A dermal piercing can be the most misunderstood piercing. This rare form of expressing your personality can be overwhelming if you don’t know what it is and how it’s done.

What is a dermal piercing?

Dermal piercings are also known as single-point piercings. Single point piercings used in dermals don’t have the usual separate entry and exit point. These piercings are trickier to change, clean and care for because it doesn’t pierce through the skin, rather it’s embedded in and sits inside the dermis layer with an anchor keeping it in place.

Dermal jewelry is screwed into the top of the post, which sits on the surface layer, giving the appearance of beads on your skin. Now you might wonder if that sounds similar to surface piercings. But dermal jewelry sits on the top layer of your skin, while surface piercings have a separate entry and exit point. They’re anchored using barbells shaped like open staples. This barbell is inserted underneath the skin. Decorative tops rest on the skin’s surface.

A dermal piercing can be placed on the area of skin which is flat. Popular areas include the:

• cheekbones
• nape of the neck
• chest 
• lower back
• abdomen
• thighs

You can get a dermal piercing pretty much everywhere, which is part of the reason why it’s gained popularity. When choosing your dermal piercing location, you need to keep in mind that those done in bonier areas, like the sternum or cheekbone, often see rejection and migration because the skin in these areas isn’t very thick. Additionally, your piercer will need to be aware of nerve endings and veins in the areas where you want to get pierced.

How are Dermals inserted?

Dermals can be inserted to almost all parts of the body where the skin is thick enough to hold the dermal anchor in place. For the dermal anchor, the piercer will create one small hole so that an “anchor” can be inserted into the middle layer (dermis) of your skin. The base of the dermal anchor is usually 6 or 7 millimeters long, just enough to secure the post.

With a dermal piercing, a qualified technician will sterilise the area and then use either a “dermal punch” to remove a small tube of flesh, or a needle to make an L-shaped pouch. Then, using dermal forceps, an anchor with either a footed or round base is inserted into the area.

In order to get a dermal piercing, your piercer will either use a piercing needle to open a hole beneath the skin by separating the tissue, or they will use a dermal punch to remove a small chunk of tissue beneath the skin where the dermal anchor will be inserted. 

While the dermal punch may seem more painful, most report that the dermal punch is far less painful than using a needle. This is because the dermal punch is so sharp, and the skin is removed so quickly, people barely notice. Many piercers will highly recommend this method. However, in some states, dermal punches are illegal unless conducted by a medical professional, so make sure that it’s an approved method in your state.

Do dermal piercings hurt?

As we’ve mentioned before, getting a dermal piercing anywhere means that the pain depends on where you get pierced. Aside from that, your personal pain threshold and piercer’s experience level will have an effect on how much pain you feel. 

Are dermal piercings permanent? How long do dermal piercings last?

There’s no real timeline for a dermal piercing. But it is very common for the skin to eventually grow and push the anchor up to the surface until it falls out. Whether this happens within the next four months or four years is in your hands and in your after case. 

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 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.
• For these piercings go for a larger gauge. 16- and 18-gauge barbells are small and more likely to migrate than a 14 or 12.

Does removing a dermal piercing hurt?

If there is ever a time where you need to remove a dermal piercing, like for work or for photos, you must see your piercer instead of attempting to remove this type of piercing on your own. 

When you go to remove the piercing, he will 

• Clean the area with an alcohol solution, 
• Descrew the jewelry top, 
• Massage the surrounding area to help dislodge the anchor.
• Use a scalpel to make a small incision relative to the size of the anchor base.
• Use the scalpel to remove any scar tissue that has formed around the anchor.
• Utilize forceps to pull the anchor out of the skin. 
• Apply a suture or bandage to the piercing site. 

There Are Two Removal Methods:

1. The area of the piercing site and its surroundings are gently massaged to dislodge the anchor from its location. Then 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 though. 

Do Dermals leave scars?

Some people are more sensitive to scarring than others. If you have a family history of keloids, which is an overgrowth of sprawling scar tissue, then a dermal piercing is not for you. 

A hypertrophic scar is another issue though. A hypertrophic scar is flatter and smaller similar to your natural complexion then you can apply jojoba oil after the piercing has been removed to shrink the scar down. However, if you don’t want to scar, make sure the anchor is removed cleanly by a good piercer (or medical practitioner in case of rejection) and correctly and the wound is kept clean. Do not remove it on your own at home.

Dermal piercings see a high rate of rejection, since a foreign object is being inserted beneath the skin, and often dermals appear in places where the piercer simply can’t pierce deeply enough to avoid rejection. Throughout the entire life of your dermal piercing, and especially during healing, keep an eye out for signs of rejection. These signs include red and flaky skin around the piercing site, a growing fistula (piercing hole), and jewelry that has clearly shifted. If you catch it quickly enough, piercing rejection should be nothing more than a minor inconvenience. However, if you wait too long to remove the jewelry, it could lead to permanent scarring. If you see signs of rejection, talk to your piercer about your options.

If deep, permanent scarring has already occurred, you may be able to minimize the appearance of scarring with a hyaluronic acid dermal fillers administered by a licensed professional.

Can a dermal reject after a year?

Yes, in fact it is common for dermal implants to migrate or reject. Usually it can take a few years depending on the location and the amount of contact the area gets. For some who are unlucky, rejection is random. 

Rejection happens when tissue grows in and around the piercing over time. Jewelry accessories tend to migrate and reject over time. When you first get it done, care for dermal piercings very carefully. These piercings are easy to snag, bump and tug, which can hurt like hell. It’s worth noting that even if you get through the initial months of cleaning and looking after this baby that over time your body might reject it just for the heck of it. 

How do I know if my dermal is rejecting?

You’ll know this is happening because it will slowly be ejected from the skin. But, to ensure it lasts as long as possible keep it (and yourself) clean, use things like antibacterial soap and only touch it with washed hands. Do the normal stuff, like showering and eating and sleeping, and your body will fill in the rest of the healing. Essentially the thing is a surgical incision so don’t go squeezing your luxe shower gel into the wound and making it sudsy. Consider buying a saline solution mist or liquid that you can dab on twice a day with a cotton bud with a drop of tea tree oil. 

If your dermals start to reject or get displaced, go back to your piercer. 

Dermal Piercing Jewelry 

Dermal piercing tops come in tons of varieties that are done with a needle or with a punch. You can get simple beads, beautiful opals and gemstones, cute charms, and more. Here are the common types: 

• Anchor: Many piercers recommend a footed anchor with holes for a stronger base that will last for years to come. You can also get a round base. Both shapes come with or without holes. It’s best to talk to your piercer about what they recommend for you and your piercing. Once you’ve chosen the best anchor for you, you’ll get to have fun picking out cute dermal tops.
• Diver:  Divers are pointed-end bases with preset jewelry on top done with a puncher. Unlike the typical anchor and topper style, divers aren’t interchangeable.
• Top: Once the anchor is in place, your piercer will top off the anchor with the type of jewelry you’ve picked out. Examples include metal studs or magnetic gems.

As you heal, if you want to switch out your dermal top, you should have your piercer do it. When you twist the top to replace it, it can put pressure on the healing anchor, displacing it. Your piercer will have the tools and know-how to safely change the top. 

After you heal, you should be able to change the top on your own. If you struggle with it, you can always have your piercer change it. You can also buy tools like a dermal holder tool to make changing your tops easier. However, if you find yourself messing with your jewelry too often, you should have a professional change out your jewelry; dermal piercings are in great danger of rejection, and the more you move the jewelry, the greater the risk.