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Dermal Piercing: Pictures, Procedure, Aftercare, and Risks

Dr. Rajesh M, is a medical doctor with MD in Internal medicine and currently a resident in Endocrinology.

Face dermal piercing

Face dermal piercing

What Is a Dermal Piercing?

A dermal piercing, also known as a microdermal piercing or a single-point piercing, is a piercing that lies on any flat surface of the body and is held in place with a dermal anchor that is installed underneath the skin. Ordinary body piercings have entry and exit points for the jewelry, but, in a dermal piercing, the jewelry sits on the surface and is secured with an anchor that is embedded in the dermal layer (underneath the flesh). This gives the appearance of having small beads on the surface of the skin.

This type of surface piercing is popular nowadays because it can be placed on almost any flat surface of the body, which allows you to decorate areas that are difficult to pierce with regular piercings.

You can form patterns using multiple dermals, or you can also attach an ornament, which is popular with dermal finger piercings. The customization options are endless!

How Are Dermal Piercings Done?

If you are completely new to this type of body modification, then you are wondering how dermal piercings work.

Because there is no exit point, the jewelry enters the body and is then held in place with an anchor that is inserted under the surface of the skin. Either a needle or a dermal punch is used to remove a small piece of your flesh, which creates a small hole in the skin. Then, a footed or round-based dermal anchor is inserted into the area. Finally, the jewelry is screwed onto the anchor.

Inserting a dermal piercing

Inserting a dermal piercing

Installing a Dermal Piercing With Needles

Installing a dermal piercing using a skin needle is similar to other conventional piercing procedures, but the needle makes an L-shaped pouch in the skin instead of just a hole.

The Process:

  1. The area is sterilized using surgical scrub.
  2. The area is marked with ink for precision.
  3. The needle is inserted into the skin and then pulled out. (This creates a pocket or pouch where the anchor will be inserted.)
  4. Using forceps, the piercer will insert the base plate of the anchor into the hole or pocket that was created earlier. The anchor is pushed in until it is completely underneath the skin and parallel to the surface.
  5. The jewelry is then screwed onto the screw head. Sometimes, the jewelry is attached before the procedure.

Note: Needles used must be specially made for piercing or medical procedures. Choosing the appropriate needle size depends on the location of the piercing and the anatomy of the client's skin.

Dermal Piercing With a Dermal Punch

When a dermal piercing is done with a punch, the pouch is made in a different way.

When using a needle, the pouch is made by separating the skin, but when using a dermal punch, the pouch is made by removing a bit of tissue. The base plate, the anchor, and the jewelry are then inserted.

Microdermal piercings are more commonly performed using a dermal punch because the punch is less painful. It is also safer than a needle because it has a protective mechanism that prevents the piercing from going too deep into the skin.

Note: The use of dermal punches by non-medical personnel is not legal in some places.

What's the Difference Between a Surface Piercing and a Dermal Piercing?

Most people use the terms dermal piercings and surface piercings to mean the same thing, but usually, when people refer to surface piercings, they are talking about barbell piercings that sit on the surface of the skin.

Unlike conventional dermal piercings (microdermal implants), surface piercings (transdermal implants) are more invasive and have an entry and exit point. Instead of the jewelry being secured with an anchor, a barbell is inserted into the flesh so that both ends of the barbell stick out from the skin while the middle bar sits below the flesh. To make way for the jewelry, the piercer will pinch the skin and stick a needle through to create the passage way.

How Do Dermal Piercings Stay In Place?

The dermal anchor has a base that holds the jewelry at a 90-degree angle. This base has holes in it (some small and some large). When the anchor is placed under the surface of the dermis, the skin begins to heal around the anchor, and new skin will grow through the hole and attach to the skin on the other side. Because skin grows through the hole, the anchor should stay in place without budging.

Risk of Migration and Rejection

Of all the types of body piercings, dermal piercings are the most prone to migration and, eventually, rejection. This means that before the skin can grow around the jewelry, the body will defend itself against this "foreign object" by pushing the jewelry closer to the surface of the skin until it is completely removed.

Dermal implants are at high risk of rejection because they cannot penetrate deep into the skin. The less skin there is to keep the jewelry in place, the more chances the body has of pushing it out.

How to Keep a Dermal Piercing in Place?

Unfortunately, some people's bodies will reject everything, so if you experience rejection once, then it is likely to happen again. With that said, you can minimize the chances of rejection by following these tips.

