If you’re thinking about getting a septum piercing or have recently gotten one, it’s important to brush up on proper septum piercing aftercare to ensure that your piercing heals well and stays with you for as many years as you want to keep it. This septum piercing care guide will teach you all the things you should and shouldn’t do while your septum piercing heals, how to clean it, what types of septum piercing problems to watch out for and what to do if you experience any issues with your piercing, when you can change your jewelry, what kind of septum jewelry options are available to you, how to stretch a healed septum piercing, and more.
What You Should Know Before Getting Your Septum Pierced
Septum piercings should be placed through what’s known as the “sweet spot”, which is in between the soft flesh on the underside of your nose and the septum cartilage above it. If you experience great pain during the septum piercing process, your piercer has likely inadvertently pierced your actual septum cartilage. If this happens to you, tell your piercer to stop, give your nose time to heal, and go to a different, more-reputable piercer later to try again. On average, septum piercings take 4-6 weeks to fully heal, so if you have a septum misadventure, you should wait at least a month before getting re-pierced.
Starter septum jewelry is most often made from either surgical stainless steel or titanium. You can choose from a bull ring-style captive bead ring, a septum pincher, or even a septum retainer that you can flip up into your nostrils when you need to hide it for work or other occasions where you feel it may be inappropriate to have your septum piercing displayed. Standard starting gauges tend to range between 16g and 12g, but some people choose to start out with heavier gauges from the beginning instead of waiting and stretching later. 
If you go with a heavier gauge, opt for a septum pincher or retainer that will put less downward pressure on your healing fistula than a captive ring would. This will aid in the septum piercing healing process rather than delay it.
Septum Piercing Care
There are a number of things you should and shouldn’t do while your septum piercing is healing. If you use the guidelines below as a supplement to the septum piercing aftercare instructions your piercer gives you, your septum piercing should heal well in a standard amount of time as long as you don’t experience any septum piercing problems.
What You Should Do While Your Septum Piercing Heals
- Do Keep Your Septum Piercing Clean. You should mist around your septum piercing 3-6 times per day with a quality saline rinse like Recovery Piercing Aftercare Spray throughout the septum piercing healing process. For the first few weeks at minimum, you should also do two full sea salt solution soaks per day. Antiseptic piercing sprays are not recommended for everyone, but they can be helpful if you experience a septum piercing problem. See our “How to Clean a Septum Piercing” section below for suggested sea salt solution soak methods you can try, as well as what type of piercing antiseptic products are best and when you should consider incorporating one into your septum piercing aftercare regime.
- Do Stay Healthy in General. Getting good quality sleep, eating nutritiously, staying hydrated, avoiding other people’s germs, minimizing stress, and practicing overall good hygiene can all positively impact your healing septum piercing. Tending to these areas of your general health will bolster your immune system so your body can focus its full attention on healing your septum piercing. As part of the “avoiding other people’s germs” aspect, it’s important to wash your hands regularly and thoroughly. Read our Guidelines for Hand Hygiene for tips on how to properly wash your hands.
What You Should NOT Do while Your Septum Piercing Heals
- Do Not Traumatize Your Septum Piercing. If you absolutely have to blow your nose at some point during the septum piercing healing process, blow very gently into a clean tissue, and do not re-use tissues. You should avoid playing with your jewelry throughout the healing process, too. In fact, it’s best not to touch your jewelry at all except when you’re cleaning your septum piercing, and then only after thoroughly washing your hands or putting on a pair of medical gloves. If you kiss someone, do it gently to avoid mashing your septum piercing against the person’s face. Try to avoid any degree of trauma to your septum piercing so you don’t delay the healing process.
