What to Know About Conch Piercing

Medically Reviewed by Shruthi N, MD on October 17, 2024
9 min read

A conch piercing is an upper ear cartilage piercing that is done in either the upper or lower concha of your ear. Concha is the scientific name for the inner, cup-like part of your ear called the conch. It’s made up of the upper conch area (cymba) and the lower part (cavum). This part of your ear is made of cartilage, which is harder than the soft tissue of your earlobe. Conch piercings are more likely to become infected than earlobe piercings, so they need special care and extra healing time.

There are a few kinds of conch piercings you can pick from depending on where you want it and how you want it to look.

Inner conch piercing. This type goes in the inner "cup" of your ear near the ear canal. Because it sits in the middle of your ear, cartilage studs are a popular jewelry choice for inner conch piercings.

Outer conch piercing. This is done on the upper, flatter part of your ear between its folded edge, also known as the helix, and the curve of the ear's antihelix. Hoops are popular for this kind of conch piercing, along with studs.

Double conch piercing. With this type, you can choose to stack two piercings in your inner conch or get an outer and inner conch piercing.

A professional piercer may use two main methods depending on the type of conch piercing you want. Regardless of the technique, they'll go through the same basic steps to prepare and complete your piercing safely.

Piercing methods

The piercer will either use a thin needle or dermal punch, a device that removes a circular part of your ear similar to a hole puncher. Dermal punch is usually used for outer conch piercings since that part of the ear is flatter than the curved inner conch.

Piercing procedure

When you get your conch piercing, your body piercer will:

  • Double-check the piercing placement with you
  • Clean your ear with alcohol or another antiseptic
  • Mark the piercing location on your skin
  • Pierce your ear
  • Insert the sterilized jewelry you chose into the piercing
  • Stop bleeding, if any
  • Clean the area with an antiseptic again

The intensity of conch piercing pain is different from person to person, but you will feel a pinch and probably some throbbing during the piercing. Since conch piercings go through ear cartilage, it will hurt more than an earlobe piercing, which is cushioned by fatty tissue. The pain won't last long though. If you are worried about the pain, ask your piercer about numbing the area ahead of time with an ice pack.

Right after a conch piercing, your ear may be tender. It's also normal to see some blood, bruises, redness, and swelling in the first couple of days. While your conch piercing heals, you may feel some pain. For the first few weeks, the area may get itchy and become discolored too. This is normal. You may also notice a pale fluid crusting onto the jewelry or some lumps around the piercing.

Because your conch piercing is an open wound, you'll experience some pain and tenderness at the site. Since some of the symptoms you experience after a piercing are similar to some of the symptoms of infection, you should know which symptoms are a normal part of the healing process.

Normal symptoms of healing after a conch piercing can include:

  • Some bleeding
  • Slight swelling around the area of the piercing
  • Some discoloration of the skin
  • Itching
  • Whitish-yellow discharge that forms a crust but is not pus

Not all ear piercings heal at the same rate because the type of tissue in each part of your ear is different. If you've pierced your ear lobes before, expect the healing process for a conch piercing to take longer. Lobe piercings usually only take 6 weeks to heal, but piercings on the side of your ear, such as conch piercings, can take 4 months to a year to heal fully.

It's normal for the piercing to seem healed before it actually is. This is because tissue heals from the outside in. Continue with your cleaning routine for the entire healing period, even if the area looks healed. Also, plan to keep jewelry in your piercing, as even piercings that have been established for years can close up if they're left empty. 

To help speed the healing of your conch piercing, do the following: 

  • Avoid irritating the area of the piercing with clothing or excessive movement, unnecessary touching, or cleaning.
  • Avoid having your conch piercing come in contact with other people's bodily fluids.
  • Avoid recreational drug use, excessive caffeine, nicotine, or alcohol, as these can all affect healing.
  • Avoid using personal care products around the piercing, such as body lotion, makeup, or hairspray.
  • Don't sleep directly on the piercing.
  • Don't add any type of charm to your jewelry until the piercing is fully healed.
  • Wash your bedding regularly.
  • Clean headphones, phones, glasses, hats, helmets, and anything else that comes into contact with your conch piercing.
  • Be careful when you're styling your hair to avoid irritating your piercing.

You can help prevent an infection if you keep your conch piercing clean. Wash your hands thoroughly before you touch your piercing, and clean it as follows:

  1. Make a cleaning solution using 1/4 teaspoon of sea salt or 1 tablespoon of table salt dissolved in one cup of warm water. You can also use mild liquid antibacterial soap diluted half and half with water.
  2. Don't use hydrogen peroxide or alcohol when you clean the piercing because they kill new, healthy cells and make you heal more slowly. Don't use ointment on your piercing because it interferes with healthy airflow.
  3. Dip a cotton swab in the cleaning solution. 
  4. Use it to soak the area of your piercing.
  5. When the area is wet, turn the jewelry in your piercing.
  6. Repeat twice a day.

