenum, Jacob’s Ladder, dydoe, kuno, lorem, and guiche piercings pierce different areas of the penis and genital area. Christina and fourchette piercings refer to piercing types surrounding female genitalia.
  9. Hip piercings are surface piercings on the hip.
  10. Pubic piercings refer to surface piercings in the pubic area for both men and women.
  11. Tragus surface piercings vertically pierce the skin next to the tragus.

List of Celebrities with Surface Piercings


Surface Piercings vs Dermal Piercings

Body piercings can be both very beautiful and unique. Dermal piercings and surface piercings offer a very different look because they don’t have a separate entrance and exit point and just stay on the surface of the skin. The jewelry lies along the surface and is held in place by an anchor located just below. Both types of piercings offer a creative way for an individual to express themselves using a wide variety of jewelry and accessories.


Dermals can be done with either a needle or a dermal punch. At Almost Famous Body Piercing, we do dermal piercings using the needle method. Dermals are single point surface piercings which differs from the traditional surface bar piercing. A needle is used to create a small hole in the skin and then the dermal anchor is inserted. In most cases, the base of the dermal anchor is about 6 or 7 millimeters long, just enough to secure the post and hold it in place. The dermal boot has holes in the base for the tissue to heal around and grow through which helps secure and stabilize the jewelry in the piercing. Once the piercing is done, you see only the decorative top of your choice on the surface of the skin. This exposed piece on the surface of your skin has internal threading, making your jewelry top interchangeable.
One of the most important pieces of information regarding microdermals is, if the piercing is healed and you want to remove the piece under the skin for any reason, it can easily be done by a trained piercer with minimal discomfort. You can not take dermals out on your own. Attempting to remove dermal anchors by pulling them out can be quite painful.

If you’re interested in getting a dermal piercing and want to view some of our jewelry options, please visit our web store.

Surface Piercings

Surface piercings are anchored using barbells that are shaped like open staples. A hollow needle is used to pierce the skin and act as a guide for the barbell to be inserted. When it has been properly positioned, decorative jewelry tops can be put in place. A surface piercing is more invasive than a dermal piercing because the barbell must be guided under the skin for a specific distance, while a dermal has just one point of entry. Surface bars tend to leave much larger and more obvious scars if the piercing rejects or migrates.

Dermals and surface bars are often used on areas of the body such as the hips, above the cheek bone, chest, nape of neck, lower back or anywhere else a person chooses to place them and has enough skin of moderate thickness to pierce. Surface piercings and dermals allow a person the freedom to express themselves in any number of ways. Because they do not penetrate through the body, they can be placed virtually anywhere.


1. The Piercing Tool

At the core of a number of the differences between surface and dermal piercings is the difference in tools. A surface piercing using a traditional piercing needle to create the holes. Dermals, on the other hand, use a dermal punch to make the hole.

Dermal punches take a high degree of skill and should only be used by professional piercers.

2. The Holes

The difference in the tools used leads to a big difference in technique. With a dermal punch, the artist pierces a single hole as the jewellery goes into the piercing, but has no exit hole.

A surface piercing is more like traditional piercings. The piercing uses a needle to make an entrance and an exit hole when inserting the jewellery. It’s important for the piercer to get the right depth. They want to keep the piercing near the surface (hence the name), but need to penetrate deep enough that the body will not reject the piercing.

3. Anchor Type

The reason for the different number of holes is the different types of anchor. Simply enough, dermal piercings use dermal anchors.

A dermal anchor sits under the skin so that only the piercing jewellery is exposed.

Surface piercings have two holes because they use a surface barbell for an anchor. The barbell sits under the skin and only the ends are visible.

How to Make Surface Piercing Last Longer

What makes a surface piercing different from a standard piercing? Well, a standard piercing goes through a defined piece of tissue- your earlobe, your nostril, your tongue, etc. A surface piercing goes along the surface of your skin, entering and exiting along that same plane. This makes surface piercings distinctly less stable than a standard piercing, and for that they are considered long term temporary. That means that the average lifespan of a surface piercing is 5-7 years, unlike standard piercings which can last a lifetime. That said some folks get lucky and have their surface work for much longer, and some get unlucky and it never makes a year. There are ways to ensure your piercings last longer.

Get them done in a low movement area, with stable tissue

Surface work does it’s best in areas that don’t move a whole lot. That means hands and feet, arms and legs, are off the table to start. Often, areas around the forehead and eyes, along the side burns, back of the neck, some chest placements, hips and lower back are the areas where these work best. That said, there are exceptions to every rule, and occasionally a more unusual placement can heal well and last with hard work from both the client, and the piercer. The most important thing going into these piercings is to accept they are long term temporary, and go into them understanding they won’t last you forever. Particularly if your goal is more unusual placements. Finding a piercer well versed in surface work, comfortable with it, and listening to their guidance about proper placement is key as well. These can’t just be done anywhere, contrary to popular belief. And even with a phenomenal piercer hand and foot placement should be avoided, simply because of how often you use your hands and how many things they come in contact with (for for feet, well, we all enjoy wearing shoes I presume.)

