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Helix Piercing 101

Helix piercings! Is there a more quintessential, more classic piercing in modern times? I’m not sure. Most teens grow up considering getting a cartilage piercing, seeing glittering studs, snug hoops, and decorative ends adorning an upper ear. These piercings are spotted on celebrities, politicians, doctors, teens, and everyone in between. They are most folks’ introduction to piercings beyond earlobes, and they are consistently one of the most popular services at most studios. They have a history that dates back hundreds and thousands of years, with cultures all over the world depicting adornments in the upper ear. Helix piercings are placed through the cartilage of the helix rim, and there is a range of placements that follow the helix rim all the way around the ear. Today, we are going to look at the classic, quintessential helix placed along the outer rim of the helix. We will be looking at all placements in this area. Helix piercings are popular with both studs and hoops and even decorative chains and charms. From big and bold to dainty and delicate, there’s no shortage of jewelry choices for this popular piercing. But there are some major considerations for piercing and healing to think about before getting your helix pierced!


Anatomy matters for every piercing, and that includes the helix. Many folks assume that everyone has the anatomy for a helix, and this is actually not true. There are some anatomies that can not safely get a helix, although these are fairly rare. The outer ear is made up of cartilage and skin, and the helix rim is a ridge of cartilage that begins where the ear attaches to the head and curls down around the outer edge of the ear. The shape of the helix is highly variable, and there are rolled, concave, fused, flat, and wide-covering scapha helixes. Some clients are born with helixes that have a unique shape or formation, and others may develop this way as they grow. Young injuries, falls, and trauma can also dramatically change the shape of the helix.

As we can see, there are so many different ears, as many as there are unique and different people! Because of this, helix placements are generally going to look a little different on everyone, as they are placed for the individual's anatomy. It’s important to consider the anatomy of the ear when considering a helix because that will impact placement, jewelry, and even the healing process. Fortunately, these anatomical variations generally don’t mean we can’t get pierced, the just effect where we get pierced!


Placement for a helix piercing is deeply varied. Do we tuck it at the apex of the fold at the top of the ear? What about directly in the middle? Can we do a low helix? Should we tuck it right into the fold or bring it out a smidge on the flat of the ear? Do we pierce it to face forward? Or to the side? Is one placement better than the other? Where is it supposed to go?!?


Get it wherever you want it!

Probably the most popular placement is somewhere in the upper 1/3 of the ear and tucked slightly into the fold of the helix. This placement is a classic for a reason- it looks great with small studs and usually leaves plenty of room to wear something larger. Hoops wear really nicely up there, both snug and dainty and big and bold. Chains work here, and decorative studs and dangles. This placement tends to steer clear of glasses, masks, and many styles of headphones, making it very practical as well as aesthetically pleasing. The vast majority of people can support a piercing in this placement, which also aids its popularity. When most folks hear the words “helix piercing” or “cartilage piercing” this is what they envision. This placement is so popular it’s in multiple forms of popular culture and media.

Darth Maul has a helix piercing because his actor forgot to remove his for filming

But, there are some big considerations for this placement. Foremost among them is the angle and exact placement we go with. This portion of our ear is usually shaped a bit like a canyon, meaning we have a low point and sloping ridges coming up from that. Some folks have a wide area here where we can fit a range of pieces comfortably, and we have lots of choices for placement. Others may have a very narrow ridge here, and jewelry will be quite limiting. Others still might have a ridge that is nearly fused, and we can’t safely pierce directly in. Depending on a client's anatomy and goals, we may need to bring this piercing further out into the scapha in order to allow it to sit well and wear jewelry correctly.

But that’s not the only thing we need to think about with this placement! Because these tiny changes in placement create big changes in angles. We want piercings to be perpendicular to the tissue. What is perpendicular is going to change as we move along this folding, curving, and sloping area of the ear. This will change how jewelry sits, and if it's visible more from the front or the side. It might change the size of pieces you can comfortably wear- one angle may allow for lots of different size ends but another may limit you to smaller pieces. Most notably, this will change how a hoop sits in your ear.

Two helixes that are placed differently and wear hoops very differently

This is something your piercer should discuss with you at the time of piercing, and you should work together to find a placement that is ideal for you, safe for your anatomy, and will allow you to wear all the jewelry that you want. There's so many small variations we can make to this placement that can totally change how these piercings wear, so it’s important that we are mindful of that!

