Written for Medical Realities by Meghan Gessner on August 28, 2025

Isabella Piercing: What It Is and Why It’s Risky

The Isabella is an extremely rare, high-risk genital piercing that passes through the clitoral shaft itself. Because the clitoris is packed with nerves and blood vessels, most reputable piercers in the U.S. won’t touch this procedure. If you’re after a similar look with far less risk, consider a Vertical Clitoral Hood (VCH) instead—it involves the hood, not the clitoris.

Why the Isabella Piercing Is Dangerous

• Direct hit to the clitoral shaft: This area contains dense nerve bundles, ligaments, and a strong blood supply. Running a needle through it puts all of that at risk.
• Possibility of permanent injury: The deep placement raises the odds of life-changing complications, including:
  • lasting nerve damage and reduced or lost sensation
  • heavy bleeding
  • compromised blood flow to the clitoris
  • scar tissue (fibrosis)
  • pain with sex
  • lowered sexual function
• High rejection rate: Because it’s invasive and risky for nerves, the body may try to push the jewelry out.
• Hard to find a willing pro: Even veteran piercers across states like New York, California, and Texas routinely refuse Isabella requests because of the danger.
• Longer healing: Depth and location slow the healing process and increase the odds of complications.

Safer Alternatives

• Vertical Clitoral Hood (VCH): Goes through the hood, not the clitoris. Safer, often enhances sensation, and can deliver a similar aesthetic.
• Triangle: Sits horizontally under the clitoral shaft at the base of the hood; considered less risky than an Isabella and can offer distinctive stimulation.
• Christina: A surface piercing where the outer labia meet. Purely decorative—doesn’t pass through the clitoris and isn’t aimed at sensation.

Important Considerations

• Anatomy first: Not every body is suited for every piercing. A professional will assess whether your tissue and hood shape are appropriate.
• See an APP member: Consult a piercer affiliated with the Association of Professional Piercers (APP) for safety-first guidance, sterile technique, and realistic expectations about healing times and aftercare.
• Plan for aftercare: Expect diligent hygiene, saline soaks if recommended, loose clothing, and a timeout from friction or sexual activity until you’re cleared to resume.

History of Piercings

Ear piercings have been a go-to accessory for ages—most women in the U.S. have at least one. Around the world, people have pierced all kinds of places for thousands of years. In the West, beyond-the-ear trend took off more recently, and now it’s common to see piercings on tongues, lips, noses, brows, nipples, and yes—the genitals. For folks with vulvas, that can include the clitoral hood, labia, or nearby surface areas.

Why Do People Get Their Genitals Pierced?

Plenty of people just like the look or the jewelry. Some say certain placements boost sexual sensation; a few even report their first orgasm after getting pierced. Others love the bold, adventurous feel. And for some survivors of trauma, choosing a genital piercing can be a way to reclaim and personalize their body on their own terms.

Types of Vaginal (Vulvar) Piercing

Vertical Clitoral Hood (VCH)

The most popular option. It goes through the clitoral hood, not the clitoris, and may add stimulation for some. Piercing the hood is much safer than piercing the clitoral shaft itself, which risks nerve damage. A VCH runs vertically above the clitoris.

Horizontal Clitoral Hood (HCH)

Sits horizontally across the hood. It doesn’t suit everyone—people with a smaller hood or clitoris may not be good candidates.

“Princess D” Piercing (aka “Duke”)

A VCH variant set to one or both sides of the hood rather than dead center. Some stack a center VCH with one on each side for a symmetrical look.

Triangle

Placed under the clitoral shaft at the base of the hood (horizontal). Can offer unique stimulation but requires the right anatomy and a very skilled, experienced piercer.

Outer Labia

Done on the outer lips; tissue here can handle heavier or multiple pieces. Can be placed horizontally or vertically depending on anatomy and jewelry choice.

Inner Labia

One or more piercings along the inner lips. Positioning closer to the clitoral area may increase sensation for some.

Christina

A decorative surface piercing where the outer labia meet below the pubic mound. More about aesthetics than stimulation.

Fourchette

Placed in the small fold between the lower vaginal opening and the anus. Jewelry can be pulled inward during penetration, so some people find this one uncomfortable with certain activities.

“Princess A” (female counterpart to the classic PA)

Rare and technically challenging. It passes through the urethra and the top of the vaginal canal. Because of the anatomy involved, it’s not commonly offered.

