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Upper Ear Cartilage Piercings Beaten to Death

A piercing through the thicker cartilage in the flat area of the upper ear. Usually at the just inside of the ear's helix. Often called a "Helix", "Backward Helix" or Outer Counch. A Helix piercing through traditionally the term Helix piercing references a piercing through the ridge of cartilage that starts at the front of the ear in a flap and then ends above the lobe. While a Conch is through the cup-shaped part of the ear.

The main reason or motivation behind getting the piercing is purely for enhancing the look of the area. 

History and Background:

The piercing of the area has become widespread in modern culture but its roots date back to the Australian Aborigines. Among the oldest known cases of ritual piercing, they may have started it all. They pierced and modified the septum, earlobes and upper ear, and genitals. Each marking a rite of passage into another stage of life.

In the case of modern the piercing seems to be rooted in the Sub-cultures of the late 60s and the Punk movement of the late 70s and 80s. They became increasingly more common as ear piercing, in general, became more widespread.

Ear Piercing Devices

First off, most ear-piercing devices have a disclaimer on the side that state to the effect that the device should not be used on any part of the body other than the Lobes. There is a number of reasons for them considering the lobe different from the thicker cartilage area of the upper ear. Mostly it is the increase of the trauma and the damage that the piercing stud does as it is forced through at a high rate of speed. There is also the issue of the fact that the device often can't fit over the ear and the piercing is done at an angle that could cause issues.

This has been an ongoing struggle with the body piercing industry to educate the public about the dangers of ear piercing devices. Since most of the general public has been pierced with them and saw little or no problems, it’s been an uphill struggle partly because they are simply so commonplace. However, even with modern cartridge style devices, there is a number of Issues:

  1. Though the cartridge is sterile before opening, the device itself is not. The act of touching the device and then opening the cartridge could lead to contamination. This is due largely to the fact that the device when used causes bodily fluid spray that collects on the device itself. Since there is no way to sterilize the device itself, there is a risk of transferring contaminants from the device to the cartridge.

  2. The lack of skill and education of the person operating the device. Since often the person operating the device has had no formal training in cross contamination, they don’t have the knowledge or habits to prevent spreading contaminates from one client to another.

  3. The piercing action of the device increases the chances of additional trauma, tearing of tissue and damage to the piercing. The devices are spring loaded and the piercing studs are not nearly as sharp as a piercing needle, thus they tend to rip and tear through the tissue instead of cutting through the tissue. This trauma can increase healing time, inflammation and other issues during the healing of the piercings.

  4. The devices action cause bodily fluids to spray. Think of a knifing like action, blood spray and what is around the piercing when it happens. Often this spray will come in contact with the device itself, the hands of the person doing the piercing and whatever is nearby. Now think about the surfaces in the area, the person who did the piercing and what they touched while they were getting ready to do the piercing. I once watched a young shop employee put on a pair of gloves and then rummage through a tube with a number of devices, picking up two or three of them before settling on the one to use. Then she helped a customer, rung them up, and then answered the phone. After all of this, while still wearing the same pair of gloves, she opened the cartridge, put it in the device, marked the piercing, handed the customer a hand mirror and then did the piercing. She touched at least 8 surfaces and didn’t wash her hands or change her gloves. Introduce Hepatitis C into that and I think you will understand my concern.

  5. The ear piercing studs are not only often dull but they are not long enough to allow space for the swelling that will occur. This can prolong healing and in the worse case cause the jewelry to become impacted into the tissue.


Like most piercing, However, the process is much slower than other parts of the body. It might take a year to go from 18g to 16g and become increasingly longer as the difference in the thickness of gauges starts to get greater. 

Jewelry Size and Type:

The size of the jewelry should always be based on the anatomy of the client. Both the shape size and thickness of the area should be considered when choosing jewelry. Also their plans for the future.

There are issues that should be considered before choosing jewelry size and type:

  1. The thickness of the jewelry will either increase or decrease damage to the piercing in the future. Also, a thicker gauge may increase the period of time the piercing can be left empty. It is a balancing act between a thickness that will not tear easily but you want the jewelry light enough to not add extra stress to the piercing during healing. Generally, I like to pierce at 18g to 12g. With larger gauges, you are making a larger piercing which means that there is more blood vessels that are going to be cut or nick. Which means that the larger the gauge the more bleeding and the longer the bleeding will continue. Since there are more impact and trauma to the area with larger gauges, it means more inflammation and longer recovery time.