Find a Piercer using Materials you trust

I’ve written an entire article specifically about Microdermals (here) but the same applies to surface barbells. Being that the bases of these piercings can’t easily be removed or changed, they need to be the correct material. Ask good questions, and make sure you trust what your pierces uses.

Don’t pack a lot of product around them, even after they heal

This applies primarily to surface piercings on the face, but can apply anywhere you wear makeup, lotion, etc. These products can build up around the base and eventually cause irritation and issues. As tempting as it is it just keep packing products right over these piercings, it can cause issues. Avoiding the area when you do makeup, or cleaning the piercings throughly, regularly, is important. If you know you wear a lot of makeup consider seeing your piercer for regular more in-depth cleanings.

The Microdermal

Microdermals, also called dermals, single point piercings, and surface anchors, are singular piercings. They have bases shaped like a small shoe with a long side and a short side. These bases sit inside the skin, and you can screw whatever gem or adornment you want to wear into them. The bases on these can only be removed if the piercing is being retired- never removed to change it. Some important considerations-

Skin divers are a bad idea, every time.

Skin divers are an alternate to Microdermals we tried in the 90s, and quickly realized they didn’t work. These have a small round base and the gems and tops are welded, meaning they can’t be changed. Not only does this leave you stuck with the same piece, but they don’t hold up well over time. Some piercers try to tout these as better, but the obvious limitations of the tops being unable to be changed alone make these less than ideal. What happens if the gem becomes damaged or has issues? You are still stuck with the same piece. Not a great idea.

Microdermals are fragile- consider placement carefully

All surface work is fragile, but Microdermals in particular. They don’t often hold up well to catches and snags. That being said, consider where you get your piercings. Center of the chest is a popular placement, but cross body purses and seatbelts will get snagged often. Hip placement is adorable, but high wasted pants don’t play nice with them!

Size Matters

Microdermals are not one size fits all piercings! The bases are made on different rises for different thickness of tissue. You want to ensure that your piercer is using a base that is the correct height for the placement you are getting pierced.

Surface Bars

Surface piercings, also called Surface Bars and Surface Barbells, are surface piercings done with a staple shaped base with two rises, and you can wear two gemstones or pieces can be worn in them. The barbell remains under the skin, and unlike a microdermal if absolutely necessary can be changed out- although changing often causes trauma and should be avoided if possible. Some important considerations-

Curved Barbells are a bad idea, every time.

While we did experiment with curved barbells in the 90’s, we quickly figured out they do not work for surface piercings, and just put pressure on the tissue eventually causing rejection. There is never a reason a curved barbell should be put in a surface piercing. This graphic helps explain why you need a staple shape that’s perpendicular to the tissue, rather than any curved barbells.

Plastic, Pathetic!

Plastic, including Tygon and PTFE, do not belong in surface piercings. Much like curved barbells, plastic doesn’t sit correctly with the skin not to mention breaks down over time. This means plastic jewelry can yellow, harden, and even fall apart after a long time being worn. Plastic jewelry is also externally threaded, which can cause irritation and issues when switched out. There is never a reason to put plastic in a piercing, but particularly not a surface piercing.

Not all bars are created equal

Like different Microdermals bases, surface barbells come in different styles and sizes. Rounded and flat bottom are both offered, as well as different rises. Different placements call for different styles. It’s crucial you see a piercer expended in surface work who will ensure that you are getting the correct style for your chose placement, and anatomy.

Surface piercings overall are super fun, unique piercings. As long as you can accept the temporary nature of these piercings, they allow for a whole new range of cute choices when it comes to being pierced. But, given their temporary nature, it’s even more important they are done correctly, and by a skilled piercer. Check portfolios, ask good questions, and never be afraid to get a second opinion!

Changing Your Surface Piercing Tops

The longer you have a surface piercing, the easier it will be to change your decorative tops yourself. You shouldn’t try to replace them until your surface piercing is fully healed, and even then, you may want to have your piercer change them for you the first time.

When you’re ready to try changing surface piercing tops yourself, make sure you’re armed with appropriate tools. Pick up one of our World’s Thinnest Microdermal Surface Anchor Holder Tools and a pair of body jewelry forceps. You can then use the holder tool to secure your surface barbell as you grab one of your tops with a pair of body jewelry forceps and unscrew it. Watch the video below to see how easy it is to change your surface piercing tops with the appropriate tools in hand.

Do’s and Don’ts for Surface Piercing

What You Should Do while Your Surface Piercing Heals

  • Do Keep Your Surface Piercing Clean. Buy a quality saline rinse, like Recovery Piercing Aftercare Spray, and spritz your surface piercing with it 3-6 times a day. You should also do two 5-minute-long sea salt solution soaks each day during the first couple months of the healing process and any time you experience a surface piercing problem thereafter. You don’t need to use an antiseptic rinse unless you develop specific surface piercing problems that can be remedied with an antiseptic. Sea salt solution and saline piercing sprays are the best tools for keeping your new piercing clean.
  • Do Stay Healthy Overall. You need a strong, healthy immune system to heal any wound, including surface piercings. To keep yourself healthy during the healing process, it’s important to stay hydrated by drinking lots of water, get sufficient sleep every night, eat nutritiously, wash your hands frequently, avoid other people’s germs, and minimize stress.
  • Do Protect Your Surface Piercing. There are a number of things you can do to protect your surface piercing while it heals. Wear loosely-fitting clothing over your piercing, don’t play with your jewelry or touch it at all unless you have to, and definitely don’t let other people touch it. When getting dressed, put your clothes on carefully to avoid snagging your surface piercing, too. If you feel it’s necessary to cover your surface piercing at night to avoid catching it on your bed linens while you sleep, use gauze or another breathable material.

