Thinking about getting a dermal piercing? If so, then this dermal piercing debrief will tell you everything you need to know before and after getting pierced! Learn about the benefits and drawbacks of microdermal piercings, your dermal anchor options, the dermal piercing healing process, how to change a dermal top, what types of dermal jewelry tops are available, and more.
The Dermal Piercing Process
Dermal piercings are single-point surface piercings, unlike traditional piercings that go in one side of your flesh and out the other. To place a dermal anchor, a piercer uses a dermal punch to remove a small circle of flesh. S/he then uses dermal forceps to insert a small dermal anchor into the resulting hole, as shown in the video below. The anchor may have a footed base or a small, round base to help secure the dermal anchor in place. 
Some dermal anchor bases are solid and some have holes in them so that tissue can grow both up through the holes and around the outside of the base as the dermal piercing heals, making the piercing more stable and secure over time.
Like other surface piercings, dermal piercings are prone to migration and rejection. Having a dermal anchor with holes in the base inserted may minimize the chances that it will migrate out. It’s also important to protect your dermal piercing while it’s healing, so it doesn’t get snagged and displaced or pulled out. Even if nothing external works against your piercing, your body may still push it out over time. It’s natural for the body to work to eject an object that’s been inserted below the surface of the skin, the way it does with a splinter. If you practice faithful piercing aftercare, though, and you do your best to protect your dermal piercing, you could have it for years to come.
The Pros & Cons of Dermal Piercings
The coolest thing about dermal piercings is that they can be placed nearly anywhere on the body. You can get a dermal anchor and a teardrop dermal top inserted below the corner of your eye. 
You can create a necklace around the base of your neck by having an arc of dermal piercings inserted. You can accent a tattoo with a few sparkly dermal tops. You can outline the curve of your hip or have a dermal placed on a finger or toe so it looks like you’re wearing a ring. You can even have spiked horns implanted on your forehead if you want. The possibilities are almost endless! Take a look at the creative dermal work of Russian body modification artist Arseniy Andersson to see just how dynamic dermal piercings can be.
The only downside to dermal piercings is that they are very prone to migration and rejection, as stated previously. It’s easy to bump a dermal piercing or catch it on your clothes and dislodge it–at least until it’s fully healed. That’s why it’s so important to practice good dermal piercing aftercare and to protect your piercing to the best of your ability, especially during the early days of the healing process, before your tissue has had a chance to grow up around the dermal anchor base and secure it in place.
While your dermal piercing is healing, you have to baby it. If you play sports, make sure to cover your dermal with a breathable bandage. When you get dressed, focus on wearing loose, breathable clothing. If you have a dermal piercing somewhere like your hips where the waistband of your pants may put pressure on it, be conscious of that and choose appropriate clothing. You don’t have to wear a muumuu dress or anything extreme like that; just make sure to wear clothes that aren’t super tight and that are made of a breathable fabric like cotton, and be careful when you put them on and take them off so that your dermal piercing doesn’t get irritated.
Dermal Piercing Aftercare
If you want your dermal piercing to heal well and last, then you have to practice good dermal piercing aftercare. That means more than just keeping your dermal clean and protected, although those things are very important, too. You have to practice good hygiene in general, eat well, get lots of sleep, and avoid nicotine, which slows down the body’s ability to heal. A dermal piercing is a wound, just like a cut from a knife or a surgical incision. Remember that, and take care of your body overall so it can do its job and heal your wound properly.
Try to touch your dermal piercing as little as possible while it’s healing. Whenever you need to touch it to clean it, make sure you’ve just washed your hands with antibacterial soap, or put on a pair of gloves first. To clean it, you don’t need soap. In fact, you should avoid soap altogether. It’s drying, and it can delay the healing process. It’s okay if some sudsy water gets on your dermal in the shower, but don’t soap it up directly. Instead, you should soak it with saline wash or homemade sea salt solution twice a day and mist it regularly with something like Recovery Piercing Aftercare Spray frequently in between soaks. Saline is a natural healer–a substance already found in your body, which means your body will be more tolerant of it. It’s soothing, hydrating and encourages healing. You can enhance it with tea tree oil, which is a natural moisturizer and antiseptic.
If you use a store-bought saline rinse to do your twice-daily soaks, saturate a cotton ball with it, and then add a drop of tea tree oil to the cotton ball, press it gently against your dermal piercing, and hold it there for 5 minutes. If you’d prefer to make a homemade sea salt solution for your full soaks, you’ll need sea salt, like aquarium salt from a pet store, sterile water (tap water that’s been boiled hard for 5 minutes is fine), and, if desired, Recovery Tea Tree Oil. Mix 1/4 teaspoon sea salt into 1 cup of sterile water, add 2-3 drops of tea tree oil, soak cotton balls in the solution, and apply them to your dermal piercing one-at-a-time until you’ve soaked your piercing for at least 5 minutes. Repeat twice a day, and your piercing should heal well.
Handling Dermal Piercing Problems
Sometimes problems arise with a piercing no matter how carefully you’ve cared for it. Here are some common dermal piercing issues and how to deal with them if they happen to you:
“Crusties”
Whenever the body’s working to heal a wound, it’s normal for it to excrete a mostly clear substance called lymph. Lymph tends to dry to a whitish crust on external piercings, forming the notorious “crusties” that are such a common complaint with healing piercings. Crusties are a natural part of the healing process and nothing to worry about. If crusties form around your dermal piercing, simply soak a cotton ball in saline wash, hold it against your piercing gently until the crusties soften, and then carefully wipe them away with a clean tissue or cotton swab.