- Don’t Thin Your Blood. Most piercings will bleed occasionally during the early days of the healing process. Often it’s because of crusties (dried lymph) freezing jewelry in place and suddenly getting torn loose from the surrounding tissue–
a problem you can mostly avoid by softening crusties with piercing aftercare spray before gently wiping them away with a clean tissue. Since bleeding could potentially be an issue for you at some point, it’s best to avoid anything that will thin your blood, particularly during the first two weeks of the healing process. That includes aspirin, alcohol (which is also dehydrating) and excessive amounts of caffeine. - Don’t Let Bacteria Infiltrate Your Septum Piercing. It’s impossible to avoid bacteria completely unless you live in a sterile bubble, but you can take measures to minimize the amount of bacteria and other harmful microorganisms that come in contact with your healing septum piercing. Avoid soaking in baths, swimming in pools, or bathing in any other communal water while your septum piercing heals. Wash your hands often and well, preferably using antibacterial soap or following up hand-washings with hand sanitizer. Don’t engage in long snogging sessions that could spread your partner’s oral bacteria all over your face. Don’t twist, turn or slide your septum jewelry to loosen crusties; instead, use the soak-and-wipe suggestion in the bullet above. You should also avoid wiping your nose with your bare hands or used tissues. If you have to wipe or blow your nose, always use a clean tissue to gently dab at your nostrils or carefully blow your nose.
- Don’t Apply Soap Directly to Your Septum Piercing. Soap is drying, so when you wash your face, avoid the area around your septum piercing, including your upper lip. It’s okay if sudsy water washes over your septum piercing when you rinse your face or hair; it’s just better not to apply soap directly to your piercing. Even if you develop a piercing problem, there are better options available than soap, with sea salt solution being at the top of the list. Science has proven that saline wash it the gentlest, most effective tool for cleaning any healing piercing. Your body will tolerate it much better than it would soap.
- Don’t Apply Creams, Oils, Balms, or Ointments to Your Septum Piercing. These things can clog your healing fistula (piercing hole), potentially trapping in bacteria and triggering an infection. If the skin around your septum piercing is dry and/or begins to crack, the best thing to do is to enhance your sea salt solution soaks with tea tree oil, as suggested in our “How to Clean a Septum Piercing” section below. Tea tree oil is a natural moisturizer and antiseptic that can work wonders for dry, irritated skin when diluted in sea salt solution.
- Don’t Change Your Septum Jewelry Prematurely. Even after you reach the six-week mark in the septum piercing healing process, your fistula will still be new and tender, which may make it hard for you to change your septum jewelry yourself initially. Over time, your fistula will strengthen and reinforce, making it progressively easier to change your jewelry. If you really want new jewelry inserted as soon as your septum piercing is fully healed, it’s best to have your piercer make the switch for you.
- Don’t Smoke, or at Least Minimize Your Nicotine Intake. Nicotine has a systemic effect on the body that delays its ability to heal. If you’re a heavy smoker, work to cut back or quit before getting any piercing, including a septum piercing. If you can’t give it up entirely, cutting back some is better than nothing. You can also try substituting regular cigarettes with an e-cigarette that releases water vapor instead of drying smoke. The E-juice for our Smokenhot electronic cigarettes comes in different nicotine levels, so you can get one with a lighter nicotine content, if desired. Nicotine gum, patches and lozenges are other good options to try, at least while your septum piercing is healing.
How to Clean a Septum Piercing
Keeping your septum piercing clean involves misting it with a quality piercing aftercare spray 3-6 times per day throughout the healing process and doing two full sea salt solution (SSS) soaks per day for at least the first few weeks after getting pierced. There are two methods for getting your full SSS soaks in each day:
- Simple Sea Salt Solution Soak Method – Gather up a handful of clean cotton balls, your piercing aftercare spray, and tea tree oil as needed for dry or irritated skin. Saturate a cotton ball with aftercare spray, add a single drop of tea tree oil to it, if desired, and gently press the wet cotton ball against your septum piercing. After 30 seconds or so, throw it away, and repeat with a fresh cotton ball. Continue this process until you’ve applied saline solution with or without tea tree oil to your septum piercing for a total of five minutes.
