Surface piercings are dynamic body piercings that can be placed nearly anywhere on the body. Nape piercings, hip piercings, anti-eyebrow piercings, chest piercings, Christina piercings, and frenum piercings are just a few of the many different types of surface piercings from which you can choose. 
If you’re interested in this popular type of body piercing but want to learn more before you get one, these FAQs will give you all the info you need to get a surface piercing with confidence. Read through all of the most frequently asked questions and answers below for a thorough education on surface piercings, or jump right to specific answers to your surface piercing questions using the hyperlinks below.
Frequently Asked Surface Piercing Questions
Q. What Is a Surface Piercing?
Q. What Types of Surface Piercings Can a Person Get?
Q. How Are Surface Piercings Different Than Dermal Piercings?
Q. How Are Surface Piercings Placed?
Q. What’s the Most Popular Gauge for Surface Bars?
Q. What’s the Best Type of Surface Piercing Barbell?
Q. What Does Proper Surface Piercing Aftercare Entail?
Q. How Long Do Surface Piercings Take to Heal on Average?
Q. What Problems Can Arise With Healing Surface Piercings?
Q. What’s the Best Way to Change Surface Piercing Tops?
Q. Where Can I Buy Surface Piercing Jewelry?
Q. What’s the Best Way to Remove a Surface Barbell?
Q. Where Can I Find More Surface Piercing Information?
Q. What Is a Surface Piercing?
A. Surface piercings are double-ended piercings that have no natural entry or exit points the way that traditional double-sided piercings like lip and ear piercings do. They’re threaded beneath the surface of the skin and embedded in the secondary layer of tissue known as the dermis, typically while a portion of skin is being pinched up to provide entry and exit points for a piercing needle and anchoring hardware. The type of anchoring hardware used for most surface piercings is known as a surface barbell or surface piercing bar. Once a surface bar has been inserted beneath the skin, the only visible part of the jewelry should be the dermal tops that screw into each of the two posts on the surface bar.
Q. What Types of Surface Piercings Can a Person Get?
A. Surface piercings can be placed nearly anywhere on the body, including on the nape of the neck, the chest, the hips, the pubic mound, and more. The only areas you should absolutely avoid having a surface piercing placed are on/around joints that are in constant motion, since the movement and friction would work against the piercing and make it more likely to migrate out or reject entirely.
The following types of piercings are all surface piercings, but you aren’t limited to just these placement options:
- Eyebrow Piercings are usually placed vertically through the eyebrows.
- Anti-Eyebrow Piercings are upper cheek piercings that are often placed at an angle below the outer corner of one eye.
- Bridge Piercings are placed horizontally through the skin across the bridge of the nose.
- Nape Piercings can be placed vertically or horizontally through the back of the neck, but horizontal placement is much more common.
- Chest Piercings are placed between the collarbone and breasts, often in pairs and at angles, as in the photo above.
- Cleavage Piercings are typically placed vertically between the breasts.
- Belly Button Piercings are traditionally placed vertically above the navel, but they can also be placed below the belly button, on the left and/or right sides, or at any angle desired around the navel.
- Hip Piercings are most often placed at angles on the left and right hips to complement the lines of the body, as shown in the photo to the right above.
- Christina Piercings are female genital piercings placed vertically through the pubic mound so that the bottom side of the Christina jewelry sits just above the clitoral hood.
- Frenum Piercings are male genital piercings that are most often placed horizontally across the underside of the penile shaft. When inserted on the top of the penile shaft, they’re called Dorsal Frenum Piercings. A row of frenum piercings is called a Jacob’s Ladder.
- Dydoe Piercings are male genital piercings placed horizontally through the top edge of the head of the penis.
- Kuno Piercings are male genital piercings for uncircumcised men that go through the foreskin.
- Lorum Piercings are male genital piercings placed horizontally through the skin at the base of the penile shaft.
- Scrotum Piercings (a.k.a. Hafada Piercings) are surface piercings of the scrotum. A row of Hafada piercings is called a Scrotal Ladder.
- Pubic Piercings are surface piercings placed anywhere on the pubis.
- Guiche Piercings are male genital piercings of the perineum, which is the erogenous zone that bridges the scrotum and anus. Fourchette Piercings are the female equivalent of guiche piercings; they’re placed at the back edge of the vulva.
Note: Surface barbells aren’t the ideal type of jewelry for all surface piercings. For instance, most of the male genital piercings listed above require straight barbells or captive rings, and bent barbells are one of the more popular types of eyebrow rings and belly button rings. Surface bars are best suited for anti-eyebrow piercings, nape piercings, chest piercings, cleavage piercings, hip piercings, Christina piercings, and surface piercings placed elsewhere on the body.