Displaced Dermals
If you bump or snag your dermal piercing, one of two things could happen: Your dermal piercing may be pushed slightly below the edge of the fistula (piercing hole), or it may be pulled out slightly. If this happens to you, make an appointment with your piercer right away. Your piercer should be able to right your piercing for you or re-do it if you’ve pulled out the dermal anchor completely.
You have to treat a displaced dermal piercing as if it’s a brand new piercing. Even if you’re a month into the healing process when your dermal is displaced, you’re starting from square one if it has to be adjusted. The reason is that whatever tissue had formed around the base previously is no longer securing your dermal anchor in place, and new tissue has to form around it to re-secure it. If you’d tapered off your sea salt soaks and other dermal piercing aftercare, ramp up your routine again for the next 4-6 weeks to help your dermal re-heal well.
Infection
Signs of infection include thick, yellowish pus, red streaks around your piercing, and skin that’s hot to the touch. If you suspect you have an infection, see a doctor. You may need an antibiotic to get over it. You also need to ramp up your aftercare routine for at least a few weeks to ensure that your piercing heals well. As long as you do that, you shouldn’t have to remove your dermal piercing even if your doctor recommends it.
Hypergranulation
Hypergranulation is the notorious “red bump” that occasionally forms around a fistula. With other piercings, hypergranulation is most often a sign that your jewelry is too tight. 
With dermal piercings, it’s more likely a sign of a moisture and/or pressure issue. If you’ve been covering your dermal piercing too frequently, stop for awhile; let it breathe. If your dermal is placed somewhere like your hips where the waistband of your pants is regularly pressing against it, then either the pressure of your clothing is causing the issue or you’re sweating too much beneath the waistband of your tight pants. Either way, you need to switch to looser clothing for awhile and let your piercing recover.
If the suggestions above don’t make your red bump go away, then it may be worth it to try putting a little space between your dermal anchor and dermal top, and see if that solves the problem. Painful Pleasures carries both dermal healing posts and dermal extension posts that can help with that. You should ask your piercer to help you change your dermal top if you decide you want to try a healing post or extender, because you could do more harm than good if you tried to change the top yourself too early in the healing process.
The other thing that can trigger hypergranulation is getting dirt/debris in your fistula. If something has worked it’s way into your dermal piercing and is causing irritation, the only thing that’s going to help get it out is regular saline washes. Your body will do the heavy lifting and push out whatever’s irritating it over time, but it’s your job to keep your piercing clean and make sure that (a) the irritant doesn’t lead to infection, and (b) that it gets washed out as soon as it’s close enough to the surface to be removed. Don’t poke around thinking you’re going to find the irritant. It could be a microscopic fleck of dirt, so the only thing you can do is be faithful with your saline washes. If there is an irritant in your piercing causing your hypergranulation issue, the red bump should subside once the irritant is flushed free.
Scarring
Some people are more prone to scarring around piercings than others, and sometimes environmental factors can trigger scarring. There are two primary types of scars that tend to develop around existing and closed dermal piercings: hypertrophic scars and keloids.
Keloids are actually fairly uncommon. Many people who experience issues with hypergranulation mistakenly think they’ve developed a keloid. If no one else in your family is prone to keloids, it’s highly unlikely you will be, because keloid scarring tends to be a genetic issue. If you are prone to keloids, don’t get a dermal piercing. You’ll just end up with a nasty scar that may require a dermatologist’s intervention to heal properly.
Hypertrophic scars are much more common than keloids. These scars tend to form immediately around the piercing site rather than “sprawling” the way keloids do (i.e. growing well beyond the piercing site and in asymmetrical patterns). Hypertrophic scars are more likely to be flat-topped, small, round scars that stay closer in color to your natural skin tone. If you develop a hypertrophic scar while you have a dermal piercing or after removing one, you can treat it with one of two things once your piercing or the hole your piercing left behind has fully healed. You can try applying jojoba oil, which is a natural skin moisturizer that’s known to reduce scarring with regular applications (twice daily for as many weeks or months as it takes to see a positive response). Alternatively, you can use a silicone gel scar therapy treatment twice daily to reduce the redness of your scar and shrink it down, as discussed in our blog post titled Is Silicone Gel Effective for Treating Piercing Scars?
Dermal Jewelry
Once your dermal piercing heals, you have a wide variety of microdermal jewelry options that you can pair with your dermal anchor base. Painful Pleasures offers everything from simple steel and titanium discs, cones, balls, and flat tops shaped like different animals to high-quality 14k white or yellow gold dermal tops with or without gemstones in your choice of colors. Click any of the first 8 categories listed below to see the many dermal top options available to you. Or, check out the final category listed to see our selection of all-in-one skin anchors, which have decorative tops permanently attached to their bases so you never have to worry about losing your dermal top or changing it.
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If you have trouble changing your dermal top yourself, try using our World’s Thinnest Dermal Holder Tool to secure your dermal anchor in place while you unscrew the top. Watch the video below to see how much easier it is to remove a dermal top with this special tool than it is with traditional dermal forceps.
If you’re unable to change your dermal top yourself, you might consider asking your piercer to put on a magnetic dermal top for you, like the set shown above. Then you can just pop out the gem top and swap in a different color yourself whenever you want, without having to unscrew the entire top every time you want to change up your look.
Other Dermal Piercing Resources
If you’re interested in learning more about dermal piercings, dermal piercing aftercare, and dermal jewelry, or even how to use a dermal punch to create a dermal piercing hole, check out the resources below.