What You Should NOT Do While Your Surface Piercing Heals

  • Don’t Wash Your Surface Piercing With Soap. Soap is drying and can delay the surface piercing healing process. It’s better to just use saline washes or homemade sea salt solution to clean your piercing. Don’t worry if some sudsy water runs over your surface piercing in the shower. You just want to avoid soaping up your piercing directly. If you feel a stronger cleanser is needed at some point, consider using a product intended for piercings once or twice a day, like X-Pressions Extra Strength Antiseptic Piercing Rinse. Just make sure you apply it in between full sea salt solution soaks and aftercare spray spritzes to get the full benefit of each cleanser you use.
  • Don’t Thin Your Blood. Aspirin, alcohol and excessive amounts of caffeine can thin your blood and make it harder for your body to form clots if you experience any bleeding in the first few weeks after getting pierced. It’s best to avoid these things until you’ve had your surface piercing for a little while. When you need to take an anti-inflammatory for pain and/or swelling, try acetaminophen (e.g. Tylenol) first. Ibuprofen (e.g. Advil) is also a good tool for pain and inflammation that won’t thin your blood, but it can compound bruising, so it’s better to use acetaminophen during the first few days after getting a surface piercing.
  • Don’t Apply Creams, Oils or Balms to Your Surface Piercing. These things can clog your fistula (piercing hole), potentially trapping in bacteria and triggering an infection. If the skin around your surface piercing becomes dry or otherwise irritated, you can add tea tree oil to your sea salt solution soaks to take advantage of its moisturizing and antiseptic properties. (See instructions below.)
  • Don’t Let Bacteria Get the Better of You. Swimming in communal water, soaking in the tub, letting someone touch your surface piercing, touching it yourself with dirty hands, eating or drinking after other people… these are all sure-fire ways to introduce potentially-harmful bacteria into your system, which could lead to a surface piercing infection. Unless you live in a sterile bubble, there’s no way to completely avoid bacteria, but keep your guard up! Washing your hands regularly, taking showers instead of baths, avoiding swimming pools and hot tubs, Smokenhot Electronic Cigarettes | E-Cigarettes and implementing a “no touch” policy with friends are good ways to protect your healing piercing.
  • Avoid Smoking as Much as Possible. Smokers have an additional challenge when it comes to surface piercing aftercare, because nicotine has a systemic effect that slows down the immune system and delays healing. If you can’t quit smoking entirely, do your best to cut back and substitute cigarettes with low-nicotine alternatives. You can try using a low-dose nicotine patch, nicotine gum, lozenges, or even an e-cigarette filled with low-dose nicotine e-juice.
  • Don’t Change Surface Piercing Tops Prematurely. With so many cool surface piercing tops available, it can be tempting to change your jewelry early. It’s just not a good idea, though, because it takes at least a few months for tissue to grow up and around a surface barbell and secure it in place. Once you reach the 3-month post-piercing mark, visit your piercer and ask him or her if s/he thinks it’s safe to change your tops. You might want to just have your piercer change them for you the first time. Before attempting to change your surface piercing tops yourself, consider investing in tools that will make the process easier, like our World’s Thinnest Microdermal Surface Anchor Holder Tool and/or jewelry forceps.

How Surface Piercings Heal

Surface piercings are actually harder to heal than traditional ones. Although it may not seem like it, surface piercings take up more surface than a traditional piercing, and it causes more damage to the tissue. It’s important to avoid any friction on the piercing. The best place to get a surface piercing is in a low key area.

When you choose an area for your piercing, make sure there is as little movement in that area as possible. The wrist and nape are a popular choice for people because they like the way it looks but it’s also high traffic areas that can cause you more problems than you need. Your wrists are constantly used for tasks such as writing, eating, typing and even shaking hands. The nape of your neck, of course, is always moving and can be a high impact area. Not only do you use your neck a lot in motion but you lay on your back and also brush your hair, and you could be hitting the piercing constantly.

ust like any other type of piercing, both dermals and surface piercings must be properly cared for. With proper care, they typically heal quickly and efficiently. As with any other body piercing, we recommend non-iodized sea salt soaks and glycerin soap washes to help heal your new piercings. Read our post on how to use the aftercare products we suggest.
If you’re interested in purchasing aftercare for your new piercing, visit one of our Almost Famous Body Piercing store locations or order from our online web store.

When you receive a dermal piercing, it’s important to wear a band-aid for the first two weeks. This is to hold the top flat against the skin so that the tissue can heal around it and create an anchoring effect.
Both dermals and surface piercings can be very painful when snagged on hair or clothing, so it’s imperative that you choose a place on the body that isn’t mobile or you can choose to be continually conscious of the area in which you choose to be pierced.

When the piercing is healing it is good practice to clean the area with a saline solution or a sea salt mix. If you can easily reach the area, then add your saline to a small cup and flip the cup over the piercing. The entire piercing will be submerged with this method for optimal healing.

