A dermal, short for dermal piercing (also called a microdermal), is a type of body piercing that sits on a flat surface of skin rather than passing through a fold of tissue like a traditional earring or belly button ring. A small anchor is inserted beneath the skin, and a decorative top sits flush on the surface, creating the appearance of a jewel or stud emerging directly from your body. You might also hear “dermal” used to describe dermal fillers, which are cosmetic injections that plump wrinkles on the face. These are completely different procedures, so this article focuses on dermal piercings, which is what most people mean when they search the term.
How a Dermal Piercing Works
Unlike a standard piercing that has an entry and exit point, a dermal piercing has only one opening in the skin. A tiny anchor, usually shaped like a flat plate with holes in it, is placed into a small pocket beneath the skin’s surface. Over time, tissue grows through the holes in the anchor’s base, securing it in place. A decorative top screws or snaps onto a post that rises from the anchor, and this top is the only part visible above the skin. You can swap out the decorative top for different styles once the piercing is fully healed.
Anchors come in a few designs. Round and footed bases are the most common, and there are also all-in-one “skin divers” with a permanently attached top. For people with metal sensitivities, biocompatible polymer bases are available as an alternative to metal.
Where Dermals Can Be Placed
A dermal piercing can go almost anywhere on the body as long as the skin is relatively flat and thick enough to hold the anchor securely. Popular spots include the cheekbones, nape of the neck, chest, lower back, abdomen, and thighs. Some people get them on the back of the hand, near the collarbone, or along the hip bones.
Not every location works equally well. Areas that experience a lot of movement, friction from clothing, or frequent bending tend to have higher rejection rates. A skilled piercer will assess the spot you want and let you know whether the skin there is a realistic candidate for long-term success.
The Insertion Process
There are two main methods for inserting a dermal anchor: a needle technique and a dermal punch. With the needle method, the piercer uses a needle to gently separate the tissue and create a small pocket for the anchor. This avoids removing any skin, which supports better blood flow to the area and reduces trauma. Some piercers prefer a dermal punch, which uses a small circular blade to remove a tiny disc of tissue. Both methods are quick, typically taking just a few seconds for the actual insertion.
You’ll feel a sharp pinch during insertion, and some pressure as the anchor is positioned. The level of discomfort depends heavily on the body location. Areas with thinner skin or more nerve endings, like the face, tend to hurt more than fleshier spots like the chest or thigh.
Jewelry Materials and Safety
Because the anchor lives inside your body permanently, the material matters. Implant-grade titanium is considered the safest option. It contains no nickel, is truly hypoallergenic, and is biocompatible, meaning it works well with human tissue. It’s the same type of material used in medical implants like pacemakers, bone screws, and dental implants.
Surgical steel (316L) is another common option, but it contains roughly 8% nickel. While many people tolerate it fine, nickel is one of the most common contact allergens. If you have sensitive skin or any history of reacting to cheap jewelry, surgical steel can cause redness, itching, or contribute to rejection. For a piercing that sits inside your skin long-term, titanium is the better choice.
Healing Timeline and Aftercare
Surface healing typically takes one to three months, but full integration of the anchor into the surrounding tissue can take longer. During this period, the tissue is growing through the holes in the base to lock the anchor in place. Until that process is complete, the piercing is vulnerable to being bumped out of position or getting infected.
Aftercare is straightforward but important. Spray the piercing with sterile saline wound wash (look for 0.9% sodium chloride as the only ingredient). Dry gently with disposable gauze or cotton swabs rather than cloth towels, which can harbor bacteria and snag on the jewelry. Don’t rotate or move the anchor during cleaning. Rotating it disrupts the healing tissue and can actually make things worse.
While sleeping, wear clean, breathable clothing that covers and protects the piercing from catching on sheets or blankets. During the day, avoid tight clothing that rubs against the site. Keep makeup, lotions, and hair products away from the area until it’s fully healed.
Signs of Rejection and Migration
Rejection is the most common long-term risk with dermal piercings. Your body sometimes treats the anchor as a foreign object and slowly pushes it toward the surface of the skin. This process, called migration, can happen weeks, months, or even years after the initial piercing.
Early warning signs include the jewelry visibly shifting from its original position, the skin around the piercing becoming red, flaky, or unusually hard, and the top starting to hang or droop differently than before. As rejection progresses, the skin between the anchor and the surface gets thinner. In some cases, you can actually see the anchor through nearly transparent skin. If left alone, the body will eventually push the piercing completely to the surface, cracking the skin open to expel it.
Catching rejection early gives you the best chance of removing the piercing cleanly with minimal scarring. If you notice any of these signs, it’s worth having a piercer evaluate the situation promptly.
How Removal Works
Dermal piercings are considered semi-permanent. They don’t come out the way a regular earring does, because the anchor is locked into the tissue beneath your skin. Removal requires a professional, either a piercer or a doctor.
The area is numbed with a local anesthetic. Then the top is removed, and the skin around the post is gently manipulated to expose the anchor. A small incision is made near the base, and scissors or a scalpel are used to carefully separate the anchor from the surrounding tissue. If scar tissue has formed around the anchor, a small punch tool can be used to cleanly remove the scarred tract. Depending on the size of the resulting opening, it may be closed with a stitch or two or left to heal on its own.
The procedure is minor and quick, but it does leave a small mark. How noticeable the scar ends up depends on the location, how long the piercing was in place, and whether any rejection or infection occurred before removal.
How Dermals Differ From Dermal Fillers
If you searched “what is a dermal” thinking about cosmetic injections, dermal fillers are a completely separate procedure. Fillers are gel-like substances injected beneath facial skin to smooth wrinkles, plump lips, or restore volume lost with aging. They’re temporary, lasting anywhere from several months to a couple of years depending on the product. Dermal piercings, by contrast, are a form of body modification involving implanted jewelry. The only thing the two share is the word “dermal,” which simply means “relating to the skin.”