Dermal Piercing & Surface Piercing FAQs

Some of the most popular types of piercings people get now are surface and dermal piercings. Why? Are dermal, microdermal and surface piercing all names for the same type of piercing, or are they actually different piercings? If they aren’t the same, then what makes them different from each other? Can I get a surface or dermal piercing anywhere on my body? Aren’t dermals and surface piercings highly prone to rejection? What can I do to make sure mine heal well and don’t migrate out?

Even people who know what a surface piercing is and how it’s different from a dermal piercing have questions they want answered before they dive in and get one. That’s why we put together this handy FAQ list, so you can learn everything you need to know to make an informed decision about getting a dermal piercing, a surface piercing, or a skin diver, as well as how to care for your new piercing after taking the plunge. If your next question is ‘What’s a skin diver?’, don’t worry; you’ll learn that, too! Just click a link below to jump right to the question that interests you most, or read all of our FAQs to get a full education on dermal piercings and surface piercings.

Common Dermal & Surface Piercing Questions

Q. Why Are Surface and Dermal Piercings so Popular?
Q. What Is a Dermal Piercing?
Q. How Are Dermal Piercings Different From Microdermal Piercings?
Q. How Do I Know What Size Dermal Anchor to Get and What Dermal Tops Go With it?
Q. Are Skin Divers Dermal Piercings or Surface Piercings?
Q. Are Surface Piercings the Same as Dermals/Microdermals?
Q. What Type of Jewelry is Best for Surface Piercings?
Q. Are There Limitations to Where Surface Piercings and Dermals Can Be Placed on the Body?
Q. Am I a Good Candidate for the Surface or Dermal Piercing I Want?
Q. I Got Pierced! What Aftercare Regime Should I Follow to Keep My Surface or Dermal Piercing Clean and Healthy?
Q. Where Else Can I Find Helpful Dermal Piercing and Surface Piercing Resources?

Answers to Dermal & Surface Piercing FAQs

Q. Why Are Surface and Dermal Piercings so Popular?

A. It’s human nature to want to be unique—to set ourselves apart from everyone else in a way that makes us feel like the individuals we are. Those who like to express their individuality through body modification are frequently drawn to surface and dermal piercings because they can be placed nearly anywhere on the body and used to enhance other mods.

It’s now chic to sport hip piercings, accent the dimples on your lower back with dermal gems, have a Christina barbell placed on your Venus mound, put a semi-permanent “ring” on a finger or toe, strategically place gems within a tattoo, get a belly button piercing even if you have an “outie”, add sparkle to your cleavage with a sternum piercing, get a unique anti-eyebrow piercing using a gem or two instead of a barbell… and the list goes on. There are an endless number of dermal and surface piercing placement options, so it’s no wonder they’ve become mainstream must-haves.

Q. What Is a Dermal Piercing?

A. Unlike standard piercings that have entrance and exit points (think earlobe piercings), dermal piercings are anchored beneath the surface of the skin. They’re also referred to as surface anchors and single-point piercings, because there is no exit point. The hole for a dermal piercing can be created using a large-gauge needle or a dermal punch.

Once your piercer creates the hole for your dermal piercing, s/he will screw a dermal top of your choice onto a dermal anchor, and then use a dermal anchor forceps tool to insert the assembled dermal jewelry. As long as the dermal anchor’s post has the right rise (i.e. post height), it will look almost as if you just affixed a press-on jewel to your skin. As your piercing heals, your body will lock the anchor in place. Once it’s fully healed, you’ll be able to change the decorative dermal top anytime. You may find a thin dermal anchor holder helpful if you want to be able to easily change your dermal tops yourself, but you can also ask your piercer for help. The key thing is not to swivel the anchor while changing the top. You don’t want to tear the tissue that’s holding it in place, or it will just spin, the top won’t come off, and you might risk pulling the anchor out completely.

Q. How Are Dermal Piercings Different From Microdermal Piercings?

A. The terms “dermal” and “microdermal” (or “micro dermal”) can be used interchangeably. Dermal anchors come with bases in different lengths and posts with different heights (called “rise”), but the term “microdermal” doesn’t apply to just those anchors with shorter bases and posts. It’s really a matter of personal preference which term you use, but more people say “dermal piercing” rather than “microdermal piercing”. The same goes for the component parts of dermal jewelry; “dermal anchor” and “dermal tops” are more commonly used than “microdermal anchor” and “microdermal tops”.