But there is also so much variety to placement outside of just the upper helix. The helix is the entire rim of cartilage, meaning we aren’t limited to piercing in the upper area. We can go lower for a mid helix, sometimes called an auricle, middle helix, or midline helix. This placement is usually done directly in the middle of the ear, often in line with the daith or tragus. This is a super cute placement, and I wear these myself! However, this placement can often be more difficult to heal for many. This is right at the outermost edge of the ear for most folks, meaning it's very easy to catch or snag piercings in this location. Many clients have a deep and narrow ridge here, meaning they are limited to wearing smaller pieces in this placement comfortably. This area is more prone to irritation bumps and issues, and just in general a trickier heal for many. While it’s a super cute placement, I would caution anyone getting it to be prepared for a potentially more difficult healing process than a classic helix.

And of course, we aren’t limited to these two areas! We can really go anywhere along that rim you want. There are even variations like helix fold piercings, vertical helixes, and forward helixes which we will discuss in future blog posts. When you are deciding on placement I would encourage you to think about your future goals for this piercing. Do you want to wear a snug-fitting hoop as your goal? Your placement may end up higher or lower to give you the look of the hoop you want, or further in or out on your ear. Are you planning on wearing big, bold, chunky jewelry long term? Your placement may need to adjust to allow ends to sit flat and nicely, and we may need to move more toward your flat. When you have very particular jewelry goals in mind discuss them with your piercer! Often we can use size placement rings or example pieces to ensure that we are piercing you to allow for your goal.

And this goes double if you are planning multiple helix piercings. If you know your goal is two cute hoops, a triple helix with ascending-size gems, or you want to drape an elegant chain between your helix and another piercing, let us know this! When we know we can plan ahead and determine placements that can allow for you to build off of them with other piercings. Where I like to place helix piercings on the ear varies greatly between doing a single stud alone or a project featuring multiples.

Initial Jewelry

Now when it comes to jewelry there is a lot to consider for a helix piercing. This is because helixes are pretty versatile piercings that can wear a huge range of styles safely and still heal well. The style of jewelry you start with is going to have a big impact on your experience healing a helix, and there are pros and cons to most styles.

The first is a classic, simple stud. Something with a flat disc on the back, and some smaller adornment on the front. Perhaps a classic bead, or a simple gemstone or opal. These are probably going to be the easiest pieces to heal with in a helix. They are easy to keep clean, and easy to work around. They can still have a lot of flash and show, but aren’t huge, making them less likely to get caught or snagged. These pieces are a classic for a reason- after all other styles aren’t secretly sneaking into cannon in major media properties! The flat backing on this style helps minimize catching and snagging on hair and clothing, and the simple design on the front will tuck into a range of anatomies. For folks with very narrow helix ridges, many of the larger and more decorative pieces don’t sit nicely in the crease or fold of their ear, and can sometimes cause irritation from movement and pressing into the surrounding skin.

But of course, it doesn’t have to be simple. Helixes are a great place to go wild with something bold and unique! A 5 gem cluster is a classic piece for a helix, giving the effect of multiple piercings graduating down your ear but only requiring one. Likewise in recent years, decorative gold clusters of gems and beads have become very popular. And these all often work just fine in an initial helix! However, these large pieces are going to be harder to heal with and harder to keep clean- be mindful that however large it is on the front you have to clean around beneath it! For clients who are more experienced with healing or who are just very motivated for that perfect piece, these can be a great choice. Large pieces like this are anatomy-dependent and some ears may not have the space to support being pierced with a very large piece. There is so much variety in these pieces, and what is large for one person's ear many be a totally reasonable size for another. And not all large pieces are made equally- open back settings, tall or rough prongs or stone settings, tiny or even sharp beads and accents may all make a difference in how a piece wears for healing. In general the smaller, simpler, and smother a piece is, the easier it will be for healing. The more fancy and over the top we get- the more work it might be! If you are prepared for that work and your ear supports it- go for it! Don’t worry though if it doesn't- you can often wear these pieces once healed, they are just a bit difficult to heal.

Some people want to go even fancier and add some chains and dangles for helix piercings and this can be a great place to do this! Chains and charms add movement, extra sparkle and shine to a piercing, and it ranges from simple small chains and dangles all the way to long, opulent pieces. A word of advice when considering chains, however- I will use pieces where the chain is welded to the end initially, but I won’t use loose chain attachments on fresh piercings. The difference here is as follows- a welded piece has the chain directly attached to a point on the decorative end. The attachment of the chain doesn’t actually have any contact with the piercing while it's healing. Those chain attachments however do- they are chains and dangles that have jump links that slide over the post. These pieces can move freely and will slide up and down the extra room on an initial piercing post. They easily become clogged with crust and debris, can be very hard to keep clean, and can drag that crust and debris against the ear. I know this because I decided to personally experiment with healing a piece that had a loose chain attachment and it was so much harder to heal than it needed to be. Getting the crust entirely clean was virtually impossible without really aggravating my piercing and it also trapped moisture against my ear. Now, it did still eventually heal, but it was so much harder than it needed to be. So for safety’s sake consider saving those chain attachments for once you are fully healed.