It’s common for a piercing to become infected so keep your eye on it. Look for drainage and crusty areas. If you do see crusty areas, don’t pull on them as they can cause more damage to the tissues. It’s best to use a wet Q-tip and gently rub the area until it comes off.

It’s important for there to be breathing room in between the barbell and the swelling. It makes it easier for the piercing to drain properly. It depends on the kind of jewelry you are using, and your piercer should know the best options for you. There is a barbell that has flat tips instead of the balls if you can get that option it would be the best one for you. It allows for less of a chance that it will get knocked or bumped.

There are many types of surface piercings that you can get depending on your own personal style. Below are some of the best surface piercings out there today

Titanium Staple Bars: Twist on Traditional Surface Piercing

Painful Pleasures came out with a new piece of jewelry that puts a fun spin on the traditional surface piercing. It’s called a Surface Staple Bar and resembles exactly what it sounds like: a staple. Here’s a little bit of information about this new mysterious bar. The piece that sits on top of the skin is a flat 28mm bar that has a 3.5mm rise. Anchored underneath the skin are 2 legs that measure 15mm (L) x 1.6mm (W) x 1.0mm (H). Each leg has holes in it to prevent migration while underneath the skin. It’s made from a very high quality implant grade titanium. The awesome part about that is that we can anodize the bar right here in our Hanover, MD Painful Pleasures facility! It’s only 25 cents extra and you can chose from 26 different colors, giving you the opportunity to customize your already unique piercing.

How do they do it?

Looking at this bar I’m sure you’re probably wondering, “How on earth does a piercer get that into my skin?” There are different methods a piercer might try to insert this, but it can be tricky. The newness of this jewelry leaves room for experimentation. They have to use a needle with a gauge big enough to accommodate the thickness of the legs. A 10g needle is large enough, but some could experiment with a smaller gauge needle that has been flattened out. Piercers can penetrate the skin with two different needles and by inserting them at an angle, they can move the legs into position underneath the skin. Some might also try to use a dermal punch.  Whatever method they choose to use, ask them about it first. It’s important to understand how they are going to do it and what you should expect

Different Types of Staple Bars

As of now Painful Pleasures has two different types of staple bars. There is a basic flat staple bar and another one that allows you to personalize it beyond anodizing. You can fit up to three dermal tops of your choice as long as they are 1.2mm internally threaded. Whether you’re interested in three crystal jewels, three opals that are all different colors and sizes, or Mr.Pacman chomping at his ghosts, the options are endless.

Is a Staple Bar Right for Me?

There are multiple factors to take into account when deciding on something like this. . Location of your staple bar is also important. You should ask questions to make sure you’re on the same page and that you understand exactly what you’re getting into. This is not just a regular piercing, it’s more of an implant. Removal often means some sort of cutting or popping – ouch! The main thing you should consider is the location of your staple bar. For example, if you have long luscious locks, you probably want to avoid getting one of these bad boys on the nape of your neck. There’s always a possibility of rejection so make sure it’s not somewhere obvious like your chest or neck if you don’t want any visible scarring. You also always want to make sure that you’re going to a reputable, professional body piercer that knows what he/she is doing.


These staple bars generally heal easily, because they are sealed inside your body. However, making sure they heal properly is important. You want to do everything you can to try to avoid migration, which could lead to future rejection. Much like a regular piercing, you don’t want to play with it. Only touch it with clean hands, keep it clean, and if you sense any sort of issues, get them checked out by a professional.  You want to make sure you’re doing daily soaks and spraying multiple times a day with our aftercare Recovery Spray. Check out our blog on Aftercare Tips to make sure you’re taking the proper steps to a full and healthy recovery.

Surface Piercing Healing Process

You should be prepared to commit around one year of healing to your surface piercing. Healing times can be longer or shorter, depending upon the location of your piercing. Before you stop aftercare practices, make sure that you talk to your piercer first.

Surface piercings have a much higher risk of rejection than other piercing types. Since it lays flat beneath your skin, your body is more likely to label the jewelry as a threat and start to push it out. If you choose the right jewelry, properly care for it, and get it pierced deeply enough, you should enjoy your surface piercing for years to come. However, even if you do everything right, your body still might reject the piercing. Some say that every surface piercing will be rejected eventually, so keep an eye on it throughout its life so that you can spot migrating jewelry before it causes scarring.

Aftercare rules

As such a unique piercing type, it might seem as though aftercare is more complicated than with other piercing types, but you’ll actually conduct much of the same practices as any other piercing.

Sea salt baths are your friend. To take care of your new surface piercing, conduct a sea salt or saline soak 2 – 3 times daily by filling a small cup or shot glass with the solution and dipping your piercing inside. With most surface piercings, you should be able to suction cup the glass to your skin so that you can move around a bit while you let the piercing soak. Once the soak is completed, gently pat the piercing dry without moving the jewelry.

Be careful with snagging. Rejection will be your biggest risk during healing. Nothing promotes rejection like ripping at your jewelry. Many surface piercings are located in areas that are at risk of snagging. The nape of your neck, your collar bone, and your pubic region all see snagging hazards on a daily basis. Throughout the life of your surface piercing, and certainly during healing, you need to take care when you dress, brush your hair, or do any activity near the piercing site.