Q. How Do I Know What Size Dermal Anchor to Get and What Dermal Tops Go With it?

A. Originally, dermal anchors were used almost exclusively for extreme body modifications, as implants that would hold things like horns or spikes. To support a larger decorative top like a horn, you’d need a dermal anchor with a longer base, and preferably an anchor with holes in the base, so new skin can grow up through and around the anchor and make it even more secure. If you were inserting a small gem high up on someone’s cheekbone, you could use a smaller anchor—possibly even a little 4.5mm-round microdermal anchor. The point is that microdermal anchors come with bases in a range of lengths so there’s one for every piercing/placement. It’s something you shouldn’t have to worry about if you go to an experienced piercer who will know what size works best for the dermal placement you want.

The post rise needed depends entirely on how deeply an anchor is going to be inserted. The goal is to have the decorative top appear to be sitting right on the skin. If you use an anchor with a rise that’s too high, the piercing won’t be flattering. If the rise is too short, it could pull the decorative top beneath the surface of the skin, and the skin could potentially heal over the dermal top completely. Again, an experienced piercer will know what size you need based on the placement you’ve chosen for your dermal piercing.

Once your dermal is fully healed, you can replace the starter top with any dermal top that has the same threading size and type to go with the anchor you have. Typically you’ll want to look for an internally-threaded dermal top with a 1.2mm thread pattern if your anchor is 12g or 14g, or .9mm if the base is 16g or 18g. Just be sure to ask your piercer what size dermal tops are compatible with the base s/he inserted when you get pierced; that way you’ll know exactly what to look for when you shop for new dermal tops.

Q. Are Skin Divers Dermal Piercings or Surface Piercings?

A. Skin divers are more like dermals than surface bars, because they’re single-point piercing jewelry. However, they’re all-in-one pieces that don’t have interchangeable decorative tops. Usually they have a rounded base with a point on it, but some have flat bases. They can only be inserted by removing a section of skin with a biopsy/dermal punch. Once the hole is created, the piercer uses a tool to hold it open while s/he inserts the skin diver. If removed, there’s a chance of scarring akin to what a dermal would cause.

Q. Are Surface Piercings the Same as Dermals / Microdermals?

A. The only similarity between surface piercings and dermal piercings is that both are placed beneath the surface of the skin. Surface piercings are not single-point piercings like dermals are, though. A surface piercing passes under the skin where there are no natural entry and exit points. There are a number of piercings that are considered surface piercings, including (but not limited to) the ones listed below. Each type of surface piercing listed contains a link to related photos in our Body Mod Photo Gallery that you can click to see examples of that piercing. Note that you must be over 18 years old, a registered member, and logged in to see mature content in our gallery.

Basically, any piercing that enters and exits the skin on the same plane—a piercing that goes under the skin rather than through—is a surface piercing. You could pierce your forearm, your bicep, your thigh, or any other part of your body that’s fleshy enough to pinch the skin and pierce through it. However, just because you can doesn’t mean you’ll be able to keep your unusually-placed surface piercing.

Surface piercings have a high rejection rate, because the body reacts to them much the same way it reacts to splinters. Unless it’s going to be more work for the body to gradually push the foreign object out than it would be to accept it and heal around it, there’s a good chance you’ll eventually lose your piercing. Little by little, the layers of skin covering your jewelry will diminish (known as the “cheese cutter effect”) until the jewelry falls out, sometimes ripping through a remaining thin layer of skin in the process and leaving you with an unsightly scar. The deeper you’re pierced and the heavier gauge jewelry you wear in a surface piercing, the less likely your body will be to reject it.

Q. What Type of Jewelry is Best for Surface Piercings?

A. Surface piercing barbells are the most effective type of jewelry to wear in most surface piercings, because they are flat where the jewelry passes beneath the surface of the skin. This puts less pressure on the healing fistula (i.e. hole where you were pierced) than a rounded straight barbell would, reducing the chance of rejection.

Some surface piercings require different types of jewelry. Curved barbells make better belly button rings, and micro curved barbells make better eyebrow rings. Also, many men prefer to use either D-rings or straight barbells with larger balls in their frenum piercings, for their partners’ pleasure during intercourse. Christina piercing barbells are the standard jewelry for Christina or Venus piercings. They’re sort of a hybrid between a surface bar and a straight barbell, because they have long barbells with one end bent at a 90⁰ angle, but the barbells themselves are rounded instead of flat. Also, the opposite end typically has a jeweled ball on it, like the ones shown here.

Q. Are There Limitations to Where Surface Piercings and Dermals Can Be Placed on the Body?

A. There are some areas of the body that are more conducive to one type of piercing over the other. For instance, a surface bar won’t work as well on a finger or toe as a dermal will. Dermals can typically be placed anywhere a surface bar would work, though. For instance, if you wanted a cleavage piercing, you could have a surface bar inserted and have two gems lined up vertically (one screwed into each 90⁰-angled threaded end), or you could insert 1 dermal or place a few dermals in a pattern in the same area. Dermals give you more flexibility to create patterns, like a necklace around your neck or a heart on your bicep. You can place them nearly anywhere on your body—even on your face and skull.