Q. How Are Surface Piercings Different Than Dermal Piercings?
A. Surface piercings enter the skin at one point and exit nearby, whereas dermal piercings are single-point piercings. A pair of dermal piercings can be inserted close to each other to look like a surface piercing, 
but there wouldn’t be hardware beneath the surface of the skin connecting and securing the two dermal tops the way there would be with a surface piercing. The two types of piercings are inserted in different ways, too. With dermal piercings, either a dermal punch is used to remove a small circle of flesh so a dermal anchor can be inserted into the dermis, or a piercing needle is used to make a hole for the dermal anchor. You can read about how surface bars are placed in the next section. (Learn more about the differences between dermal and surface piercings.)
Q. How Are Surface Piercings Placed?
A. Surface piercings are a bit more invasive than dermal piercings, and they can sometimes be more complicated to place. When inserting a surface bar more shallowly or placing a smaller surface barbell beneath the skin, a piercer may just pinch the skin together to create an exit and entry point, pierce it straight through with a needle, and pull the hardware through behind the needle. Alternatively, a piercer may use a scalpel to slice through the epidermis and insert a surface barbell more deeply into the dermis beneath. The scalpel method has the benefit of minimizing the chances of migration and rejection of a surface bar. Whichever method your piercer uses, only the tops of the two surface bar posts will be visible after you’ve had a surface bar inserted.
Q. What’s the Most Popular Gauge for Surface Bars?
A. 
The two most common surface bar gauges are 14 gauge and 16 gauge, but 12 gauge and 10 gauge surface barbells are also available. Where you’re having a surface piercing placed will largely determine the best gauge surface bar to use. For instance, 16g surface bars are ideal for facial surface piercings like anti-eyebrow piercings, whereas a 12g or 10g surface bar may be better suited for a meatier part of the body.
You can often use the same surface bar tops with 14g and 12g surface barbells. Just make sure that any new tops you choose have a thread pattern and size that matches up with that of your surface barbell posts.
Q. What’s the Best Type of Surface Piercing Barbell?
A. Surface barbells are typically made of either implant-grade titanium or surgical stainless steel. If you have metal sensitivities, you should opt for a titanium surface bar. You’ll also have a choice of length and post angles. The length of the surface bar determines how close the dermal tops sitting atop the surface of your skin will be to each other. Wider angled posts are needed for some surface piercing placements, so the decorative tops will sit flush against the surface of the skin. 
Your piercer will be able to recommend the best style of surface barbell for the surface piercing you want, but you can request a titanium or surgical steel surface bar and specify your desired barbell length.
Q. What Does Proper Surface Piercing Aftercare Entail?
A. As with any new body piercing, proper surface piercing aftercare is critical to the success of your piercing. Here are some tips for caring for your new surface piercing to ensure that it heals fully and well:
- Bolster your immune system during the healing process by getting sufficient sleep every night, drinking plenty of water to stay hydrated, eating nutritiously, washing your hands frequently, and practicing good hygiene overall.
- Don’t consume alcohol, excessive amounts of caffeine or aspirin during the first couple weeks of the healing process. These things act as blood thinners and can make it harder for your body to form clots if you experience occasional bleeding after getting a surface piercing. If you need to take an anti-inflammatory, acetaminophen (e.g. Tylenol) is your best option. Ibuprofen (e.g. Advil) is also an acceptable alternative to aspirin, but it can cause additional bruising.
- Avoid swimming, soaking in communal water and baths to protect your new surface piercing from bacteria while it heals.
- Don’t touch your surface piercing jewelry unless you have to, and then only with clean or gloved hands. Absolutely don’t let anyone else touch your healing piercing.
- Wear loosely-fitting clothing over your surface piercing to minimize friction and pressure and to reduce the chances of migration or full rejection.
- Most importantly, keep your new surface piercing clean. Spritz it 3-6 times a day with a quality saline wash like Recovery Piercing Aftercare Spray to keep your fistula (piercing hole) flushed of debris and to cool and hydrate the skin around your piercing. You should also do two full sea salt solution soaks per day throughout the healing process. You can either saturate a series of cotton balls with piercing aftercare spray, applying each one for 30 seconds before tossing it, or you can use homemade sea salt solution comprised of one cup of sterile water (boil tap water for 5 minutes to sterilize it, or buy sterile water) and 1/4 teaspoon sea salt.
- If you suffer from dry skin around your surface piercing, add 2-3 drops of tea tree oil to each cup of homemade sea salt solution you make, or apply 1 drop of tea tree oil to each piercing aftercare spray-soaked cotton ball you apply to your surface piercing. Never apply creams, oils or balms to treat dry skin around your surface piercing, as these things can clog your fistula, trapping in bacteria and potentially triggering an infection to develop. (Tip: Buy our Recovery Aftercare Sea Salt From the Dead Sea & Tea Tree Oil Combo Pack to save money on both ingredients.)