- Homemade Sea Salt Solution Method – If you want to use homemade sea salt solution during your twice-daily soaks, you’ll need a good quality sea salt (not table salt, which contains iodine) like our Recovery Sea Salt From the Dead Sea, sterile water, and possibly tea tree oil. (If you need to buy tea tree oil and sea salt, consider buying our Recovery combo pack to save money on high-quality SSS ingredients.) You can boil tap water for five minutes to sterilize it or purchase sterile water. Measure out one cup of water, and mix in 1/4 tsp. of sea salt. Enhance the cup of SSS with 2-3 drops of tea tree oil, if desired. Once the salt has fully dissolved in the water, use a series of clean cotton balls to apply the solution to your septum piercing until you’ve kept it saturated for a total of five minutes.
If you feel that you need to incorporate an antiseptic piercing spray into your septum piercing aftercare regime because you’re experiencing a piercing problem, try a product like Tattoo Goo’s X-Pressions Extra Strength Antiseptic Piercing Aftercare Spray or X-Pressions Antiseptic Piercing Swabs. These products are formulated for healing and irritated piercings, making them superior to general antiseptics like hydrogen peroxide. Initially, you should only use an antiseptic rinse or swab once a day, in between sea salt solution soaks and aftercare spray mistings. (You don’t want to wash away one cleanser with the other.) If your piercing problem persists, you can increase to twice-a-day applications. Beyond that, you should explore other remedies to your piercing problem. Use the information in our “Septum Piercing Problems” section below to identify the exact problem you’re experiencing, and then try our suggestions for remedying that particular issue.
Septum Piercing Problems
There are a number of issues that may present around a septum piercing if your septum jewelry is a poor fit, if you’re exposed to harmful microorganisms, if you’ve been neglecting your septum piercing aftercare regime, or for other reasons that sometimes aren’t obvious. Read through this section to familiarize yourself with potential septum piercing problems so you can quickly identify and address any issues you experience with your healing septum piercing.
Severe Swelling With or Without Bruising
Starter septum jewelry is either extra long or has a large diameter to accommodate any swelling that occurs during the healing process. If your nose swells severely, though, there’s a chance your septum jewelry may begin to cut into your skin in an uncomfortable and potentially harmful way. Prolonged pressure on a fistula can cause necrosis (tissue death), which can lead to infection, so it’s important to get the pressure off ASAP. Consider taking a non-steroidal anti-inflammatory drug like acetaminophen (e.g. Tylenol) to help reduce swelling. Ibuprofen (e.g. Advil) and aspirin aren’t ideal alternatives, since ibuprofen can cause additional bruising and aspirin thins the blood. If acetaminophen doesn’t help and you haven’t experienced any bruising, you can try a little ibuprofen once the acetaminophen is out of your system (usually within 4-6 hours) and see if that’s more effective. It just shouldn’t be the first thing you grab for swelling.
Applying cool compresses gently to your swollen nose may also help reduce swelling. Get a clean wash cloth, soak it in cold water, and gently apply it to your nose until the cloth warms up. 
At that point you should either stop or grab a new washcloth before applying more cold water to your swollen nose. If you have a very small cold gel pack, you can use that instead. Just wrap it in a clean paper towel or thin cloth before gently pressing it against the underside of your nose.
After taking a non-steroidal anti-inflammatory and/or applying a cool compress, see if the swelling around your nose has gone down at all. If it hasn’t and your jewelry is cutting into your skin uncomfortably, visit your piercer as soon as possible. S/he will be able to outfit you with better-fitting septum jewelry until your swelling subsides.
If your swelling is accompanied by any degree of bruising, don’t be alarmed. It will go away with a little time, so be patient. There’s nothing you can do to minimize bruising except to avoid ibuprofen and aspirin.