Try not to move the jewelry too much. Depending on the location of your piercing, it will see some movement regardless of how careful you are. (For example, anti-eyebrow piercings, located along the cheekbone, will see movement as you talk and smile.) Do your best to minimize movement in order to avoid rejection. If you want to get a surface piercing in an area that sees lots of movement, like your finger or arm, think about getting a dermal piercing instead.

Rejection or migration of a surface piercing is a very real possibility, and more common with surface bars than other types of body jewelry, including dermal anchors. This is when the piercing moves closer to the surface of the skin, and eventually pushes itself all the way out.

After your jewelry is inserted, follow proper aftercare instructions to avoid migration, infection, and other complications. Keep the area clean and keep clothing or accessories that could irritate the piercing away from the area. If you need to wear something over the pierced area, choose a loose cotton item that will not rub on the piercing. You should also place a bandage over the jewelry while you sleep to keep it from getting caught on clothing or bedding.

Clean the piercing two to three times a day with both glycerin soap and non-iodized sea salt. Soaking the piercing in the sea salt and water mixture softens and rinses out any drainage that can build up around the jewelry. Washing the area of the piercing with water and glycerin soap can remove any dried drainage or “crusties” from the surface.
Keep in mind that surface piercings can take up to a year or longer to fully heal. With surface piercings, you can change the ends of your jewelry after about three months if no complications are present. It is best to come in and have jewelry changes done by a piercer as unscrewing the ends can move the jewelry underneath the skin, reinjuring the tissue and prolonging the time it takes the piercing to heal.

Sea Salt Solution Soaks for Surface Piercing

Sea salt solution is the absolute best cleanser for all healing piercings, including surface piercings. In addition to misting your piercing with a quality saline wash 3-6 times a day, you should also do two 5-minute-long sea salt solution soaks daily throughout the healing process (3 if you’re experiencing a surface piercing problem). You have two options for your full soaks: You can either saturate a clean cotton ball with a store-bought saline wash like Recovery Piercing Aftercare Spray, apply it to your piercing for 30 seconds, discard it, and repeat with fresh cotton balls until you’ve soaked your piercing for 5 minutes total, or you can make a homemade sea salt solution to apply to your piercing with cotton balls.

To make your own sea salt solution, you’ll need a quality sea salt like Recovery Aftercare Sea Salt From the Dead Sea, sterile water, and tea tree oil (optional). You can either buy sterile water or boil tap water for 5 minutes to sterilize it. Measure out 1 cup of sterile water, stir in 1/4 teaspoon sea salt until it’s dissolved, and add 2-3 drops of tea tree oil, if desired. (Tea tree oil has moisturizing and antiseptic properties that will keep the skin around your surface piercing happy and healthy when diluted in sea salt solution.) Dip a clean cotton ball in the solution, apply it to your surface piercing for 30 seconds or so, throw it away, and repeat with a series of fresh cotton balls until you’ve soaked your piercing for 5 minutes.

Note: If you opt to use a store-bought saline rinse for your twice daily soaks, you can still enhance it with tea tree oil. Just add a single drop of oil to each saline-soaked cotton ball before applying it to your surface piercing.

Surface Piercing Problems

There are a few different surface piercing problems you may encounter during the initial healing process or even after you’ve had a surface piercing for awhile. It’s a good idea to familiarize yourself with these potential issues so that you can act quickly and effectively if you experience any of them.

Excessive Swelling

Nearly everyone experiences some degree of swelling after getting pierced, so don’t let a little swelling concern you. However, if you swell so much that your swollen skin engulfs your surface piercing tops, you need to act fast. If you don’t, the prolonged pressure could cause necrosis (tissue death), which can lead to a surface piercing infection. There are a few things you can do to reduce swelling and get the pressure off your healing piercing so that doesn’t happen:

  1. If you can tolerate a non-steroidal anti-inflammatory like acetaminophen or ibuprofen, take the strongest dose recommended for adults on the medication’s label. Acetaminophen (e.g. Tylenol) should be your first choice if you notice any bruising around your piercing, since ibuprofen (e.g. Advil) can cause additional bruising.
  2. Wrap a small gel ice pack with a clean paper towel or a thin cloth, and apply it to the swollen area for up to 15 minutes. You can repeat this process every hour as necessary until the swelling subsides.
  3. If an anti-inflammatory and/or cold compresses don’t get the swelling down and keep it down, see your piercer as soon as possible. S/he may want to outfit you with dermal healing posts (shown to the right) to reduce pressure on the skin around your piercing until the swelling subsides.

Migration & Rejection

As mentioned earlier, surface piercings are more prone to migration and rejection than double-sided piercings. If your piercer uses a standard surface piercing barbell and inserts it deeply enough, and if you practice vigilant surface piercing aftercare, you shouldn’t have to worry about your barbell migrating out. Unfortunately, though, some people reject surface piercings despite their best efforts. If the skin around your surface piercing stays irritated-looking and you start to see more of the barbell over time, your body is trying to push the jewelry out much the same way it would force out a splinter. When that happens, sometimes the only course of action is to have the surface barbell removed.