Now, if we are talking about studs for helix piercings we have to mention a butterfly backing. I have a whole article here about why this backing style isn’t ideal anywhere, but particularly not in helixes. Those large backings can very easily tangle in hair, clothing, or pillowcases and get snagged or cause damage or issues. These backings are quite large, and they can become caught and snagged easily while sleeping. Worse than that they are just very uncomfortable for many to sleep on, and can dig into the side of your head behind your ear if you lay on them. It also creates spaces for the natural secretions of the piercing to collect and become crusty and gross. These styles are most commonly used with piercing guns, which we also know are unsafe. I see so many clients every month come in with a butterfly back in their cartilage begging me to find them something comfortable, something they can sleep on, something they won’t get caught on.

And, of course, Hoops. Helixes are one of the few piercings I will start with a hoop, but only after a very in-depth consultation. This is because what I mean when I say “a hoop for an initial helix piercing” and what a client means when they say “I want to be pierced with a hoop” are usually not the same thing. See, new piercings are just that, new piercings. They need time to heal! Part of that healing process often includes swelling. Another part of the healing process includes secretions and debris that need to be cleaned away. In order to accommodate that healing, we need to use a ring with a diameter that is large enough to have room for swelling.

When we use a ring that is a snug or tight fit, there’s no room for swelling, cleaning, and healing. This can cause those dreaded irritation bumps to form, or worse it can actually cause the hoop to migrate through the helix. We talked on this blog before about the cheese wire effect. This is a bigger concern with hoops than it is with studs. That also means if I’m piercing someone with a hoop initially it’s going to be a thicker gauge to be stable enough for healing. Most clients when they ask for a hoop are picturing a dainty, snug, or mostly snug-fitting hoop. They are not picturing a thick, oversized hoop with a bead on it (because as I discuss in this blog post, we don’t want to put simple seam rings in initial piercings). So a lot of clients don’t actually want the hoop they would need for initial healing- they want the cute tiny hoop they’d get once healed! And if that’s the case, then I always suggest starting with a stud. Why?

Healing with hoops is often harder. Even when we size them appropriately, even when they are thick enough to be stable, they are just trickier for many clients to heal with. They get caught and snagged, they move around more, and they often fare worse than studs when dealing with bouts of swelling. Climate can also play a large role in this, and humid areas or areas with constant weather cycles may see more swelling that can make hoops even trickier to heal with.

Now like I said above, I am happy to use a hoop for a client's initial helix. If the client is aware it’s going to be larger for swelling, a thicker gauge for stability, probably more difficult to heal with, and I am not concerned about issues with excess swelling due to climate, health conditions, allergies, etc. The fact of the matter is this is really only about 5-10% of my clients if that. The vast majority of folks don’t want to deal with a potentially more difficult healing and also frankly don’t like the look of the chunky hoop that is appropriate for initial piercing. If your goal is that dainty, tiny, delicate little hoop then get pierced with a stud that’s going to be easier to heal and more your style, let it heal, and then swap it for your perfect hoop. However if you are someone who likes the aesthetic of a thicker, more oversized hoop, if you are okay with your piercing being a slightly larger gauge, and you are prepared to deal with healing it, then let’s go! It’s no secret I am a fan of chunky jewelry and big hoops, and my first nostril piercing was done with a 14g captive bead ring (which I swapped for a stud about 5 months in because I was 14 and absolutely not responsible enough for healing with a hoop. Oops!)

However, some piercers and studios simply won’t offer hoops for initial helixes. If that is the case, please be respectful of that! It’s done out of an abundance of care for clients and wanting things to heal well. A studio may have seen too many clients who were very unhappy with the aesthetic of the larger hoop and asked for it to be changed. They may have seen too many issues with healing hoops. You may be in an area where climate makes swelling a major concern for piercings, and hoops that much more difficult to heal with. A piercer may not have experience using hoops initially and not want to cause you harm or issues. Please respect that these policies are in place to make sure you have a smooth and easy healing process and happy healthy piercings.

Healing Expectations

So we understand that there is a huge range of placements that work for this piercing and that different locations may be harder or easier to heal. We know what jewelry we might get, and that jewelry choice and style will also likely affect the healing process. But what is that healing process going to look like? And what about those awful bumps people get? Let’s talk about it.