Infected Septum Piercings
Sometimes despite their best efforts, people with new septum piercings develop infections. The signs to watch out for are discharge of thick, yellowish pus instead of harmless clear lymph that dries to a whitish crust, red streaks radiating out from your piercing site, skin that’s hot to the touch, and in some cases fever. If you suspect you might be developing an infection, ramp up your septum piercing aftercare regime immediately. Do 3 full sea salt solution soaks per day, and add an antiseptic piercing rinse or antiseptic swabs to your cleaning routine once or twice a day as needed. Continue misting your piercing with a quality saline wash like Recovery Piercing Aftercare Spray 3-6 times per day in between your full SSS soaks and antiseptic rinse applications.
If your symptoms of infection don’t begin to go away over the first few days after ramping up your septum piercing aftercare regime, or if your symptoms get worse at any point, see your family physician right away. S/he will be able to prescribe an antibiotic if one is needed. Make sure you take the full course, and continue your enhanced aftercare regime while you take the antibiotic. It’s best that you not remove your jewelry while your infection clears up either. If bacteria got trapped inside the closing fistula, it could cause an abscess to form. If you do remove your septum jewelry, be sure to continue your septum piercing aftercare regime until the fistula is fully closed.
Migration or Rejection of Septum Jewelry
If your piercer missed your sweet spot and pierced your septum too low, there’s a chance your septum jewelry may begin to migrate out and/or be completely rejected over time. If you notice the position of your piercing has shifted, ask your piercer if there’s enough room to insert heavier-gauge septum jewelry to slow down and hopefully halt the rejection process. 
Alternatively, you can remove your jewelry, care for your fistula as it closes, and get re-pierced in 6+ weeks. That’s probably your best option if your piercing was placed incorrectly from the start.
Septum Piercing Hypergranulations
Hypergranulation issues sometimes develop around piercing sites in response to excess moisture, excess pressure, or a combination of the two things. Hypergranulations may present as angry-red, puffy tissue all or partway around your septum piercing, or you may develop a red or pinkish piercing bump that appears fluid-filled. 
This is also a hypergranulation problem, but the coloring and taut tissue sometimes causes people to mistakenly think they’re developing a keloid scar instead. You’ll know the difference if the irritation forms immediately around or by your piercing and doesn’t progress any further. Very few people actually develop keloid scars, but for those who do, the scar tissue will grow out of control well beyond the piercing site.
If you develop a hypergranulation around your septum piercing, see your piercer and ask him or her to replace your septum jewelry with larger, more loosely-fitting jewelry. Getting the pressure off in combination with an enhanced septum piercing aftercare regime like that described in the “Infected Septum Piercing” section above is usually all it takes to reverse a hypergranulation issue. It may take a week or more for the problem to fully dissipate, but it should go away with time and proper septum piercing care. If the issue persists, note whether or not you regularly suffer from a runny nose. If you do, the moisture constantly coming from your sinuses could also be contributing to your hypergranulation problem. In that case, try taking an antihistamine like Benadryl once or twice a day as needed during the rest of the healing process to dry up your runny nose.
Septum Piercing Scars
The two most common types of scars that form around healed septum piercings or over top of retired septum piercing holes are hypertrophic scars and atrophic scars, respectively. Hypertrophic scars aren’t likely to form during the initial septum piercing healing process, but anyone can develop them at any time. They’re characterized by fairly skin-colored, raised scar tissue forming immediately around either the entry or exit point of a septum piercing. Atrophic scars tend to only form where septum piercing holes once were. These are recessed scars that are also usually close to the same color as your natural skin tone; they’re the result of new tissue failing to entirely fill your closed fistula, leaving you with a little divot at the entrance and/or exit points of your retired septum piercing. 
Fortunately, if you develop either a hypertrophic scar around your septum piercing or an atrophic scar where a retired septum piercing once was, it likely won’t be noticeable to anyone else but you. That said, if you want to try to reduce or eliminate the scar tissue, both types of scars can be easily treated at home with silicone scar therapy gel or jojoba oil, if you prefer a more natural treatment option. Whichever product you use, just rub a small amount into the scar tissue twice a day until the scarring is sufficiently minimized or eliminated altogether. The process may take months, but it’s non-invasive and more effective than alternatives, like having a hypertrophic scar surgically removed.