If your surface piercing begins to look like the one in the image to the left, see your piercer right away. S/he may recommend removing your jewelry, letting the fistula close, and re-piercing you more deeply, with a heavier-gauge or different type of surface barbell, and/or using a different insertion method later. If you’d rather not jump right to removing your jewelry, you can try ramping up your surface piercing aftercare regime first. Do 3 full sea salt solution soaks per day, use an antiseptic rinse once or twice a day in between full soaks, and wear loosely-fitting clothing over your surface piercing. Just keep in mind that the longer you wait to have your barbell removed, the more likely you are to end up with a nasty scar. If the migration process progresses in the wrong direction after a week or two of extra-diligent aftercare, have your piercer remove your surface bar right away. Do NOT try to remove it yourself!

If you do end up having your piercer remove your surface bar, make sure you keep your fistula clean as it closes to minimize scarring and avoid developing a surface piercing infection or abscess.
Surface Piercing Infections

Signs of a surface piercing infection include discharge of thick, yellowish pus, red streaks radiating from your piercing site, skin that’s hot to the touch, and/or fever. If you experience any of these symptoms, you may be able to avoid a full-blown infection by ramping up your surface piercing aftercare regime. Do 3 full sea salt solution soaks enhanced with tea tree oil each day, apply a piercing antiseptic rinse or antiseptic swabs twice a day in between soaks, and continue spritzing your surface piercing with a saline rinse like Recovery Piercing Aftercare Spray 3-6 times a day in between your full soaks and antiseptic applications.

If your symptoms persist or become worse at any point, visit your family physician. S/he may prescribe an antibiotic to help you get over your surface piercing infection. Make sure you take the full course of antibiotics; taking a partial course can strengthen the infection rather than eliminate it.


It’s very common for people to develop hypergranulations around irritated piercings. They can manifest in two ways: as a single reddish piercing bump that appears fluid filled, or as a ring of red, puffy tissue around one side of a surface piercing. Their coloring and raised appearance often causes people to jump to the conclusion that they’re developing a keloid scar, but that’s rarely the case. Keloids grow out of control well beyond a piercing site, whereas hypergranulations form closely around a piercing.

Hypergranulations typically form due to a combination of pressure and excess moisture, making them fairly easy to remedy. If you’re experiencing excessive swelling and develop a hypergranulation as a result of prolonged pressure, you may need your piercer to temporarily replace your decorative tops with dermal healing posts to get the pressure off your piercing. Whether or not you need healing posts temporarily, you should ramp up your surface piercing aftercare regime until your hypergranulation issue subsides. Use the instructions under “Surface Piercing Infections” above.

Surface Piercing Scars

Piercing scars typically only form around established and retired surface piercings. There are three types–hypertrophic scars, atrophic scars and keloid scars–but only a small percentage of the population are prone to keloids. Hypertrophic scars are raised, flesh-tone scars that form closely around a piercing site when the body over-produces collagen while it heals a piercing wound or fills a retired fistula with new skin cells. Atrophic scars are recessed skin-tone scars that typically only form over top of retired surface piercing entry and exit points. They’re caused by the body under-producing collagen when filling a piercing hole with new skin cells. Keloid scars are genetically-triggered, bulbous, purplish-red scars that grow excessively beyond a piercing site. If you or someone in your immediate family is prone to keloids, you should be cautious about getting any piercing.

You can minimize your chances of developing a piercing scar by practicing thorough surface piercing aftercare both after getting pierced and after having a surface barbell removed. If you develop a hypertrophic or atrophic scar despite your best efforts, you can address it at home by massaging a small dot of either jojoba oil or silicone scar therapy gel into the scar tissue twice a day for as many weeks or months as it takes to sufficiently minimize the scar tissue. Keloid scars have to be addressed by a dermatologist. They can be treated using a variety of therapies, including laser therapy to burn off the scar tissue, cryotherapy to freeze it off, surgical removal, and corticosteroid injections to shrink the scar tissue.

Surface Piercing FAQs

Q. What Is a Surface Piercing?

A. Surface piercings are double-ended piercings that have no natural entry or exit points the way that traditional double-sided piercings like lip and ear piercings do. They’re threaded beneath the surface of the skin and embedded in the secondary layer of tissue known as the dermis, typically while a portion of skin is being pinched up to provide entry and exit points for a piercing needle and anchoring hardware. The type of anchoring hardware used for most surface piercings is known as a surface barbell or surface piercing bar. Once a surface bar has been inserted beneath the skin, the only visible part of the jewelry should be the dermal tops that screw into each of the two posts on the surface bar.

Q. What Types of Surface Piercings Can a Person Get?

A. Surface piercings can be placed nearly anywhere on the body, including on the nape of the neck, the chest, the hips, the pubic mound, and more. The only areas you should absolutely avoid having a surface piercing placed are on/around joints that are in constant motion, since the movement and friction would work against the piercing and make it more likely to migrate out or reject entirely.