An infection can develop in your piercing if bacteria invade the wound before it's healed. This can be caused by:

  • Nonsterile piercing tools or an unhygienic environment
  • Removing jewelry from the piercing too early
  • Touching the piercing with dirty hands
  • Forgetting to clean your piercing every day
  • Swimming in a natural body of water, a hot tub, or a pool

Symptoms of an infection in a conch piercing can include:

  • A discharge from the pierced area
  • Fever
  • Warm, red, or swollen skin around the piercing
  • Soreness or pain around the piercing

Infections of the pierced area are not uncommon, but they usually respond well to treatment. If you suspect you have an infection, contact your health care provider for advice.

Other complications occur less often than infections. Some can be serious, including: 

Bloodstream infections. Use a piercer with a good reputation. Unclean conditions and instruments that aren't properly sterilized put you in danger of blood infections. You could develop hepatitis B or C or tetanus from contaminated piercing tools. You should also have all of your vaccines before any type of piercing. 

Keloids. A keloid is a type of scar that forms after an injury, such as a piercing. Keloids extend beyond the original area of the wound. A keloid may not form until 3 to 12 months after your conch piercing. People who are prone to developing keloids should avoid piercings. A keloid may be treated with different options depending on how big it is and how much it bothers you. Some keloid treatments include: 

  • Corticosteroids
  • Surgery
  • Cryotherapy
  • Laser treatment
  • Radiation therapy

Allergic reactions. A nickel allergy is the most common cause of an allergic reaction to a piercing. Many types of jewelry contain nickel, including some gold jewelry. Only good-quality jewelry that doesn't contain nickel should be used for piercings.

Conch piercing rejection is when the piercing jewelry comes all the way to the surface and is pushed from your body. This can happen because of a harsh aftercare product, physical or emotional stress while the piercing is healing, poor health habits, or for unknown reasons.

Piercing rejection isn't common, but symptoms you can look out for include:

Piercing thickness. See if the tissue between the piercing openings gets smaller or thinner over time. If there's 1/4 inch of space or less between them, you might have rejection. Another sign to look for is if there's only a thin strand of almost transparent tissue left, and you can see the jewelry through your skin.

Piercing irritation. If the skin between the piercing holes is flaking or peeling, red or inflamed, or hard and calloused, your body may be rejecting the piercing.

If you have any of these symptoms and think you have rejection, remove the piercing and speak to your piercing professional.

You'll want to be choosy when picking jewelry for conch piercings. Not all materials are made for new piercings. As a general rule of thumb, look for jewelry with the American Society for Testing and Materials Standard (ASTM) or International Standards Organization (ISO) code designations. These organizations set materials standards so you know the quality of the jewelry and can trust that it's from a reputable source. Your piercer should have this information on hand.

Approved jewelry materials

Some of the best conch piercing jewelry materials to look for include:

Surgical steel. Only some stainless steels are made for body piercings. Look for steel with these standards:

  • ASTM F-138 or ISO 5832-1
  • ISO 10993-(6,10, or 11)
  • EEC [European] Nickel Directive

Titanium. This is a popular choice for people with nickel sensitivity. Pick implant-certified titanium (Ti6Al4V ELI) that's certified with one of these standards:

  • ASTM F-136
  • ASTM F1295
  • ISO 5832-3
  • Commercially pure titanium that is ASTM F-67 compliant

Niobium. This material is similar to titanium and is popular for piercings, but it doesn't have an implant-grade designation.

Gold. Across rose, yellow, and white gold, only pick gold that is 14k or higher, free of nickel and cadmium, and alloyed for use on skin. You shouldn't use higher than 18k on new piercings, as the metal is too soft. Also avoid gold-plated, gold-filled, or gold overlay/vermeil jewelry for a fresh conch piercing.

Platinum. While this is a great sturdy material for body piercings, it's rarer to find since it's more expensive to make and harder to fashion into jewelry.

Glass. Glass has long been used as jewelry for body piercings. You'll want to pick fused quartz glass, lead-free borosilicate, or lead-free soda-lime glass for initial piercings.

Best jewelry types for conch piercing

There are many jewelry options to choose from to make your inner or outer conch piercing stand out. Here are some of the most popular ones.

Rings. These hoops come in different diameter sizes and are a popular choice for high-ear piercings, such as outer conch piercings.

Cartilage studs. Common inner ear jewelry, these look similar to lobe studs and come in a range of styles and sizes.

Barbells. These can be straight or curved and have balls that thread onto both sides. Barbell jewelry is popular for outer and inner conch piercings.

Before you get a conch piercing, make sure you understand the process along with the pros and cons. You'll also want to make sure you can ask the right questions about jewelry to pick ASTM- or ISO-certified materials that don't bother your skin. Conch piercings take longer to heal than earlobe piercings, so be prepared to care for them properly to avoid and manage any potential infections.

How much does conch piercing cost?

This can vary depending on the type of jewelry you pick. Many studios charge a fee based on the site of the piercing and add the jewelry price on top of that. Total pricing can range from $75 to over $100.

Can I wear earphones after a conch piercing?

Depending on where in your ear the piercing is, you can. But make sure to keep your earphones clean and disinfected. If the piercing is closer to the ear canal, you'll want to avoid in-ear earphones for a while to avoid irritation.

Which is more painful, a conch or helix piercing?

Some people say both of these piercings cause similar levels of pain, while others say a conch piercing is more painful since it goes through thicker cartilage. Generally, you can expect conch piercings to be about as painful as other cartilage piercings.