Pierced Cartilage Help

What is a Cartilage Piercing?

Cartilage is a connective tissue that is harder than skin but softer than the bones. An ear cartilage piercing goes straight through the “harder” tissue (cartilage) in the ear and out the back. Cartilage piercings are very popular because of how versatile they are. The ear has different spots that can be pierced. For example, some of these piercings are: the snug, upper helix, anti-helix, conch, orbital, daith, and tragus. The most common and basic cartilage piercing is the helix piercing, this is a piercing at the tip of the upper ear. When you go in for your piercing appointment your piercer will help find jewelry to fit your ear and sterilize your chosen jewelry. After setting up their piercing station your piercer will clean your ear and mark the spot that will be pierced. When you agree on the exact placement of the piercing the piercer will use a hollow needle to pierce the cartilage and they will insert the jewelry immediately after. The process takes a few minutes to complete from start to finish.

Conch Piercing

The Jewelry

Cartilage piercings are prone to swelling, especially towards the back so they are started with larger and longer jewelry. For the first two to three months of healing they are started with a captive bead ring or a barbell. The most common size of the captive ring and the barbell are an 18 gauge, 16 gauge and 14 gauge (if you are looking for a larger size). The length of the jewelry will accommodate for any swelling, it is important that the starter jewelry is not done with anything smaller then 5/16". A basic barbell and captive ring as used to start with because of how easy they are to clean. More intricate cartilage rings with many different cabochons can have a lot of nooks and cranny’s that will harbor bacteria. After the first two or three months your piercer can change out the jewelry to something smaller, that fits snug to the ear.

After the piercing is done healing there are thousands of more ornate jewelry options. Barbells have the most unique jewelry options because the front of the barbell can be many different shapes and hold multiple cabochons with different colors or stones. They can give the illusion that there is more than one piercing on the helix by using cluster jewelry. This is a barbell that has a front with multiple cabochons attached together, making a bigger design.

Cartilage Piercing Jewelry


The other unique part about cartilage piercings is that you can have multiple piercings in a small area. These piercings can be done for a custom project and will create an overall design. For example, some people will do three or four piercings to create the shape of a cascading flower. The different designs and “ball” for the front of the piercing make the cartilage a great way to create different designs and looks that are unique to you.

Cartilage Piercings Names

Types of Cartilage Piercings

As mentioned, the cartilage is where your ear feels "harder" or "tougher" than normal skin, which is everything above the ear lobe! Each cartilage piercing has a different name based on the area of cartilage that is being pierced. Read below to find out where each piercing is located and which kinds of jewelry you can wear in each.

Outer Conch and Inner Conch

Conch piercings go through the middle of the shell of the ear, which is also the largest and thickest piece of cartilage in the ear. It’s called a conch because this part of the ear looks like a conch seashell. The outer conch is in the lower part of the middle of the ear. The inner conch piercing goes through the upper middle shell (conch) of the ear, which would be above the outer conch piercing and slightly closer to the ear canal.

Jewelry with a straight post like a barbell, flatback barbell (also called labret jewelry), or threadless or pushpin posts are worn in conch piercings. Circular barbells and captive rings are often uncomfortable to sleep on in conch piercings and aren’t usually recommended for long-term wear.

A conch piercing will include the price of the jewelry, so the cost can range from $30-$50 for standard jewelry or $80 and up for something more ornate or decorative. The initial piercing can be done from an 18G to a 14G, depending on the look you want. (Note: Cartilage piercings don’t stretch like ear lobe piercings do, so if you want a large-gauge conch piercing, you will have to pierce it at that size.)


A tragus piercing goes through the center of the small flap of cartilage directly in front of the ear canal, which is called the tragus. This piercing isn’t recommend for a first cartilage piercing since the piercing process can be a little more difficult to do if your tragus is small or thick, and the proximity to your ear canal means you can hear a pop when the needle goes through, which can be unsettling.

The initial piercing is usually done at 16G with a straight barbell, flatback barbell, or threadless post, so there is room for swelling during healing. After healing, you can change the jewelry to a captive ring, hoop, circular barbell, or curved barbell. A tragus piercing can cost between $40-$60, and the cost will go up if you choose jewelry with more decorative ends like gemstones.


Antitragus piercings go through the flap or ridge of cartilage that is between your tragus and your ear lobe. The antitragus has to be very prominent for this piercing to work. The antitragus is typically pierced at a 16G with a curved or flat barbell to allow for swelling. Once the piercing is healed, you can change to a captive ring or circular barbell. An antitragus piercing can cost between $40-$60, and the cost will go up if you choose jewelry with decorative or jeweled ends.


The helix piercing is the official name for the upper ear piercing that we know and love from the 80s! One of the more common cartilage piercings, helix piercings are usually pierced with a captive ring, circular barbell, or straight barbell at a small gauge, anywhere from 18G to 14G, depending on your ear and the jewelry you want to wear. Helix piercings cost from $30-$50 to start.

Forward Helix

The forward helix piercing is on the same ridge of cartilage on the upper ear as the helix piercing, but it is placed so that the piercing is facing forward, above the tragus. Many people opt to 2 or 3 piercings aligned vertically up the ear, and this called a double or triple forward helix.