The following types of piercings are all surface piercings, but you aren’t limited to just these placement options:

  • Eyebrow Piercings are usually placed vertically through the eyebrows.
  • Anti-Eyebrow Piercings are upper cheek piercings that are often placed at an angle below the outer corner of one eye.
  • Bridge Piercings are placed horizontally through the skin across the bridge of the nose.
  • Nape Piercings can be placed vertically or horizontally through the back of the neck, but horizontal placement is much more common.
  • Chest Piercings are placed between the collarbone and breasts, often in pairs and at angles, as in the photo above.
  • Cleavage Piercings are typically placed vertically between the breasts.
  • Belly Button Piercings are traditionally placed vertically above the navel, but they can also be placed below the belly button, on the left and/or right sides, or at any angle desired around the navel.
  • Hip Piercings are most often placed at angles on the left and right hips to complement the lines of the body, as shown in the photo to the right above.
  • Christina Piercings are female genital piercings placed vertically through the pubic mound so that the bottom side of the Christina jewelry sits just above the clitoral hood.
  • Frenum Piercings are male genital piercings that are most often placed horizontally across the underside of the penile shaft. When inserted on the top of the penile shaft, they’re called Dorsal Frenum Piercings. A row of frenum piercings is called a Jacob’s Ladder.
  • Dydoe Piercings are male genital piercings placed horizontally through the top edge of the head of the penis.
  • Kuno Piercings are male genital piercings for uncircumcised men that go through the foreskin.
  • Lorum Piercings are male genital piercings placed horizontally through the skin at the base of the penile shaft.
  • Scrotum Piercings (a.k.a. Hafada Piercings) are surface piercings of the scrotum. A row of Hafada piercings is called a Scrotal Ladder.
  • Pubic Piercings are surface piercings placed anywhere on the pubis.
  • Guiche Piercings are male genital piercings of the perineum, which is the erogenous zone that bridges the scrotum and anus. Fourchette Piercings are the female equivalent of guiche piercings; they’re placed at the back edge of the vulva.

Note: Surface barbells aren’t the ideal type of jewelry for all surface piercings. For instance, most of the male genital piercings listed above require straight barbells or captive rings, and bent barbells are one of the more popular types of eyebrow rings and belly button ringsSurface bars are best suited for anti-eyebrow piercings, nape piercings, chest piercings, cleavage piercings, hip piercings, Christina piercings, and surface piercings placed elsewhere on the body.

Q. How Are Surface Piercings Different Than Dermal Piercings?

A. Surface piercings enter the skin at one point and exit nearby, whereas dermal piercings are single-point piercings. A pair of dermal piercings can be inserted close to each other to look like a surface piercing, but there wouldn’t be hardware beneath the surface of the skin connecting and securing the two dermal tops the way there would be with a surface piercing. The two types of piercings are inserted in different ways, too. With dermal piercings, either a dermal punch is used to remove a small circle of flesh so a dermal anchor can be inserted into the dermis, or a piercing needle is used to make a hole for the dermal anchor. You can read about how surface bars are placed in the next section. (Learn more about the differences between dermal and surface piercings.)

Q. How Are Surface Piercings Placed?

A. Surface piercings are a bit more invasive than dermal piercings, and they can sometimes be more complicated to place. When inserting a surface bar more shallowly or placing a smaller surface barbell beneath the skin, a piercer may just pinch the skin together to create an exit and entry point, pierce it straight through with a needle, and pull the hardware through behind the needle. Alternatively, a piercer may use a scalpel to slice through the epidermis and insert a surface barbell more deeply into the dermis beneath. The scalpel method has the benefit of minimizing the chances of migration and rejection of a surface bar. Whichever method your piercer uses, only the tops of the two surface bar posts will be visible after you’ve had a surface bar inserted.

Q. What’s the Most Popular Gauge for Surface Bars?

A. The two most common surface bar gauges are 14 gauge and 16 gauge, but 12 gauge and 10 gauge surface barbells are also available. Where you’re having a surface piercing placed will largely determine the best gauge surface bar to use. For instance, 16g surface bars are ideal for facial surface piercings like anti-eyebrow piercings, whereas a 12g or 10g surface bar may be better suited for a meatier part of the body.

You can often use the same surface bar tops with 14g and 12g surface barbells. Just make sure that any new tops you choose have a thread pattern and size that matches up with that of your surface barbell posts.

Q. What’s the Best Type of Surface Piercing Barbell?

A. Surface barbells are typically made of either implant-grade titanium or surgical stainless steel. If you have metal sensitivities, you should opt for a titanium surface bar. You’ll also have a choice of length and post angles. The length of the surface bar determines how close the dermal tops sitting atop the surface of your skin will be to each other. Wider angled posts are needed for some surface piercing placements, so the decorative tops will sit flush against the surface of the skin. Your piercer will be able to recommend the best style of surface barbell for the surface piercing you want, but you can request a titanium or surgical steel surface bar and specify your desired barbell length.