The third type of scarring is a type that most people will never have to worry about: keloid scars. Keloid scarring tends to be a hereditary issue, so if someone in your immediate family is prone to developing keloids, you may be, too. Most people will find out at a young age if they’re prone to getting keloids, because they’ll form around any wound, not just piercings. If the first major “wound” you ever have is a piercing, it’ll likely be an earlobe piercing that will alert you to the fact that you have a genetic predisposition to keloid scarring. Those few who do develop keloid scars around a septum piercing will need to seek professional help from a dermatologist. Treatment options include surgical removal, cryogenically freezing off the scar tissue, lasering off scar tissue, and/or injection of corticosteroids to reduce inflammation in the scar tissue. Some doctors also recommend using a silicone scar therapy gel or jojoba oil in conjunction with one or more of those medical keloid treatment options.
Changing Your Septum Jewelry
As mentioned earlier, the longer you wait to change your septum jewelry, the easier it will be for you to do it yourself. If you want to get your jewelry changed right at the 6-week mark, ask your piercer for help. Beyond that, you can try one of these tricks for replacing your jewelry yourself as smoothly as possible:
- Use your new septum jewelry–which should be the same gauge as your existing septum jewelry the first time you change jewelry yourself–to carefully push the old jewelry out while threading the new jewelry through your piercing.
- Get a piercing taper that’s thickest point is the same gauge as your current jewelry, remove your jewelry, apply a tiny drop of water-based lubricant to the end of the taper, insert it partway into your septum piercing, and then use the taper to work your new jewelry into your septum piercing.
If you have trouble getting your new jewelry in, see your piercer ASAP so your piercing doesn’t begin to close up on you and prevent you from inserting any new septum jewelry at all. After changing your septum jewelry, you may want to re-start your septum piercing aftercare regime and continue doing daily saline rinse and sea salt solution applications until the tissue around your piercing calms back down.
Choosing New Septum Jewelry
Unlike your starter jewelry, the jewelry you wear once your septum piercing is fully healed doesn’t necessarily have to be surgical stainless steel or titanium. There are many other material options available, including 14k white or yellow gold, sterling silver, niobium, and clear mono-filament (usually used to make septum retainers). We offer an extensive selection of septum jewelry with options made of these materials and more and that come in a variety of gauges and styles. 
Some feature jewels, others are simpler designs. Have fun exploring your many septum jewelry options!
Stretching Your Septum Piercing
If you want to stretch your septum piercing to the next largest gauge, it’s best to wait until you’ve had it for at least 9 weeks, if not longer. 
Don’t attempt to stretch at all until you’ve successfully inserted septum jewelry yourself at least once, and don’t start stretching immediately after inserting new jewelry, because your fistula will be irritated from the jewelry change. For a week or so before beginning the stretching process, it’s best to apply emu oil to the skin around your piercing to increase its natural elasticity. When you’re ready to make the change, only go up a single size at a time at most. If you go up a full size, you’ll need to wait one-and-a-half times as long as it took for your septum piercing to heal initially before attempting another stretch.
A better alternative is to slowly stretch your septum piercing over time by adding a single layer of stretching tape to your septum jewelry every week or two. Once you get up to the next full size, you can replace your taped-up jewelry with jewelry in the next gauge up, and then begin the process again, if you want to stretch further.
More Septum Piercing Information
To learn more about septum piercings, check out these informative nose piercing articles from our Piercing Information library:
If you’re interested in seeing septum piercing photos that our online community members have shared, visit the Septum Piercing Pictures section of our photo gallery. Check out the Facial/Oral Piercings section of our online forum to read about other people’s septum piercing experiences. If you want to share your own septum piercing photos, questions or stories, just sign up for a Painful Pleasures account.