- If you encounter any piercing problems, like signs of infection or a piercing hypergranulation, ramp up your aftercare regime. Do three full sea salt solution soaks per day until the issue subsides, and use a piercing antiseptic cleanser once or twice a day in between full soaks as needed.
- Do not change your surface bar tops prematurely. It takes time for the dermis to grow around a surface barbell and secure it in place, and until that happens, you’re at risk of dislodging the surface bar if you tinker with your dermal tops.
Q. How Long Do Surface Piercings Take to Heal on Average?
A. Some surface piercings take longer than others to fully heal, but generally speaking, you should wait at least three months before attempting to change your decorative tops. If you experience any surface piercing problems, you might need to wait longer. You may want to have your piercer confirm that you’re well healed enough for a jewelry change before you alter your surface piercing jewelry. For a small fee, your piercer can change out your surface piercing tops for you. The longer you’ve had your surface piercing, the easier it will be for you to change decorative tops yourself.
Q. What Problems Can Arise With Healing Surface Piercings?
A. The most common types of surface piercing problems include excessive swelling, development of hypergranulations, infection, migration, rejection, and scarring. It’s important to familiarize yourself with these problems and how to address them so that you can treat any issues that arise quickly and effectively.
Excessive Swelling
If the skin around your new surface piercing swells so much that your decorative tops become embedded, you need to act quickly. Take a non-steroidal anti-inflammatory like acetaminophen or ibuprofen to reduce the swelling, if you can tolerate one of these over-the-counter drugs. You can also apply a gel ice pack wrapped in a paper towel or a thin, clean towel to reduce swelling. Next, visit your piercer and see if s/he thinks you should temporarily replace your decorative tops with healing posts that won’t put undue pressure on the skin around your surface piercing. Excessive, prolonged pressure can cause necrosis (tissue death), which can lead to infection, so it’s important to address excess swelling quickly.
Surface Piercing Hypergranulations
If you develop a taut, red bump that appears fluid-filled or a ring of puffy red, irritated tissue around one side of your surface piercing, you’re most likely dealing with a hypergranulation. Hypergranulations are often mistaken for keloid scars, which have a similar appearance but only effect a very small percentage of the population. If the bump forms closely by your piercing and doesn’t continue to grow well beyond the piercing site, it’s likely a hypergranulation, not a keloid scar.
Hypergranulations typically form around a wound in response to excessive pressure and moisture. Swelling is one of the biggest triggers for hypergranulations around surface piercings. If your decorative tops are pressing into your skin rather than sitting atop it as they should, you need to see your piercer to have healing posts temporarily inserted and get the pressure off. You should also ramp up your surface piercing aftercare routine until the hypergranulation subsides. 
Do three full sea salt solution soaks per day, preferably enhanced with antiseptic tea tree oil as recommended in the Surface Piercing Aftercare section above. You should also continue to spritz your surface piercing with piercing aftercare spray 3-6 times per day, and apply an antiseptic piercing rinse or swabs to the irritated tissue once or twice a day, as needed.
Surface Piercing Infections
Signs of infection include discharge of thick, yellowish pus, red streaks radiating from your surface piercing, skin that’s hot to the touch, and/or fever. You can avoid developing an infection by following the surface piercing aftercare tips above. If you begin to see signs of infection at any point during the healing process despite your best efforts, ramp up your aftercare regime. Do three full sea salt solution soaks enhanced with tea tree oil per day, rinse your piercing 3-6 times a day with a quality saline wash like Recovery Piercing Aftercare Spray, and clean your surface piercing with a piercing antiseptic like X-Pressions Extra Strength Piercing Aftercare Rinse or Swabs one to two times a day. If your symptoms of infection persist or get worse at any point, see your family doctor right away. If s/he prescribes an antibiotic, make sure you take the full course and continue your enhanced surface piercing aftercare routine throughout.
Migration & Rejection of Surface Piercings
Surface piercings are more prone to migration and rejection than other types of body piercings, because they have no natural entry or exit points. The body is prone to treat them the way it would a splinter, pushing the hardware towards the surface of the skin in an attempt to remove it altogether. Your piercer can help you minimize your chances of migration and rejection by piercing you as deeply as possible and with the heaviest gauge surface bar that’s appropriate for the area you’re having pierced. Using a scalpel to insert your surface piercing instead of a piercing needle can also help minimize migration.
