What is Microdermal Piercing?
Microdermal piercing is a type of permanent piercing wherein the piercings are inserted on the flat surfaces of the body. This kind of piercing differs from the traditional body piercings used. Unlike the traditional types, microdermal piercings only have one visible end on the skin. One end is seen on the surface of the skin while the other end is embedded into the dermal layer of the skin. The end appearance of this is like having tiny beads on the skin surface .
This procedure involves skin perforation where the microdermal anchors are inserted. Then, tissue growth occurs through the anchor base’s holes. This is what makes this type of piercing permanent . Removal of this microdermal piercings will require surgical removal done by medical professionals .
Microdermal Piercing Locations
Microdermal piercing can be applied almost anywhere in the body skin surface. The term “dermis” is defined as the deep vascular layer of the skin located between the subcutaneous tissue and epidermis. Some of the common sites where microdermal piercings are placed include hips, navels, nose, and ears . Other common locations include:
- Usually done at the nape or side of the neck
Picture 1: Microdermal piercing on neck
- Most people who are into piercings prefer its installation near the eyes. It is a very popular choice among them.
- Though it is one of the most preferred microdermal piercing sites, it may cause pain and discomfort during the procedure.
- Another common location of microdermal piercings
- In this area of perforation, meticulous care should be observed for 1-2 months.
Picture 2: Microdermal piercing on ear
- Areas of the face which are preferred by people who are into piercing include: lips, tongue, eyebrows, and portion under the eyes
- Many people have troubles in aftercare of this area. This is due to the accidental rubbing of the chest using a towel. This may result to injury of the area.
6. Wrist and fingers
- These areas are another popular site of choice for teenagers. Dermal piercing of the wrist is usually not recommended because the wrist is involved in lots of activities.
- For the fingers, people may involve one or more for microdermal piercings. Some also request for designs of beads surrounding the finger, giving it a ring-like appearance.
Picture 3: Microdermal Piercing on finger
7. Lower back
- Typically located at the area above the buttocks. People who get piercing in this location are advised to sleep on soft surfaces to prevent pressure on the perforation site.
8. Other areas:
- Genitals 
How is Microdermal Piercing Done?
The procedure used in the microdermal piercing is less invasive compared to other types of piercing. Here, the procedure is less painful and is approximated to be finished within an hour . The microdermal piercing can be done using two methods:
1. Piercing through needle
The use of this method is quite difficult and it requires a professional piercer to perform it. Needles used in this procedure are chosen based on the desired location of piercing and the skin anatomy of the client.
- Prior to the start of procedure, the site is sterilized with the use of an antiseptic or surgical scrub.
- The desired piercing location is marked with surgical marker.
- A needle is utilized for piercing the skin to produce an L-shaped pouch on the skin surface.
- The pouch produced will now accommodate the microdermal piercings’ anchors and base plate. These are applied with the use of forceps.
- After the insertion of the anchors and base plate, the jewellery, is then screwed into the plate. [1, 4]
Picture 4: Insertion of microdermal piercing using needle
2. Piercing through dermal punch
- This method is more commonly used although it is illegal in some places.
- However, it is less painful and safer to use because it has a protective mechanism. It ensures that the piercing will not go too deep into the skin.
- It is also started with cleaning the site with antiseptic and surgical scrub.
- Surgical marker is also used to mark the location where piercing will be done.
- In this method, the skin is separated to make a pouch.
- The tissues, which are located at the area of piercing, are removed to facilitate for the production of a pouch.
- After a pouch has been made, the base plate, anchors, and jewellery piece are placed respectively. 
Picture 5: Dermal punch used for insertion of microdermal punch
Microdermal Piercing Aftercare
First 24 hours following the piercing procedure:
- Do not remove the bandage applied for the anchors. When the bandage is maintained, the bandage will help in stabilizing the jewellery in its place. Also, tissue healing will start by the growth of tissues through the holes of the base. The growth of skin tissue will facilitate further stabilization of the anchor.
- Also, dressing will be applied on the piercing location. This is done to control or minimize bleeding. [1, 5]
Other tips in microdermal piercing aftercare include:
1. Cleaning the location of piercing regularly and properly
- Remember to wash hands prior to touching the area of piercing. This is important to prevent irritation and infection of the site.
- Cleanse the site with the use of lukewarm salt solution. This is made by mixing ½ teaspoon of salt into a glass of water. Apply it gently with cotton balls for regular washing of the area. Ideally it should be done twice a day for 4-5 minutes. Allow it to air dry afterwards.
- When taking a bath, make sure that the soap used is mild. Refrain from using strong soaps to avoid irritation to the pierced area.
2. Proper nutrition
- Proper and balanced meals play a role in the healing process. With consumption of healthy foods, the immune system can also be strengthened to prevent infections. 
3. Know what to avoid
- The healing process of the pierced area takes about 1-3 months. During this span of time, it recommended to avoid any instance of putting stress on the piercing. Avoid moving the piercing to prevent tissue damage and trauma.
- Be careful in using clothes and towels because these are the main causes why piercings are removed accidentally. 
Microdermal Piercing Risks
1. Tissue Damage
- This is the leading risk when any kind of piercing is done on the body.
- It results from improper placement of piercing which results to damage to the nerves and vessels located at the dermis part of the skin.
- Improper placement of piercing may be too deep or too shallow.
- For deep installation, the layers of the skin may be pulled together. This results to embedding.
- On the other hand, if the piercing is placed shallowly, the migration of piercing may occur. 
When the pierced area gets infected, inflammation occurs as well. The site may appear red, tender, and pus-filled. This condition results from the following causes:
- Contact of dirty hands with the pierced area
- Use of unsterilized needle in piercing the location
- Not cleaning the pierced area regularly and properly [1, 3]
Picture 6: Microdermal piercing infection
3. Microdermal piercing rejection
- This condition results from the body’s immune reaction to insertion of foreign object. For some reason, the body detects this foreign object as a threat. As a result, the body fights it off by pushing it outwards and healing the skin pierced by the procedure.
- It occurs rarely since rejection happens to 2% of people getting their microdermal piercing.
- In this case, it is recommended that body pierces used should be made from registered types of titanium because its risk for rejection is low. [1, 2]
Picture 7: Microdermal piercing rejection
4. Other risks related to microdermal piercing
- Keloid formation
- Inward Travelling Infection
- Hypertrophic Scarring
- Deep Microdermal Placement 
Microdermal Piercing Removal
Removal of microdermal piercing involves two surgical instruments, which are forceps and scalpel. When seeking removal procedures for this kind of piercing, it is best to ask help from a medical professional to ensure safety. These are the steps in removal of microdermal piercing:
- It is started by cleaning the area with antiseptic or surgical scrub. This is to keep the area sterile and prevent infection.
- Using the scalpel, an incision is made on the skin which surrounds the anchor. The skin is incised big enough to enable the removal of the microdermal jewellery with the use of forceps. 
Points to Consider
Many people are getting themselves pierced for aesthetic reasons. In undergoing procedures such as getting microdermal piercing, just make sure to have it done by a professional piercer. Also, ensure that the place and materials used for piercing are clean and sterile. This is to ensure that infection and other risks can be prevented. Aftercare of the pierced area is essential as well. Remember to clean the site and avoid activities that might cause dislodgement of the piercing. Lastly, for those who want removal of their microdermal piercing, again, go to a trusted professional who can perform the procedure.
by on in Public Health