Dermal piercings aren’t universally illegal, but they are banned or heavily restricted in several jurisdictions because regulators classify them as a medical procedure rather than a cosmetic piercing. The core issue is that dermal anchors are implanted beneath the skin, which crosses the legal line from piercing into surgery in many places.
What Makes Dermal Piercings Different
A traditional piercing passes through a fold of skin with an entry and exit point. A dermal piercing, also called a microdermal anchor, works differently. A small metal plate is inserted into the dermis (the lower layer of skin) through a single puncture, and a post attached to that plate sticks up through the surface for decorative jewelry. There’s no exit hole. The plate sits under your skin, and your tissue grows around it to hold it in place.
This design is exactly what creates the legal problem. Placing a foreign object beneath the skin and allowing tissue to integrate around it looks, to medical boards and health regulators, a lot more like a surgical implant than a piercing.
The “Practice of Medicine” Classification
The most significant legal barrier comes from medical boards that have formally ruled dermal anchoring constitutes the practice of medicine. In Nevada, the State Board of Medical Examiners reviewed microdermal procedures and determined that “the placement and removal of microdermal anchoring… constituted the practice of medicine.” The Southern Nevada Health District followed by classifying single-point piercings as “extreme body modification” and prohibiting them in tattoo and piercing establishments.
This classification means that only licensed medical professionals can legally perform the procedure. Since most body piercers don’t hold medical licenses, the procedure effectively becomes unavailable at piercing studios. A piercer who performs one anyway risks being charged with the unauthorized practice of medicine, which in some states is a felony. New York’s Education Law, for example, treats unauthorized medical practice as a criminal offense that can result in felony indictment.
The reasoning isn’t arbitrary. Regulators point to the fact that the procedure involves cutting into skin, implanting a device, and creating a wound that heals around a foreign body. These are characteristics of minor surgery, not cosmetic piercing.
Why Removal Makes the Legal Case Stronger
If insertion is the first legal concern, removal is the second. Once a dermal anchor has been in place for a while, the surrounding tissue grows into and around the base plate. Getting it out isn’t as simple as pulling out a ring or stud. In many cases, it requires a small incision to free the plate from the tissue.
British dermatologists have raised direct concerns about this. The British Association of Dermatologists noted that anchors can become embedded into the dermis and require surgical removal by medical professionals. As one dermatologist stated, “The practice of clinical surgery without medical qualifications is a criminal offence in the UK. With dermal anchors the distinction between piercing and surgery is becoming less clear.”
There’s also the pain factor. Removing an embedded anchor properly often calls for local anesthetic injections, which only medically qualified practitioners can administer. Without anesthesia, the removal process can be extremely painful, and piercers who attempt it are working outside their scope of practice.
How Regulations Vary by Location
The legal landscape is inconsistent, which adds to the confusion. There is no single nationwide ban in the United States. Instead, the rules depend on your state, county, or even city.
Nevada explicitly prohibits the procedure in piercing shops, treating it as a medical act. Other states may not have specific rulings on dermal anchors but have broad enough definitions of “practice of medicine” that placing an implant under the skin would fall under that umbrella. Some jurisdictions simply haven’t addressed the question yet, leaving piercers in a legal gray area.
In England and Wales, the Local Government Act 2003 expanded regulation of piercing businesses to cover “cosmetic piercing” more broadly, requiring registration of both practitioners and premises. But the act regulates piercing rather than banning it outright. The deeper concern in the UK comes from the medical side: dermatologists argue that dermal anchoring crosses into clinical surgery, which is already illegal to perform without medical qualifications. Local councils can set their own additional licensing conditions, so rules vary from one area to the next.
Health Risks That Drive Regulation
Regulators don’t restrict dermal piercings purely on legal technicality. The health concerns are real and go beyond the typical infection risk of standard piercings.
- Rejection and migration: Because the body recognizes the anchor as a foreign object, it sometimes pushes the plate toward the surface over time. This can cause scarring, tissue damage, and eventual loss of the piercing.
- Infection risk: The open wound created during placement heals slowly, and the design of the anchor creates a channel where bacteria can travel beneath the skin. Infections below the skin surface are harder to treat than surface-level ones.
- MRI complications: Some dermal anchors contain magnetic components. During an MRI scan, magnetic metal under your skin can feel a significant pull, distort the imaging, and potentially cause heating. NHS guidelines require that any magnetic components be removed before a patient enters the MRI room. If the anchor can’t be removed, it may delay or prevent imaging you need.
- Scarring from removal: Whether a dermal anchor is removed intentionally or rejected by the body, it typically leaves a scar. Surgical removal by a doctor produces a cleaner result than a traumatic rejection, but scarring is nearly unavoidable either way.
These risks are compounded by the fact that many people getting dermal piercings don’t realize they’re functionally permanent. Unlike a nose ring you can slide out, a dermal anchor is designed to stay put. The need for professional, sometimes surgical, removal catches many people off guard.
Where Dermal Piercings Are Still Available
In many parts of the US and UK, dermal piercings remain available at piercing studios. The procedure isn’t illegal everywhere, and in jurisdictions without specific rulings, experienced piercers continue to offer it. The legality often depends on whether your local health department or medical board has taken a formal position on whether implanting an anchor qualifies as medicine.
If you’re considering one, the most practical step is checking your local health department’s body art regulations. Some regions publish explicit lists of prohibited procedures. In areas where the procedure is permitted, look for piercers who are licensed, work in inspected facilities, and use implant-grade titanium anchors, which are less likely to cause reactions or MRI problems than cheaper alternatives.