There are a few things you can do to prevent your surface piercing from migrating out, too. Be sure to wear loosely-fitting clothing over the area where you’re pierced for the first few months of the healing process. Friction and pressure caused by tight clothing can trigger migration and rejection, so this is very important. You should also practice religious surface piercing aftercare, using saline wash rather than soap to clean your piercing several times a day. (Soap is drying and can delay healing.)
If your surface bar begins to migrate out despite your best efforts, consult with your piercer rather than letting the process go on unchecked. S/he may suggest removing the barbell, letting the fistula heal, and re-piercing you later. If you just let your body reject the jewelry instead, you’re more likely to end up with ugly piercing scars.
Piercing Scars
If you develop a piercing scar around your surface piercing or over top of the entry and exit points where a retired surface piercing once was, it likely won’t happen within the first three months after getting pierced. If a strange red piercing bump appears within the first few months, it’s more likely to be a hypergranulation or a sign that your body is trying to reject your surface bar.
There are three types of scars that you may encounter with any existing or retired body piercing: keloid scars, hypertrophic scars and atrophic scars. Keloid scars are taut, bulbous, purplish-red scars that grow well beyond a piercing site. They’re actually very uncommon; they impact a small percentage of the population, and they’re typically hereditary. If someone in your immediate family is prone to keloids, you may also be, but you’ll likely know well before you ever get a piercing. If you do develop a keloid scar around a surface piercing, you’ll need to have your surface bar removed and see a dermatologist for treatment methods such as cryotherapy to freeze off the scar tissue, laser therapy to burn it off, or surgical removal.
Hypertrophic scars and atrophic scars are much more common than keloid scars. Hypertrophic scars are raised, flesh-tone scars that form tightly around a piercing, whereas atrophic scars are recessed skin-tone scars that tend to form where a retired piercing once was. Hypertrophic scars are caused by an overproduction of mutated skin cells, and atrophic scars are caused by the body under-producing new skin cells when attempting to fill a piercing hole.
If you develop a hypertrophic scar around your surface piercing or atrophic scars where you just had a surface bar removed, you can treat the scar tissue easily at home. Just massage a small dot of silicone scar therapy gel or jojoba oil into the scar tissue twice a day for as many weeks or months as it takes to sufficiently diminish the scar. If you want to avoid developing one of these types of piercing scars, perform regular, thorough aftercare both immediately after getting a surface piercing and after having a surface barbell removed.
Q. What’s the Best Way to Change Surface Piercing Tops?
A. Surface barbells aren’t as easily dislodged as dermal anchors, which means that you should be able to change your surface bar tops by hand with little trouble once your surface piercing has fully healed. If a top gets stuck or you need a little extra leverage to start unscrewing your decorative tops, we carry two types of tools that you may find useful:
World’s Thinnest Dermal/Surface Anchor Holder Tool – This handy little tool is the thinnest of its kind on the market, making it easy to slip it in between your skin and surface bar tops, secure your hardware, and unscrew the tops. See how it works by watching the video below.
Body Jewelry Forceps – If you still have trouble unscrewing your surface bar tops even with our World’s Thinnest Dermal/Surface Anchor Holder Tool, then try using a pair of body jewelry forceps to grab the tops securely and unscrew them.
Tip: If you’d like to be able to interchange colorful jeweled tops without ever having to unscrew them from your surface bar, 
check out our magnetic dermal tops. You can have your piercer insert a magnetic base in place of each of your starter tops or insert them yourself at home. Once that’s done, you can interchange jeweled dermal tops as often as you like without ever having to unscrew the magnetic bases from your surface bar again.
Q. Where Can I Buy Surface Piercing Jewelry?
A. 
We offer an extensive selection of surgical steel surface bars, titanium surface barbells, and unique surface bar tops. 
Choose from decorative tops in unique shapes, like bees and dragonflies, jeweled surface bar tops, custom-made dermal tops, discs, cones, and many other stunning options at some of the lowest prices you’ll find online. Visit our Surface Barbells section to see our full selection of surface piercing jewelry. For a really unique look, be sure to check out our surface bar staples, shown to the left.
Q. What’s the Best Way to Remove a Surface Barbell?
A. When you’re ready to retire a surface piercing, you should absolutely visit your piercer and have him or her remove it for you. If you try to remove a surface bar yourself, you’re much more likely to end up with nasty piercing scars than if you have a professional remove it for you for a nominal fee.
Q. Where Can I Find More Surface Piercing Information?
A. 
We offer several unique sources for surface piercing information on our website beyond these Surface Piercing FAQs. For surface piercing placement ideas, check out the Surface Piercing Pictures section of our online photo gallery. Visit the Surface Piercings section of our forum to read other people’s surface piercing experiences and post questions for our knowledgeable moderators and forum members to answer. You’ll also find additional surface piercing blog posts and full-length articles in our Information Center, including:
