Written for Medical Realities by Meghan Gessner on September 2, 2025

What Is a Conch Piercing?

A conch piercing goes through the “bowl” of your ear—aka the concha. That bowl has two zones: the upper cup (cymba) and the lower cup (cavum). It’s all cartilage, which is tougher than your earlobe, so it takes longer to heal and needs extra care to dodge infections.

Types of Conch Piercings

• Inner conch: Sits in the center cup near the ear canal. Low-profile studs (flat backs) are the crowd favorite here so headphones and hair don’t snag.
• Outer conch: Placed on the flatter area between the helix (outer rim) and antihelix. Hoops look great once you’re healed, but studs are the smart starter.
• Double conch: Two conch piercings—either stacked inside the inner cup, or one inner + one outer for a layered look.

How Is a Conch Piercing Done?

Go to a licensed pro who works clean and uses sterile, single-use tools. The exact approach depends on your anatomy and the look you want.

• Methods: Most piercers use a thin, single-use needle. Some studios may use a dermal punch for certain outer conch placements to create room for larger jewelry. Your piercer will walk you through options and aftercare for either method.
• Step-by-step: You’ll confirm placement in the mirror, the area gets cleaned and marked, the piercing is done, jewelry goes in, any minor bleeding is controlled, and everything gets cleaned again before you head out with an aftercare plan.

Does a Conch Piercing Hurt?

It’s cartilage, so expect a sharper pinch than a lobe and a short, dull throb afterward. Pain is quick, not all-day. Right after, it’s normal to see some redness, mild bruising, swelling, or a little blood.

• First weeks: Tenderness, itchiness, and some color changes are common. You might see a pale, crusty fluid on the jewelry—that’s typical wound drainage while it heals.
• Numbing? If you’re nervous, ask your piercer about safe cooling (like an ice pack before the appointment). They’ll let you know what’s appropriate in their studio.

What to Expect After a Conch Piercing

What’s Normal While It Heals

Your conch is basically an intentional wound in cartilage, so some drama is expected at first. Typical healing stuff includes a little bleeding, mild swelling, light redness or bruising, itchiness, and a whitish-yellow crust that dries on the jewelry (that’s normal lymph fluid, not pus). Tender to the touch is standard.

Conch Piercing Healing Time

Cartilage heals slow. Earlobes can be fine in ~6 weeks, but a conch usually needs 4–12 months for a truly stable heal. It often looks healed on the surface way before the inside is ready—keep aftercare going the whole window and keep jewelry in place (even old rook piercings can close if left empty).

Healing Tips (Do’s & Don’ts)

• Hands off: The less you touch, the fewer problems. No twisting, spinning, or “breaking crusties.”
• Skip pressure: Don’t sleep on that side. Use a travel/donut pillow to keep the ear floating.
• Avoid irritation: Keep hair, hats, helmets, glasses arms, and headphones from rubbing or snagging.
• Keep it clean: Wash pillowcases/bedding often. Wipe down phones, glasses, headphones, and anything that touches your ear.
• Hold the extras: No charms or heavy hoops until fully healed. Stick with your starter stud until your piercer clears a swap.
• Lifestyle matters: Minimize excessive alcohol, nicotine, recreational drugs, and even heavy caffeine—they can slow healing.
• Product perimeter: Keep lotions, makeup, hairspray, and dry shampoo away from the piercing channel.

How to Clean a Conch Piercing (Safe Method)

• Wash hands first with soap and water.
• Use sterile saline wound wash 1–2× daily. If you DIY, mix ¼ tsp non-iodized sea salt into 1 cup (240 ml) warm sterile or distilled water to make an isotonic soak.
• Soak or compress: Gently soak the area or hold a saline-soaked gauze/pad on it for 5–10 minutes. Let warm shower water soften buildup first.
• Pat dry with a clean paper towel (not cloth—less bacteria, no lint).
• Do not use alcohol, hydrogen peroxide, witch hazel, or ointments—they’re too harsh and can slow healing.
• Do not turn/twist the jewelry—movement irritates cartilage and invites bumps.

What Can Trigger an Infection

• Unsterile tools or a sketchy environment
• Removing or changing jewelry too early
• Touching with unwashed hands or over-cleaning/overhandling
• Skipping daily saline care
• Swimming in pools, hot tubs, lakes, or the ocean before you’re healed

Signs of a Possible Infection

• Thick yellow/green/gray discharge with odor (not the normal light crust)
• Spreading redness, warmth, or swelling that’s getting worse
• Increasing pain or throbbing
• Fever, chills, nausea, or feeling unwell

If you see those red flags, keep the jewelry in (so the channel can drain) and check in with a healthcare pro. Your piercer can help troubleshoot fit and aftercare, too.

Conch Piercing Risks

Infection: common, fixable

A fresh conch is an open wound in cartilage, so mild redness, tenderness, and a little clear/yellow crust is normal. If you think it’s crossing into true infection territory, call your health care provider. Most ear infections caught early respond well to proper care and, if needed, meds.

Serious but less common issues

Bloodstream infections

Choose a studio with a solid rep that uses single-use, sterile needles and properly sterilized tools. Dirty conditions can expose you to blood-borne infections like hepatitis B/C or tetanus. Make sure your routine vaccines are up to date before you get pierced.

Keloids (raised scars)

Keloids are overgrowths of scar tissue that spread beyond the original wound. They may show up 3–12 months after piercing. If you’re prone to keloids, skip cartilage piercings. Treatment depends on size and symptoms and can include:

• Corticosteroid injections
• Surgical removal
• Cryotherapy (freezing)
• Laser therapy
• Radiation therapy (select cases)

Allergic reactions

Nickel is the usual culprit. Plenty of “gold” jewelry still contains nickel, especially if it’s low-karat or plated. Start with metals that are truly nickel-free and safe for new piercings.

Conch Piercing Rejection

“Rejection” is when your body gradually pushes the jewelry toward the surface until it’s barely held in. It’s not super common, but it happens—sometimes due to harsh products, constant pressure/snagging, stress, or just bad luck.

Watch for:

• Thinning tissue: The skin between the entry/exit holes keeps shrinking. If there’s ~¼ inch or less—or you can practically see the jewelry through a thin, shiny layer—flag it.
• Chronic irritation: Peeling or flaking skin, persistent redness/inflammation, hard/calloused tissue between the holes.

If you suspect rejection, don’t wait. See your piercer ASAP; you’ll likely need to remove the jewelry to prevent scarring.

Choosing Jewelry for a Conch Piercing

Go picky here—fresh cartilage needs implant-grade, nickel-free metals from reputable sources. Ask your piercer to show you the material specs (ASTM/ISO codes).

Stainless steel (only certain grades)

Use body-safe, implant-appropriate steels:

• ASTM F-138 or ISO 5832-1
• ISO 10993-(6, 10, or 11) biocompatibility
• Compliance with the EU Nickel Directive

Titanium (top choice for sensitivity)

Lightweight, nickel-free, and highly biocompatible. Look for:

• ASTM F-136 (Ti-6Al-4V ELI)
• ASTM F-1295
• ISO 5832-3
• Commercially pure titanium ASTM F-67

Niobium

Biocompatible and nickel-free; not formally “implant grade,” but widely used and well-tolerated for piercings.

Gold

Stick to solid 14k–18k (no nickel, no cadmium), made for body wear. Avoid plated, filled, vermeil/overlay on fresh piercings—they can flake and irritate. Skip >18k for new piercings (too soft for dating).

Platinum

Excellent and inert, just pricier and less common in piercing jewelry.

Glass

Only certain glasses are safe for initial wear:

• Fused quartz
• Lead-free borosilicate
• Lead-free soda-lime