Helix piercings, like most cartilage, take on average take about 6-9 months to heal, up to a year. Some folks, due to anatomy medical conditions, lifestyle, climate, or jewelry choice may find that it takes a full year or even a little longer for this piercing to be fully healed and comfortable. Hoops are notorious for taking a full year to heal in this placement, sometimes even longer. This is pretty normal and if you are someone who is a slower healer when it comes to your helix piercing don’t be discouraged- a lot of us are. Side sleepers, people who wear headsets at work, and folks who are just clumsy and catch and snag things easier are all going to probably have a trickier time healing this.

I have a blog post here that discusses how healing actually occurs in piercings which is very helpful when it comes to helix piercings if you are curious about specifics of the actual healing. I have another here that discusses aftercare methods.

Many clients will have a fairly uneventful healing process for their helix. They’ll get them pierced, probably snag them a few times on pillowcases and shirts and glasses while you adjust to having it there, and then before you know it it’s healed and you are changing it in and out without issue. We love to see it!

But, many clients (myself included) will have a bit of a …bumpier ride.

That’s right- the helix bump. Almost everyone either has experienced this or knows someone who has- getting a little bump or irritation on your piercing at some point during the healing process. I actually have an entire very in-depth article on these bumps and how and why they happen here that I strongly suggest you read. But, I wanna give you some helix-specific tips in this blog post.

The first is to consider the basics. Are you sleeping on this side? See, we don’t often realize it but the human head weighs about 8-10 lbs. So when we sleep on our healing piercing that’s 8-10 lbs of pressure all night long. That is a ton of pressure and in helix piercings, this can cause irritation, but it can also cause the piercing to migrate.

All that pressure usually pushes the helix at an angle when you lay on that side, for hours and hours all night long. Eventually, the jewelry shifts through the skin and begins to lay at that angle. This migration is often permanent and can result in some pretty nasty bumps. Not sleeping on your helix and downsizing it when it's ready to prevent extra length from getting torqued like that can help prevent this migration. My favorite trick is using a travel pillow like folks use at the airport, and putting my ear in the little space. That way I can still side sleep without crushing my poor piercing all night long. One of the most common reasons we see irritation in helixes is from being slept on, and this is the culprit for dozens and dozens of bumps.

Have you caught or snagged this recently? Helixes are a pretty high-traffic area that can get a good bonk or snag somewhat often. These can absolutely cause the piercing to become irritated. If you did, and that’s the cause of your bump, then some extra TLC and care & some time, and patience are all this needs to heal right up. What about being sick recently? A cold or the flu? Maybe seasonal allergies, or even seasonal weather change? When you are sick, and your whole body is sick, then your piercing understandably is going to be all grumpy too. Focus on getting yourself feeling better- your piercing can’t recover until you have recovered first!

And then consider some other factors. What jewelry were you pierced with- Did you opt for something ideal for healing like a high-quality implant-grade titanium labret post, or did you get the “one size fits all” piercing gun earring….maybe steel? Did you decide on the extra large and sparkly gem that gets snagged a bit more often or did you play it safe with something smaller and less likely to catch? Did you opt for the hoop, and the healing challenges it might bring? As we discussed above some jewelry styles can affect how this piercing heals, and you may be experiencing a bump as a side effect of this jewelry style, material, and quality.

Perhaps there is an issue with aftercare that could be causing this irritation. Often clients, accidentally, end up getting products like hair spray, gel, or dye into their helix piercings that can cause the piercing to become very irritated. Sometimes it's an external factor like wearing a mask, headphones, or a scarf.

Whatever the cause, if you have a bump or an issue with your piercing it’s important to get back in touch with your piercer so they can help you determine the cause of the irritation and how to treat it. If it’s grumpy because you snagged it, it likely just needs some patience and time to recover. If it’s irritated because you have a low-quality, “one size fits all” butterfly back, you likely need to get better-quality jewelry. And if it's becoming irritated from being slept on, you may need to get a travel pillow and change your routine to allow it to recover. Your piercer's job isn’t over just because they did your piercing- a huge part of our job is then helping you heal that piercing!

Hoop, Please!

The follow-up question whenever we discuss healing a helix is always “When can I change jewelry then!” And for many, this is because their goal was a fitted hoop but they opted to heal with a stud first, and they wanna know when they can get that goal piece! So, let’s get into it, changing jewelry and getting your goal piece!

Like I mentioned above most helix piercings take 6-9 months to fully heal, but it’s not uncommon for it to take longer for many people. The timeframe to change your jewelry out is when your piercing is fully healed, which means this answer varies from person to person. Someone who heals really easily and really well might be changing things in and out at that 6 month mark, and getting the snuggest cutest hoop. Someone who maybe heals more slowly or had a bump they had to be patient with going away might be changing their jewelry at around the 9-12 month mark. And someone who had a very hard time healing, and fought bumps on and off the entire time, might be waiting a year and a half or even two years to ensure everything is very very well established and fully healed before changing things.