Not everyone has the anatomy for every piercing. Hood size, tissue thickness, and positioning matter. An in-person assessment with a pro is key.

How Is Vaginal Piercing Done?

The area is cleansed thoroughly with antiseptic first—super important to lower infection risk. A professional then uses a 12–16 gauge hollow needle to create the channel and immediately places the jewelry. For some spots, the piercer may use sterile clamps to keep tissue steady.

As for pain: it’s quick, but perception varies. You might assume piercing such sensitive tissue would be off-the-charts painful, yet many people say it feels similar to other body piercings—brief and sharp, then it’s over.

Are There Any Risks to Vaginal Piercings?

Any time you put a needle through skin, there’s risk. With genital piercings, the big worries are infection and bad technique. Shady shops can expose you to blood-borne infections like tetanus, hepatitis B, and hepatitis C.

Possible complications

• Pain and bleeding
• Scar tissue or keloids
• Skin infections
• Metal allergies from the jewelry
• Blood-flow issues with certain placements (like triangle piercings)
• Tearing at the site
• Condom snags or diaphragm displacement, which can mean pregnancy risk or less protection against STIs

How to Lower the Risk

• Vet the studio. Laws vary state to state, so do your homework. Read policies, check sterilization practices, and make sure they use brand-new, single-use sterile needles (never piercing guns).
• Pick a pro. Look for someone who’s a member of the Association of Professional Piercers (APP) and—ideally—experienced with genital work. They should: verify your ID, clean the area with antiseptic, glove up, and keep everything sterile start to finish.
• Choose safe metals. Go for implant-grade titanium, niobium, or high-quality surgical stainless steel to cut down the chance of irritation or allergy.
• Ask about anatomy. Not every body is a match for every piercing. A good piercer will say “no” if a placement isn’t safe for you.

Vaginal Piercing Jewelry

What you wear depends on your anatomy and the specific piercing. You’ll typically start with thicker jewelry to allow for swelling and initial shrinkage as it heals.

• Barbell: Straight bar with a ball on each end.
• Curved barbell: Same idea, but curved to fit the area; a fully curved “open circle” version is often called a circular barbell (aka horseshoe).
• Captive bead ring (CBR): A hoop that closes with a single bead. Fixed-bead rings are similar, but the bead is attached to the ring.

For labia piercings, some folks add charms or tiny bells after they’re fully healed.

Vaginal Piercing Aftercare

Healing can take weeks to a few months, depending on placement and your body. Keep it clean, low-friction, and hands-off.

• Clean like a pro. Follow your piercer’s instructions. Typically that means once-daily gentle wash with mild soap and water, plus sterile saline soaks/compresses in the first couple weeks. Pat dry with a clean paper towel.
• Skip the harsh stuff. No alcohol, hydrogen peroxide, Betadine, ointments, or antibacterial soaps (they can wreck the good bacteria and irritate skin).
• Hands off. Wash your hands before any care. Don’t twist/rotate or “check” the jewelry unless you’re cleaning.
• Dress for healing. Loose, breathable underwear and clothing to cut friction.
• Sex break. Avoid sex (including oral) for at least 2 weeks or as long as your piercer/clinician recommends. When you resume, rinse with saline or clean water afterward.
• Water rule. Stay out of pools, hot tubs, lakes, and the ocean for at least 2 weeks.
• Birth control & STI protection. Jewelry can poke holes in condoms or dislodge a diaphragm. Use a backup birth control method and remember condoms are the only option that helps protect against STIs.

What’s normal vs. not during healing

• Normal: Mild redness, tenderness, swelling, a little clear/whitish discharge.
• Not normal: Green/yellow discharge, foul odor, spreading redness, fever, intense pain. Leave the jewelry in, switch to saline soaks/warm compresses, and contact a clinician; you may need an antibiotic.

Sources for typical U.S. pricing and materials standards include studio price lists and APP guidance. Examples: Infinite Body (genital service fee + jewelry ranges), Piercology (VCH/HCH/Christina fees), Black Rose Body Piercing (genital totals), Industrial Tattoo (triangle/Princess Albertina fees), Koi Piercing SLC (vulva fees + starter jewelry), and APP initial-jewelry standards for implant-grade titanium/niobium.