Dermal Punching

Dermal Punching

A dermal punch is similar to a needle without the bevel, it is extremely sharp and rounded, like a miniature cookie cutter! Dermal punches, also known as biopsy punches, are used within the medical industry to take biopsy samples, but they are also used by body modification artists to remove tissue from the ears or nostrils for aesthetic purposes or sometimes to remove scar tissue (for example, to remove a ‘blow out’ in a lobe to leave a clean large gauge fistula that, once healed, the owner can start to stretch again).

In the case of ear and nostril cartilage, dermal punching is a great alternative to the long and sometimes complicated process of stretching. Cartilage piercings are prone to hypertrophic scarring and are difficult to stretch. Dermal punching cartilage eliminates the pressure that a piercing puts on the injured tissue thus the chances of the area suffering from hypertrophic scarring are drastically reduced. Dermal punching gives a cleaner hole over a greater surface area that results in a less problematic fistula.

A dermal punch allows for an initial piercing as large as 10mm (anatomy dependent). We advise you have cartilage punches at a larger gauge and then (if desired) downsize the hole within 2 to 3 weeks. Small dermal punches (2.4mm, 3.2mm, 4mm) are healed the same way as a regular piercing. Large dermal punches through cartilage (5mm, 6mm, 8mm, 10mm) can be healed a little differently. You can wear the jewellery for a couple of days to allow the fresh cut tissue to heal, after this time the jewellery can be removed for a short period of time. This is because a piercing without jewellery will heal much faster but care must be taken to ensure that the piercing doesn’t close.

We advise you to think very carefully before deciding to have your cartilage dermal punched. Dermal punching removes the cartilage from the area – the resulting fistula rarely shrinks down to nothing, and is almost impossible to reconstruct. Some shrinkage will occur with larger gauge punches if the jewellery is removed, but it is highly unlikely that the area will ever return back to normal. It is therefore considered a permanent modification. We recommend you speak with your doctor before undergoing a dermal punching procedure, and if he suggests a prophylactic course of antibiotics may be beneficial, we suggest you take these.


9 mm Upper and 6mm Inner Conch Dermal Punches with Gorilla Glass


Upper and Inner Conches, Fresh Dermal punches


4mm Fresh Nostril Punches


Things to expect:

Soon after the punch, it may bleed if knocked. This is common and perfectly normal! Just apply some sterile gauze and pressure for a couple of minutes until the blood clots.

For the first few weeks, expect the area to be red, swollen, tender, puffy, and sometimes bruised.

Expect the fistula to secrete clear/white/pale yellow fluid throughout the healing process. Many people mistake this fluid as a sign of infection – please don’t worry. A smelly fluid indicates infection.

Things to avoid:

Soap, shampoo, and chemical residues from showering/bathing. Be sure to rinse the area with clean water following a shower or a bath!

Antiseptic preparations such as Savlon cream or spray, TCP, Hydrogen Peroxide, Dettol, Surgical Spirit etc –DO NOT USE THESE to clean your punch! These are very harsh and will cause irritation and delay healing.

Playing or fiddling with the area using dirty fingers. This will likely increase healing time, cause swelling, and/or infection.

Moving or twisting the jewellery whilst dry. If any secreted discharge has hardened on the jewellery, turning it may tear the fistula or surrounding tissue and prolong healing.

Knocking the punch or causing any trauma.

Swimming pools for the first few weeks.

Do your best to avoid sleeping on your punch.

Prior to cleaning, hands should be washed,

O-rings removed from the jewellery and any dried matter soaked off.

Clean your punch twice daily using a cotton bud dipped in the salt water solution described above. Alternatively, a very gentle antibacterial handwash such as Carex or Simple can be used on your punch twice daily. Please follow the manufacturers instructions and only use instead of a salt solution. If irritation occurs, discontinue use.

Between sea salt water soaks, we recommend you use a product called H2Ocean piercing aftercare spray around 3 times daily. It is a 0.9% saltwater solution (perfect salinity to match the body) which gently removes crusts without the need to touch your piercing. It is naturally antibacterial without nasty chemicals and encourages healing as it contains an enzyme called Lysozyme, which is naturally found within our mucosal membranes. Cross contamination is impossible as the spray is a sterile pressurized container (each spray is therefore sterile until the very end of the can!)

This spray simply helps heal your punch faster.

Expect some swelling or soreness from your punch. Ears and nostrils are subjected to temperature changes and environmental stress – A knock may cause swelling or soreness to flare up again throughout the healing phase.

Cartilage piercings occasionally form lumps. Sometimes these are fluid build-ups caused simply because bloodflow to the area isn’t great, or can be caused by irritation. This is easy to resolve using heat and pressure from a hot salt water OR hot chamomile teabag compress once daily, replacing one of your daily cleanings.