  • Choose an area on the body with more skin. Locations where jewelry is most likely to be rejected include the sternum, anywhere on the face, the nape, and the throat area (a.k.a. madison piercing). The back or the thighs are areas that are least likely to reject because there is more skin to work with.
  • Try using titanium or niobium rather than stainless steel.
  • If you are getting a surface piercing, try a larger gauge. 16- and 18-gauge barbells are small and more likely to migrate than a 14 or 12.
Cheekbone piercing

Cheekbone piercing

Types of Microdermal Jewelry

  1. Dermal Anchors: There are two types of dermal anchors. There is the flat-footed dermal anchor and the rounded-base variety. The footed one is more secure because the foot is angled, so it is less likely to pop straight out of your skin.
  2. Dermal Tops: This is the jewelry that is screwed on the top of the anchor. This can be changed. Usually, a piercer will screw and unscrew the microdermal stud for you because it requires careful maneuvering. If you don't want to go through the trouble of seeing a piercer every time you want a change, try getting a magnetic top.
  3. Barbells: Micro barbells are preferred for surface piercings that have an entry and exit point on the surface of the skin.
  4. Skin Divers: A skin diver has a pointed-end base and a piece of jewelry on the top. To insert, the piercer makes a biopsy punch to create a pouch where the base will sit. Once the skin heals over, the jewelry cannot be interchanged.


  1. Titanium or Anodized Titanium: This is the safest option for those with sensitive skin. It is the least likely to cause irritation. Anodized titanium is any metal that is coated with titanium.
  2. Surgical-Grade Stainless Steel: This is the most popular material used for body jewelry. It is safe, but there is a chance that it can cause irritation.
  3. Niobium: Like titanium, niobium is hypoallergenic and non-corrosive.
Neck dermal piercing

Neck dermal piercing

Healing Time

The healing time is one to three months, but may take longer depending on the location. During this time, it is important to protect the piercing from being pulled, moved around, or accidentally removed. The piercing may get caught on clothes or towels, so care must be taken when drying the body. Fabrics with small holes should be avoided.

For further information on Dermal piercing pictures aftercare, read the article in the link.


  • After the piercing procedure is finished, the area is covered with a dressing or Band-Aid for up to a few days.
  • After that, you should clean the area using a homemade sea salt solution twice a day. Dissolve ¼ teaspoon of non-iodized salt in one cup of warm water and use a clean cotton ball to dab the area. You can also spray the solution on to the piercing. Gently dry the area with a tissue or a paper towel using a dabbing motion. A new tissue or paper towel must be used every time the piercing is cleansed because used towels and tissues may accumulate dirt and bacteria, which will cause an infection.
  • Avoid using soaps as they are drying. It's okay if soapy water gets on the piercing in the shower, but don't apply soap directly to the area.
  • Every once in a while, you can dab some diluted tea tree oil onto the area using a cotton swab. Tea tree oil is naturally anti-fungal and anti-bacterial, but do not overuse it as it can be very drying.
  • Crusting is normal. You should not pick at it or try to remove it by force. Simply clean it using a saline solution to keep the area bacteria-free.
  • Follow these instructions carefully to reduce the healing time. If you are careless, you will incur an infection, which will prolong the healing process.

Changing a Dermal Piercing

You should have a professional piercer change your piercing, however, it is also possible to do it yourself. The only thing to be aware of is that force might move the anchor and cause it to become loose. Do this at your own risk!

  1. Sterilize the area.
  2. Using either your fingers or pliers, unscrew the top (tip: lefty loosey to unscrew).
  3. If the anchor base moves around, use an anchor holder to keep it down.
  4. Screw on the new anchor top (screw to the right this time).
  5. Clean the area with a saline solution and gently dry.

Removing a Dermal Piercing

If you want to remove a dermal piercing, you should get help from a professional piercer. Do not remove it on your own at home.

There Are Two Removal Methods:

  1. The area of the piercing is gently massaged to dislodge the piercing from its location. The piercer will twist the anchor to break the skin and allow for its removal.
  2. If the piercing is an old one, it may be more difficult to remove because tissues might have grown on the plate area. In this case, the piecer will make a small incision using a scalpel or use tweezers to work it out. Anesthetics may be used to minimize pain. You should expect scarring.
Most tragus piercings are cartilage piercings in which the jewelry goes through the cartilage in the tragus area of your ear. Vertical tragus piercings only go through the skin.

Most tragus piercings are cartilage piercings in which the jewelry goes through the cartilage in the tragus area of your ear. Vertical tragus piercings only go through the skin.