An important thing to remember is that there are different definitions of “healed” when we talk about piercings. This article is a must-read for the in-depth breakdown of that. But essentially, there are a few ways a piercing can be “healed”. There’s as soon as it’s no longer an open wound, and there’s skin along the inside of the channel. A lot of folks consider this healed, even though this skin is very fragile and can very very easily be damaged or broken. Then there’s once tissue maturation occurs, when that fragile skin becomes stronger and more stable. Think of when you skin your knee or elbow- there's the healed where you have shiny pink skin that’s pretty tender and fragile and just a small scratch will break open. And then there’s the healed as it becomes thicker, more durable, and starts to return to skin color or scar color. A lot of times when we say a piercing needs to be fully healed we mean not only is it no longer an open wound, but the tissue is stable and strong and healthy.

For some people, this process takes much longer than others. I am one of those people- I have an autoimmune skin condition called psoriasis that affects the skin on my body. My piercings heal slowly, and often with irritation bumps and issues. Even once I do get piercings to that fully healed place, it often takes me even longer to begin wearing decorative jewelry or hoops. I’ll change something out, get and bump, and have to immediately swap back to something simple. This is because my medical condition affects how my tissue matures and stabilizes after a wound, and for me, this means it takes a lot longer. And this isn’t limited to psoriasis, many many medical conditions such as EDS, Eczema, diabetes, PCOS, acne, and more can affect someone's ability to heal.

I think as an industry we have this mindset of getting a piercing > heal a piercing > get your goal jewelry, and that it needs to look like this liner, easy process. But that just isn’t the case for a lot of us. For many of us, the process looks more like get a piercing > get a bump > heal a piercing > change jewelry > get a bump > Change back and wait longer > get your goal jewelry. And often with a lot of bouncing around between those levels. I want to mention that because I see so many clients who don’t have an easy time getting into their goal jewelry in their piercings- myself included! I felt like a failure as a teen and young adult for how much I struggled, with ear piercings in particular. I know now as a professional piercer that my body simply has a harder time healing, and that is okay. If you are someone who heals a piercing and gets right into your goal jewelry- that’s amazing! But if you aren’t, and it's a bit of a struggle for you, please know that’s ok too.

A note on migration

I touched on migration with helixes briefly above but I would really be remiss not to take a section of this blog to really get into it. I would say helixes are one of the most common places we see migration of every piercing. You hear about it more often with things like surface piercings, navels, and eyebrows- piercings that often migrate fully to rejection. They are pushed entirely out of the body when this occurs. But this is not the only type of migration that can happen. A piercing shifting angle and becoming crooked from pressure over time, like happens in helixes, is also a form of migration. Sure, you still usually can keep the piercing but often times it now sits at a very funky angle and jewelry may not look the way you want it to. You also usually get irritation bumps and scarring from migrations and very often this is permanent.

This migration is no joke, and I’ve seen more clients than I can count heartbroken over either having to remove the piercing and start over or permeant scars left behind from this migration. It’s really important that you try not to sleep on this while it’s healing, and that’s part of why I suggest getting one side of your head pierced at a time. But realistically, we can’t perfectly control what we do in our sleep. We can try, with things like travel pillows, or putting a small claw clip in our hair near your ear so it stops us from rolling over. But some of us are rough sleepers and just gonna move all around. So downsizing in time is very important. When the initial piercing jewelry is left long there is more room for that bar to torque at a more extreme angle, and put more pressure on the channel causing irritation and migration. Pay attention to the downsize timeline your piercer gives you, and if you are super worried consider sending them photos of your piercing to see if you are ready. Downsizing will shorten that excess post and limit how much damage can happen when you lay on that side. Between downsizing and taking some extra measures like using the right pillow, we can greatly minimize concerns with migration and just have happy, healthy piercings.

There you have it folks, a comprehensive breakdown on all of the things to consider when getting your helix pierced! This popular piercing is one of my favorites, and I genuinely haven’t met a single person I think doesn’t look good with a helix piercing. They are just so damn flattering on every ear! I hope this blog post can help you prepare and make some informed choices about placement, jewelry, and aftercare. Happy healing!

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Hi! I really like this post and I’m currently struggling with healing a 2 year old double helix. It’s had bumps on and off for most of the healing process and I haven’t been able to downsize one of the piercings because of the bump. is there any concern of crusties getting stuck behind the back after you downsize and how can you avoid that?

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