Straight barbells, flatback barbells, and threadless/pushpin posts are used for healing forward helix piercings. There are a lot of options for endpieces for that accentuate the ear, but you should wait until the piercing is healed to swap to a captive ring, circular barbell, or seamless ring. Forward helix piercings are much trickier than standard helix piercings because they need to be lined up to your anatomy to sit well, so the cost can range from $30-$60 for one. Getting multiple piercings at one time will multiply the cost, there is not typically a bundled price offered.


The industrial piercing is technically two piercings, an outer helix piercing and a forward helix piercing, that are connected with a long straight barbell. The industrial piercing was created first pierced in the 90s as an edgier cartilage piercing, because it is not as delicate as the other cartilage piercings can look. It’s usually pierced at a 14G for this reason too. It’s usually not possible to take an existing cartilage piercing and turn it into an industrial because both piercings need to align correctly. Industrials used to just be limited to the stainless steel barbell, but there are now customized barbells made specifically for industrials that have decorative accents or bends to the bar and more decorative ends. Industrial piercings range from $60-$100.


The orbital piercing is another piercing that is technically two piercings in one, with a captive ring or seamless ring connecting both piercings. This gives the look that the jewelry is orbiting the ear, so it is called the orbital piercing. A few of the cartilage piercings can be turned into an orbital: the helix, the inner conch, and the rook. Orbitals are pierced at a 16G or 14G with a captive ring and can cost between $50-$80.


The rook piercing is a vertical piercing through the cartilage fold above the tragus that rests in the conch, also called the anti-helix. Rook piercings range from $30-$50 and are initially pierced at a 16G with a curved barbell for healing. After healing, the barbell can be change to a captive ring, but this placement is great for curved barbells because it rests with both ends visible from the front of the ear.


The snug piercing is a horizontal piercing through the cartilage fold above the antitragus that lines the conch towards the edge of the ear. Snug piercings are usually pierced with a curved barbell at 16G. The curved barbell is an ideal shape for this piercing as the ends of the barbell sit neatly against the ear. A snug piercing will range from $30-50.


The daith piercing goes through the smallest fold of cartilage in the ear, right above the ear canal. The piercing sits behind and above the tragus, sort of floating in front of the conch. It’s pierced at a 16G with a captive ring, seamless ring or clicker ring. The daith piercing is one of the only cartilage piercings that a captive ring or other ring jewelry is encouraged for healing. There are also rings that are shaped like hearts, stars, crescent moons, etc. and these kinds of jewelry also work in a daith piercing. Daith piercings cost between $30-$60 depending on the quality and style of jewelry used with the piercing.

Fun fact: Have you ever heard about treating migraines with piercings? The daith piercing aligns with an acupuncture pressure point that is typically used to treat migraines, so some migraine sufferers have found relief through getting it pierced.


Cartilage piercings can take quite a bit of time to heal, depending on the placement of the piercing it can be anywhere from four months to a year. Cartilage is more involved than a simple skin piercing. During the healing time jewelry should be kept in, if the jewelry is out for any period of time there is a risk that the piercing will close up. The larger the gauge (such as a 14 gauge) the longer the healing time. When healing it is important to clean the piercing once in the morning and once at night. The best way to do this is with a salt water soak. You will need a gallon of distilled water and a bottle of Non-iodized seal salt.

These items can be found at any local grocery store or pharmacy. It is important that the gallon of water reads “distilled” and it is not being substituted for any other type of water. The only ingredient on the bottle of non-iodized sea salt should be sea salt. This is organic, pure, sea salt. When you have both of these items, pour four teaspoons of the non-iodized sea salt into the gallon of distilled water and shake the bottle. When you are ready to clean your piercing pour the solution into a coffee cup or a shot glass. Make sure these glasses are made of porcelain or glass, paper and plastic products will contaminate your sea salt solution. Once in a cup, put it in the microwave for a few seconds. The goal is to get the temperature to lukewarm or body temperature, anything hotter will burn you and your piercing. Each microwave is a little different, so it might take a few tries to get the perfect temperature. Once you’re happy with the solution hold your ear into the cup for seven to fifteen minutes. After you are done with the soak you can rinse your ear with water or pat it dry.

Infections and Other Problems

Cartilage piercings are prone to infection, excess swelling, and hypertrophic swelling, migration, and rejection just like any other piercing. It is important not to touch the piercing or move it in any way. Take extra caution to sleep on the opposite side of the piercing and be cautious not to get it snagged on your hair or sheets. If you have to touch the piercing for any reason, wash your hands for two to three minutes with antibacterial soap before doing so.

Avoid foreign bodies of waters such as; pools, Jacuzzi’s, ponds, lakes, and oceans. Touching the piercing or submerging it into different bodies of water will introduce it to different types of bacteria, and it can lead to infection. Always keep the piercing clean, this will create an optimal healing experience. As always, do your research on your piercer and what piercing methods they use.

A cartilage piercing should be performed with a hollow needle. This piercing should never be performed with any type of piercing gun. A Piercing gun can shatter the cartilage and there is no way to properly clean this type of instrument.

Disclaimer: If you have any questions or concerns about your piercing please contact a Professional Piercer or Medical Doctor.