While it may be possible to place surface piercings and dermal piercings nearly anywhere on the body, you should keep in mind that certain body parts are more prone to rejecting these piercings. If you get a piercing in an area that’s constantly rubbed by clothing, such as on your hips, it’ll have a hard time healing and will be more likely to reject. Also, leaner areas–like your fingers, toes, wrists, and the bridge of your nose–will be more likely to reject a surface or dermal piercing, because there isn’t room to pierce as deeply as in other spots on your body. If you really want a piercing in a less fleshy area like the bridge of your nose, ask for the heaviest gauge barbell that’s still appropriate for the placement you’re requesting.

Q. Am I a Good Candidate for the Surface or Dermal Piercing I Want?

A. It really depends on where you want the piercing and your lifestyle. If you work with young children or animals, it could be problematic to get a visible piercing that might be constantly tugged or brushed against. If you play sports, certain piercings may not be allowed because of the potential for injury. For instance, even though they’re covered with clothing, belly button rings are a big no-no in sports like lacrosse.) If you wear tight clothing that will be constantly pressing against and/or rubbing your piercing, you might want to consider a different placement. These are the kinds of things you need to think about when deciding whether or not you really are a good candidate for the piercing you want.

If you’re wondering if you could get a surface or dermal piercing as long as you keep it covered with a bandage when you’re playing sports, working, etc., remember that a piercing is an open wound, and open wounds need fresh air to heal. That’s not to say you shouldn’t cover your piercing at times—for example, if you’re worried about rubbing a facial dermal against your pillow, you might cover it at night for awhile. However, you can’t keep your piercing covered all the time and expect good results.

Q. I Got Pierced! What Aftercare Regime Should I Follow to Keep My Surface or Dermal Piercing Clean and Healthy?

A. Proper aftercare is the #1 most important factor in ensuring that your piercing heals well and stays with you for a long time to come. Your piercer will give you a list of aftercare instructions to follow, but in general, these are good rules to abide by:

Stay healthy in general by eating nutritious foods, getting good rest, and practicing good hygiene. Rest is more important than you might think when it comes to healing a dermal piercing or a surface piercing, because our bodies heal best while we sleep.
Do NOT touch your dermal or surface piercing unless you’re wearing gloves or have just washed your hands. Even then, you should only touch it to clean it or gently remove “crusties” (explained below). Definitely don’t ever “play” with your new jewelry, even if your hands are clean.
If “crusties” form around your piercing—and they usually do—don’t jump to the conclusion that you have an infection. Crusties are just lymph that your piercing excretes as a natural part of the healing process. It dries to a whitish crust that you can soften with a sea salt aftercare spray like Recovery or H2Ocean and then gently wipe away with a clean tissue or cotton ball.
Spray your dermal piercing or surface piercing 3-6 times per day with a sea salt solution aftercare spray to keep your piercing flushed of dirt and debris, and to moisturize the skin around your piercing.
You can supplement with homemade sea salt solutions, if desired. Just mix ¼ tsp. of sea salt (NOT table salt, which contains iodine) into 1 cup boiled-then-cooled water, and apply the mixture to your piercing with a series of clean cotton balls. Repeat until you’ve soaked your piercing for at least 5 minutes. (The easier alternative is to saturate cotton balls with Recovery Aftercare Spray and apply them to your dermal piercing or both ends of your surface piercing.) If your skin is dry, add 1-3 drops of tea tree oil to your solution for its moisturizing and antiseptic qualities.
If you experience extreme swelling, discharge of a thick, yellowish pus, skin that’s hot to the touch, and/or red streaking around your piercing, see your doctor ASAP. You may need an antibiotic. If your doctor suggests removing the piercing, consider trying to ramp up your aftercare regime while taking the antibiotic and see if there’s an improvement before giving up on your piercing.
See the additional tips in our Piercing Aftercare article.

Q. Where Else Can I Find Helpful Dermal Piercing and Surface Piercing Resources?

A. Watch a dermal anchor being inserted in this video: Painful Pleasures’ Jason Coale Inserting a Chest Dermal.

Learn how to use the best tool available for changing a dermal top in this video: How to Change Your Dermal Top Using Painful Pleasures’ Product PT-080.

Visit our forum to read about other people’s surface piercing and dermal piercing experiences or to submit your own question, tell your surface or dermal piercing experience(s), or reach out to other community members.

Check out our gallery to see how different types of piercings look. Just click on the Navel Piercing, Surface Piercing, or other relevant links in the left-hand navigation to find the photos you want to see most.

Our Blog and Information Center articles are also filled with great information you may find useful!