Dermal Piercing Risks

  1. Tissue Damage: The primary risk of dermal piercing is tissue damage, especially when the piercing is done by a person other than a professional body modification expert. The dermal layer contains nerves and blood vessels, which may be damaged when the piercing is not installed properly. If the piercing is installed too deeply in the skin, it may pull the skin layers together, which causes embedding. If the piercing is too shallow, it can migrate. While healing, it is important to avoid twisting or pulling the implant, or snagging it on clothing or towels.
  2. Infection: Infection can happen when the equipment used is not sterilized or when the piercing is not cleaned regularly. An infection of the deeper layers of the skin and fat, called cellulitis, may be caused by airborne bacteria infecting the piercing location while the procedure is done. Symptoms of infection include inflammation of the surrounding area, redness, rash, pus, and/or pain. If you experience these symptoms, talk to your doctor right away. Antibiotics may be given.
  3. Hypergranulation: This is a red bump that appears around the fistula (the hole in your skin where the jewelry is placed). Hypergranulation occurs when the jewelry is too tight or there is too much pressure placed on the area. Do not cover the piercing too much; let it breathe. If your surface piercing is in an area where you wear tight clothing (such as the belt-line area), then wear looser-fitting clothes. Sometimes a tightly screwed anchor top might also be the cause. If you suspect the top is screwed on too tightly, go back to the piercer and ask them to loosen it up. Do not try to loosen it yourself while you are still healing.
  4. Scarring: You may experience scarring around the area if you remove the jewelry or it is rejected. To reduce scarring, keep the area clean and moisturize with a gentle oil, like jojoba oil. If deep, permanent scarring has already occurred, you may be able to minimize the appearance of scarring with hyaluronic acid dermal fillers administered by a licensed professional.


  1. Coffee, Maude. "Types of Piercing Needles." LiveStrong. July 18, 2017. Accessed October 30, 2017.
  2. Dickerson, Jamie. "Single Point Piercing, " Blue Boutique. February 22, 2012. Accessed October 30, 2017.
  3. Hudson, Karen L. "Piercing Guide—Surface Implants—Anchors, Dermals, and Micro-Dermals." LiveAbout. December 3, 2016. Accessed October 30, 2017.
  4. Prime Health Channel, "Dermal Piercing – Pictures, Procedure, Infection, Healing and Aftercare." February 19, 2011. Accessed October 30, 2017.
  5. "What's the Difference Between Surface and Dermal Piercings," Almost Famous Piercing. Accessed October 30, 2017.
  6. Laura, "Everything You Need to Know About Dermal Piercings," Painful Pleasures. August 27, 2014. Accessed October 30, 2017.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2013 Dr Rajesh


Eva on November 14, 2014:

I got a dermal piercing on my face over a year ago. It used to lay right on the skin, but now it is slowing coming up. I thought that when your body rejects the piercing, it would happen immediately. Didn't realize that it could happen so slowly. If that's what's happening with me, I might as well get it taken out. It's very disappointing! :( But I guess you have to consider that your body might reject the dermal piercing if you decide to get one. Is it worth it? I don't know... I love my piercing; however, it's coming out.

Leanne on November 07, 2014:

Iv had my dermal for well over a year iv got it on my wrist and iv had afew infections, this one has to be the most painful infection iv had it’s hot to the touch swollen and a red ring around it that’s getting bigger :-(

Keisha Hunter from Kingston, Jamaica on November 01, 2014:

Ouch! I love piercings, but some of these just seem like a bit much! I'd love to have the lower back ones, but i'm much too care-free to remember to be careful when dressing, sitting, etc. Kudos to you guys...

Sheyanne on October 07, 2014:

I have dermals in my forward helix. I just depends on where you go to get it done. I have 2 dermals and the 3rd (top one) is a regular piercing that comes out the back.

I honestly feel like getting dermals in your ear is the worst place you can get them. It's been trying to heal for a couple of months now and no luck.

But to the other people, yes. Those are dermals

jennelle on July 10, 2014:

I have four dermals on my hips and two are sinking in...Īm scared..n doesn't know what to do ..Īm even scared of getting them removed what should i do?

Amanda on June 07, 2014:

Triple anti helix DERMALS if the piercing doesn't have an exit point than it's a dermal piercing..

Ezza on May 17, 2014:

The first pics are actually triple ANTI helix piercings, not helix and not dermals.

Breanna on April 19, 2014:

I have 6 dermals 2 on my back 2 on my collar 1 on my side and 1 in my hip. The one on my hip is starting to sink in and it’s tender to the touch. I’ve had this specific dermal for about 3 months now. I can’t tell if it’s red cuz it’s on a black and gray tattoo. None of the other 5 dermals are doing this. I just recently started tanning in a tanning bed again, I use tanning lotion, and I also lay on my stomach while I tan. Could this be the reason my the dermal on my hip is sinking in because of the lotion and then laying on my stomach putting pressure on my hips/dermal?

james on March 21, 2014:

Sara, I was thinking the same thing. Clearly those are piercings, not dermals!!!

Sara on March 20, 2014:

Those are a triple helix, not dermals. Not even gonna read it now because they're obviously stupid

Amy on March 18, 2014:

I have a dermal under my collar bone didn't hurt half as much as I thought it might of. Looks really good and am just cleaning it well as I only had it done yesterday. It's not hurting only when I touch to clean.

mee on March 16, 2014:

It is scary to get them, because the way they get pushed in, i got one on my belly and it hurt really bad. But its never gotten infected and looks really cute. Only hurt for about an hour.