  2. The width needs to be wide enough to not only pass comfortably through the piercing without causing pressure on the piercing but to allow for inflammation, cleaning and allow for the penis to become erect without causing stress on the piercing(s). The standard is to have a 1/8 to 1/4 of an inch of extra space between the width of the piercing and the width of the jewelry. With rings, additional width is needed to allow the part of the ring that is in the piercing to be as flat as possible. Also, the ring must wrap around the helix of the ear comfortably and not add stress on the piercing or helix. Usually, with rings, I use a minimum of 3/8 of an inch and 5/16th with labret studs.

  3. When picking the gauge of the jewelry there also needs to be a discussion about whether or not the piercing is going to be stretched in the future. Not only would piercing at a larger gauge speed up them getting to their goal but piercing at a small gauge and allowing the piercing to heal completely, can lead to a stronger piercing. A Stronger piercing will stretch much more easily without issues.

Jewelry Styles:

It depends on the space of the anatomy and the placement of the piercing. The most common are rings. However, if the piercing is further into the flat area and away from the edge a Labret should be used. A labret is a barbell style stud with a flat disc on one side and a ball or shaped end on the other side.

For more detailed information on what Jewelry to buy go to my blog Post Healing Jewelry Guide


I always do this piercing freehand with a cork on the back side of the ear. 

The Procedure:

  • Consultation and paperwork.

  • Evaluating the piercee's anatomy to ensure that the piercing can be done safely and to size the jewelry.

  • Setup

  • Disinfecting the piercing area with a surgical scrub

  • Marking the piercing

  • Reclining the piercee

  • Place a cork loosely on the exit of the piercing.

  • Lining up the needle and distract the piercee.

  • Injecting the piercing needle through the piercing area and into a piece of cork.

  • Insert and closing the jewelry. 

    • With rings, no additional step is needed. The jewelry simply follows the needle.

    • With Labret studs, the needle is pushed out with a taper pin. Then the taper pin is inserted into the inside of the taper on the back side of the ear and then the taper pin is used to guide the jewelry into the piercing.

  • Stopping any bleeding and cleaning up the piercing area.

Hassles and Aftercare:

Though they heal rather quickly healing in two to three months, during the first couple of weeks they are prone to discoloration, redness, tenderness to the touch, bleeding, redness and swelling.

Basic aftercare will involve hot soaks or hot compresses with warm water and sea salt twice a day and cleaning the piercing in the shower twice daily. Also, you will need to take steps to reduce the likelihood of cross-contamination. For more details go to Basic Aftercare Instructions.

Somethings to consider before getting the piercing and additional precautions:

  • Do not sleep on the piercing at all. If you have to sleep on that side, find a way to elevate it off the bedding. The most common way of doing this is to take a clean towel, roll it up and place it in the shape of a doughnut. Then sleep with your ear in the center. 
  • Avoid wearing hats, headphones, headbands, helmets, and anything that puts stress or comes in contact with the piercing.
  • Cover the piercing when using anything on your hair that comes out of a spray bottle or can. When you get a haircut or styled, cover the piercing and tell your beautician or barber that it is a healing piercing and stay away from it.
  • Need to avoid contact with telephones until the piercing is completely healed.
  • This piercing is prone to "grumpiness" even after it heals and many people will find the piercing will get soar when slept on, abused and when they are getting sick or about to begin their monthly cycle.


The piercing can be painful or not painful at all. It tends to vary greatly from person to person. Immediately afterward, the piercing will often throb and ache for around 20 or 30 minutes after the piercing is done. Then it will be tender to the touch often for up to a month.

Risks & Concerns:

Since there is often less circulation in the area, the piercing is more prone to slow healing and infection. An infection or improperly sized jewelry can cause damage to the structure of the ear, if not resolved and taken care of immediately. 

The location of the piercing tends to come in contact with clothing and other objects more often than other piercings. Thus it is more prone to abuse, being problematic and being damaged even after the piercing is healed.


The piercing is more prone to problems than other piercing and will take additional care and precautions to heal correctly and without issues. However, if you avoid abuse to the piercing, usually it heals out within a few months and with little issues.

Ear Piercings