Q. What Does Proper Surface Piercing Aftercare Entail?

A. As with any new body piercing, proper surface piercing aftercare is critical to the success of your piercing. Here are some tips for caring for your new surface piercing to ensure that it heals fully and well:

  • Bolster your immune system during the healing process by getting sufficient sleep every night, drinking plenty of water to stay hydrated, eating nutritiously, washing your hands frequently, and practicing good hygiene overall.
  • Don’t consume alcohol, excessive amounts of caffeine or aspirin during the first couple weeks of the healing process. These things act as blood thinners and can make it harder for your body to form clots if you experience occasional bleeding after getting a surface piercing. If you need to take an anti-inflammatory, acetaminophen (e.g. Tylenol) is your best option. Ibuprofen (e.g. Advil) is also an acceptable alternative to aspirin, but it can cause additional bruising.
  • Avoid swimming, soaking in communal water and baths to protect your new surface piercing from bacteria while it heals.
  • Don’t touch your surface piercing jewelry unless you have to, and then only with clean or gloved hands. Absolutely don’t let anyone else touch your healing piercing.
  • Wear loosely-fitting clothing over your surface piercing to minimize friction and pressure and to reduce the chances of migration or full rejection.
  • Most importantly, keep your new surface piercing clean. Spritz it 3-6 times a day with a quality saline wash like Recovery Piercing Aftercare Spray to keep your fistula (piercing hole) flushed of debris and to cool and hydrate the skin around your piercing. You should also do two full sea salt solution soaks per day throughout the healing process. You can either saturate a series of cotton balls with piercing aftercare spray, applying each one for 30 seconds before tossing it, or you can use homemade sea salt solution comprised of one cup of sterile water (boil tap water for 5 minutes to sterilize it, or buy sterile water) and 1/4 teaspoon sea salt.
  • If you suffer from dry skin around your surface piercing, add 2-3 drops of tea tree oil to each cup of homemade sea salt solution you make, or apply 1 drop of tea tree oil to each piercing aftercare spray-soaked cotton ball you apply to your surface piercing. Never apply creams, oils or balms to treat dry skin around your surface piercing, as these things can clog your fistula, trapping in bacteria and potentially triggering an infection to develop. (Tip: Buy our Recovery Aftercare Sea Salt From the Dead Sea & Tea Tree Oil Combo Pack to save money on both ingredients.)
  • If you encounter any piercing problems, like signs of infection or a piercing hypergranulation, ramp up your aftercare regime. Do three full sea salt solution soaks per day until the issue subsides, and use a piercing antiseptic cleanser once or twice a day in between full soaks as needed.
  • Do not change your surface bar tops prematurely. It takes time for the dermis to grow around a surface barbell and secure it in place, and until that happens, you’re at risk of dislodging the surface bar if you tinker with your dermal tops.

Q. How Long Do Surface Piercings Take to Heal on Average?

A. Some surface piercings take longer than others to fully heal, but generally speaking, you should wait at least three months before attempting to change your decorative tops. If you experience any surface piercing problems, you might need to wait longer. You may want to have your piercer confirm that you’re well healed enough for a jewelry change before you alter your surface piercing jewelry. For a small fee, your piercer can change out your surface piercing tops for you. The longer you’ve had your surface piercing, the easier it will be for you to change decorative tops yourself.


Q. What Problems Can Arise With Healing Surface Piercings?

A. The most common types of surface piercing problems include excessive swelling, development of hypergranulations, infection, migration, rejection, and scarring. It’s important to familiarize yourself with these problems and how to address them so that you can treat any issues that arise quickly and effectively.

Excessive Swelling

Surface Piercing Hypergranulations

Surface Piercing Infections

Migration & Rejection of Surface Piercings

Piercing Scars

Q. What’s the Best Way to Change Surface Piercing Tops?

A. Surface barbells aren’t as easily dislodged as dermal anchors, which means that you should be able to change your surface bar tops by hand with little trouble once your surface piercing has fully healed. If a top gets stuck or you need a little extra leverage to start unscrewing your decorative tops, we carry two types of tools that you may find useful:

World’s Thinnest Dermal/Surface Anchor Holder Tool – This handy little tool is the thinnest of its kind on the market, making it easy to slip it in between your skin and surface bar tops, secure your hardware, and unscrew the tops. See how it works by watching the video below.

Body Jewelry Forceps – If you still have trouble unscrewing your surface bar tops even with our World’s Thinnest Dermal/Surface Anchor Holder Tool, then try using a pair of body jewelry forceps to grab the tops securely and unscrew them.

Tip: If you’d like to be able to interchange colorful jeweled tops without ever having to unscrew them from your surface bar, check out our magnetic dermal tops. You can have your piercer insert a magnetic base in place of each of your starter tops or insert them yourself at home. Once that’s done, you can interchange jeweled dermal tops as often as you like without ever having to unscrew the magnetic bases from your surface bar again.

Q. Where Can I Buy Surface Piercing Jewelry?

A. We offer an extensive selection of surgical steel surface barstitanium surface barbells, and unique surface bar tops. Choose from decorative tops in unique shapes, like bees and dragonflies, jeweled surface bar tops, custom-made dermal tops, discs, cones, and many other stunning options at some of the lowest prices you’ll find online. Visit our Surface Barbells section to see our full selection of surface piercing jewelry. For a really unique look, be sure to check out our surface bar staples, shown to the left.

Q. What’s the Best Way to Remove a Surface Barbell?

A. When you’re ready to retire a surface piercing, you should absolutely visit your piercer and have him or her remove it for you. If you try to remove a surface bar yourself, you’re much more likely to end up with nasty piercing scars than if you have a professional remove it for you for a nominal fee.

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