Surface Piercing Aftercare | Painful Pleasures Community

Surface Piercing Aftercare

Proper surface piercing care is critical if you want your new or irritated piercing to heal well, and we have all the info you need right here. In this Surface Piercing Aftercare guide, we'll teach you how to keep your surface piercing clean, what you can and can't do during the healing process, what problems to watch out for, what you should do if you experience certain surface piercing problems, how to change your surface barbell tops, and more.

by Emily Starkman Last Updated: April 5, 2022

Temple Piercing | Facial Surface Piercings Proper surface piercing care is critical if you want your new or irritated piercing to heal well, and we have all the info you need right here. In this Surface Piercing Aftercare guide, we’ll teach you how to keep your surface piercing clean, what you can and can’t do during the healing process, what problems to watch out for, what you should do if you experience certain surface piercing problems, and more.

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 barbell, 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.Surface Piercing in Progress (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 Care

Surface piercings take a minimum of three months to heal, and often longer. During that time, there are a number of things you should and shouldn’t do if you want your new piercing to heal well. Following the guidelines below will help you avoid surface piercing problems and enjoy your piercing for many years to come.

What You Should Do while Your Surface Piercing Heals

  • Do Keep Your Surface Piercing Clean. Recovery Piercing Aftercare Spray 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. X-Pressions Extra Strength Piercing Antiseptic Rinse 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. World's Thinnest Dermal Surface Anchor Holder Tool 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.

Sea Salt Solution Soaks

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 washRecovery Aftercare Sea Salt From the Dead Sea and Tea Tree Oil Combo Pack 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. To save money on quality ingredients for homemade sea salt solution, check out our Recovery Aftercare Sea Salt & Tea Tree Oil Combo Pack.

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 SwellingSwollen Surface Piercings | Surface Piercing Pictures on

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.Dermal and Surface Piercing Healing Posts
  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, Rejecting Surface Piercing | Migration and Rejection 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 InfectionsX-Pressions Piercing Antiseptic Swabs

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. Surface Piercing Hypergranulations 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.

Types of Piercing Scars

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.

To learn more about surface piercing scars and the best ways to address each type, read our Body Piercing Scars article.Jeweled Tops for Surface Barbells | Surface Barbell Tops

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.

Opal Surface Piercing Tops | Surface Barbell Tops If you’re looking for unique surface piercing tops, you’ll find an extensive collection of options in varying diameters and materials in our Surface Barbell Tops section. Choose from simple steel balls, spikes, jeweled tops, custom-made 14k gold surface barbells tops, opal balls and discs, dermal tops shaped like bees and dragonflies, and other cool surface barbell tops.

More Surface Piercing Information

Surface Piercing Staples If you’d like to learn more about surface piercings, be sure to check out our other surface piercing articles and blog posts:

You can also join our online community to participate in surface piercing forum conversations and get full access to our piercing photo gallery. Once you’ve signed up for an account, you’ll be able to rate and comment on other people’s photos, share piercing pictures of your own, post questions in our forum, and more.

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