Montgomery  Dermatology, LLC

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860 1st Ave #8b, King of Prussia, PA 19406
10000 Shannondell Drive, Audubon, PA 19403

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Helix Piercing | The basics

Updated: Oct 22, 2019


by Dr Erum ILYAS

When people think about piercings they do not always think about their Dermatologist. Dermatologists are trained in piercings in addition to the complications that arise from piercings.


I have seen my fair share of issues that patients deal with as a result of piercings:

  • Torn earlobes

  • Stretched piercings

  • Keloids

  • Recurrent infections

  • Tatto’ed skin from silver from the piercing

  • Embedded earrings

  • Contact Dermatitis

  • Cysts

  • etc...


The good news is that all of these can be treated or managed safely, quickly and effectively.



Helix piercing refers to piercing of the upper outer portion of the ear through the cartilage. Most people are familiar with traditional ear piercing through the ear lobe which contains no cartilage.  Helix piercing tends to be more painful than traditional ear lobe piercing because puncturing the cartilage is a bit more painful. That being said, just like with traditional piercing, it’s a quick pinch and the discomfort doesn’t last long.  I find it’s the anticipation that bothers people more!


The main caution I tend to have for patients obtaining piercings through cartilage is to make sure that the earring used is made of stainless steel or hypoallergenic.


It’s common for piercings to ‘tattoo’ the skin in this area (also an issue for nose piercing). This happens more with silver jewelry and is called localized cutaneous argyria. This can be lasered but it’s easily avoided. It is also important to note that these piercings should stay in place for a few months and not the usual 4-6 weeks for the ear lobe. They can take a little longer to heal successfully. 

For after care, the most important tip is to keep the piercing clean. Wash gently with soap and water. Blot 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. It is ok to apply antibiotic ointment or Vaseline to prevent the scabbing and speed healing. Try to avoid sleeping on the piercing- it’s really common for the piercing to get caught or pulled— ouch! 

With earlobe piercing we tend to recommend spinning the stud to avoid build up of scabbing. You cannot really do this with helix piercing, however you can gently move it up and down. If any swelling, thickened scar tissue, bumps, or tenderness develops and persists be sure to see your dermatologist. I promise we don’t pull the piercing out most of the time. Usually I just have to inject a little steroid around the base to reduce the inflammation and accelerate healing. I worry some people don’t come in for a check because they assume the only response we will have is to pull the piercing. It’s rare that i ever do this to someone who really wants to keep it! I can usually figure out a way to make it work. 

In choosing a piercer, if you do not go to your Dermatologist then it’s a good idea to check with the piercer to see what type of device they use to pierce. See if they have an autoclave that they use to clean their tools with. Many states and counties do have licensing requirements for body piercing and tattoo artists. This generally involves proving  training in the field but also an understanding of blood borne pathogens through OSHA training or courses. If someone is knowledgeable they will be less likely to cross contaminate and put your health at risk. I’ve been in practice for 15 years and seen significant improvements in the industry with regards to safety. Trust your gut- if you don’t have a good feeling about a place, just don’t go. There are plenty of options!