Including where each type ranks on the pain scale.

By Caroline Shannon-Karasik
Nov 11, 2019 @ 6:00 pm
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When it comes to ear piercings, you're likely familiar with the tried-and-true lobe variety you snagged in grade school at your local Claire's.

But if you've looking to up your ear jewelry game with a cartilage piercing, it can be overwhelming once you delve into the world of daith, conch, and helix piercings. And, of course, there’s always the ultimate question: How bad will it hurt? (Spoiler: it depends on the person and the piercing; more on that below.)

Thinking about getting a cartilage piercing? Here’s everything you need to know, including the various styles to choose from, and what to expect while your cartilage piercing heals.

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What are the different types of cartilage piercings?

Put simply, a cartilage piercing is located in an area where the ear tissue is more rigid compared to the earlobe, explains fine jewelry designer Maria Tash, who owns several piercing stores.

However, there are several types of cartilage piercing styles. Here are a few of the most popular:

Helix: Your standard cartilage piercing and the most popular style, located on the upper, outer rim of your ear. 

Rook: This piecing is located in the upper ear through what is known as the antihelix — aka the fold that's right beneath the rim, or helix of the ear.

Tragus: This piercing goes through the tiny piece of cartilage that hangs in front of the ear canal.

Earhead: Also known as a 'forward helix', this is a piercing in the outer rim of your ear, directly above the tragus.

Daith: This piercing occurs through the ear's inner fold of cartilage. (For what it's worth, some studies show daith piercings may help ease anxiety and alleviate migraine pain by compressing specific pressure points.)

Conch: There are two types of conch piercings: Inner and outer. The inner conch piercing is placed through the middle ear and decorated with a stud. The outer conch piercing (or "orbital") is pierced through the outer part of the ear's cartilage, like the photo below. This conch piercing actually requires two piercings, so have a friend nearby for when you need a hand to squeeze.

OK, how bad will it hurt? 

While it would be nice to know exactly what to expect in terms of pain, it's important to keep in mind that pain level is subjective, Tash says. “The pain level associated with each area of the body is usually a function of how nerve dense the area is and how thick the tissue is," she explains. (So you can count on, for example, the conch piercing ranking up there on the yowza scale, while the rook is a bit milder in terms of pain.)

However, there are a number of factors that can make a difference in the level of pain you experience, including the quality of the needles, the skill of the piercer, the comfort level with the piercer and the level of anxiety of the client, Tash says.

All of that being said, cartilage piercings are known for hurting more than your average ear lobe piercing. Plus, it takes longer for cartilage piercings to heal (six to 12 months), so you’ll likely experience more long-lasting pain than you would with a traditional earlobe piercing.

Does it matter what jewelry I choose?

While you may be more focused on the aesthetics of your new piercing, choosing the right jewelry is important for preventing infection, too.

"The main caution I have for patients getting piercings through cartilage is to make sure that the earring used is made of stainless steel or is hypoallergenic," says Erum Ilyas, M.D., a board-certified dermatologist.

There's another reason to be careful about the metal you're using. She explains that it's not uncommon for piercings to ‘tattoo’ the skin on the ears (which can also be an issue for nose piercings) as a result of using silver jewelry. Otherwise known as "localized cutaneous argyria," Dr. Ilyas says the imprint can be removed with lasers, but is also easily avoided by choosing the right jewelry in the first place.

What about who does my piercing? 

You’ll also want to make sure you choose a piercer who makes you feel comfortable, Tash says. This includes someone who is willing to discuss the inspiration behind your piercing, whether it be through photos or the type of jewelry you are seeking, as well as a piercer who can address the best way to achieve (and heal) your vision.

“Ask to see the room in which you will be pierced and ask how the process is done,” Tash explains, noting that it should include single-use disposable needles and an autoclave to sterilize body jewelry and all the tools used during the piercing process.

You can also double-check that they have proper licensing. "Many states and counties do have licensing requirements for body piercing and tattoo artists," Dr. Ilyas says. "This generally involves proven training in the field, but also an understanding of bloodborne pathogens through OSHA (Occupational Safety and Health Act) training or courses. If someone is knowledgeable they will be less likely to cross-contaminate and put your health at risk."

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What's the aftercare and healing process like? 

Keeping your ear clean is the number one thing to keep in mind while your piercing heals, Dr. Ilyas says. She recommends washing the area gently with soap and water, then blotting dry.

"If a little oozing, crusting, or scabbing develops, take a cotton tip swab soaked in saline and gently wipe the edges of the piercing," she explains.

Tash agrees, adding that you’ll want to limit how often you are cleaning the piercing because “over-cleaning can create irritation.” Stick to cleaning your cartilage piercing twice per day until it’s healed. Tash says you can also help to keep piercings clean by changing your bedding frequently.

“When you sleep, the body creates dander which irritates fresh piercings, so it’s important to keep your bedsheets, and especially pillowcases, clean,” Tash says.

Speaking of sleeping, you’ll want to keep from lying on your piercing to avoid pulling at it or caught it caught on something, Dr. Ilyas says.

But the most important rule? Wash your hands, Tash says, emphasizing that you should never put unclean hands anywhere near your cartilage piercing and, really, just avoid touching it altogether. 

In the event you notice swelling, thickened scar tissue, bumps and/or tenderness, you should see your dermatologist, Dr. Ilyas says. While an infection doesn't have to mean the loss of a piercing, she says it will require quick care — such as ain injectable steroid — to reduce the inflammation and speed up the healing process.

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