So, you’ve finally reached that point. Your microdermal is healed, it looks great, and you’re bored of the basic titanium ball or flat disc that the piercer put in six months ago. You want something sparkly, or maybe a spiked top, or something gold to match your other jewelry. But here is the thing about how to change a microdermal piercing: it is not like changing an earlobe stud. If you mess it up, you aren't just looking at a bit of irritation; you're looking at a full-blown rejection where your body literally pushes the jewelry out of your skin like a splinter.
Most people think "changing" means the whole thing comes out. It doesn't.
A dermal piercing consists of two parts. There is the anchor, which sits under your skin (the "foot"), and the decorative top that screws into that anchor. When we talk about changing the piercing, we are strictly talking about unscrewing that top piece. You should almost never—and I mean never—try to remove or change the underlying anchor yourself. That is a surgical procedure for a professional.
Honestly, the first time you do this, your heart is going to race a little. It's okay. Your skin is holding onto that metal for dear life, and the last thing you want to do is yank it.
The Anatomy of Why This is Tricky
Microdermals are "single-point" piercings. Unlike a barbell that goes in one side and out the other, these stay put because skin tissue grows through little holes in the anchor's base. This process is called tissue integration. According to the Association of Professional Piercers (APP), this is what makes them "semi-permanent." They aren't meant to stay in your body for 50 years, but they also aren't meant to be fiddled with daily.
💡 You might also like: How to Make the World's Best Paper Airplane: What the Pros Get Right
If you twist the top and the anchor twists with it? You’re tearing that internal scar tissue. That leads to inflammation. Inflammation leads to the "dreaded tilt," where the piercing starts sitting crooked. Once it tilts, the countdown to rejection usually starts.
When are you actually ready?
Don't rush it. I know the initial jewelry can be boring. But if you try to learn how to change a microdermal piercing before the 12-week mark, you're asking for a bad time. Some piercers, like the well-known Elayne Angel (author of The Piercing Bible), suggest waiting even longer—up to six months—to ensure the anchor is rock solid.
Is there crusting? Is it red? Does it feel "tight" or sore when you touch it? If yes, keep your hands off. A healthy dermal should feel like nothing. It should be flush against the skin, no discharge, no tenderness. If it's even slightly moody, wait another month.
Tools you'll actually need
You can't just use your fingernails. You'll slip, you'll scratch the skin, and you'll get frustrated. Professional piercers use specific tools, and you should too if you’re doing this at home.
- World’s tiniest pliers: Specifically, hemostats or micro-dermal holders.
- Gloves: Latex or nitrile. This isn't just for germs. It’s for grip. Smooth metal and skin are slippery.
- Saline solution: To soften any microscopic crusties hidden under the rim.
- The new jewelry: Ensure it is the correct gauge (usually 14g or 16g).
The Step-by-Step Reality of How to Change a Microdermal Piercing
First, wash your hands. Then wash them again.
🔗 Read more: 1201 Locust St Walnut Creek CA: Why This Downtown Corner Matters More Than You Think
1. Soften the site
Soak the piercing with a warm saline compress for about five minutes. This softens any "lymph" (that crusty stuff) that has acted like glue between the top and the anchor. If you try to unscrew it while it's dry, that crust will act like sandpaper inside your skin. Not fun.
2. The Anchor Lock
This is the part everyone skips. You need to stabilize the anchor. Use your non-dominant hand to press down firmly on the skin surrounding the dermal. Some people use a pair of thin hemostats to gently grip the base of the anchor through the skin, but you have to be incredibly careful not to pinch yourself too hard.
3. Lefty-Loosey
Most dermal tops use standard internal threading. Put on your gloves. Grip the top firmly. Turn it counter-clockwise.
Wait. If it doesn't budge with a gentle turn, stop. Don't torque it. If it’s stuck, it might be cross-threaded or held by dried matter. If you force it, you risk the anchor spinning. A spinning anchor is a dying anchor. If it’s stuck, see a pro. It’ll cost you ten bucks and save your piercing.
4. The Cleaning Gap
Once the top is off, you’ll see the top of the anchor sitting just at the skin's surface. It might look a little gross. That’s normal. Use a pointed cotton swab dipped in saline to gently clean the threading of the anchor. Do not let the skin close over it.
5. The New Top
Screw the new jewelry in clockwise. Don't over-tighten it. Just "finger tight" is plenty. If you over-tighten, you’ll have a nightmare of a time getting it off next time, and the pressure can cause the anchor to shift.
Common Mistakes That Kill Dermals
I've seen so many people lose their piercings because they bought cheap jewelry from a random mall kiosk.
Material matters. If you put a "mystery metal" or cheap surgical steel top on a high-quality titanium anchor, you can get galvanic corrosion. Or, more likely, your skin will react to the nickel in the cheap top. Since the top sits flush against the skin, any irritation there will travel straight down to the anchor. Stick to implant-grade titanium (ASTM F-136) or 14k/18k gold.
The "High Profile" Trap.
When you change your jewelry, you might be tempted by a big, chunky gem that stands high off the skin. These are snag magnets. One hit from a bath towel or a t-shirt and that anchor is going to take the hit. If your dermal is in a high-movement area like your wrist or chest, keep the tops flat and low-profile.
Dealing with the "What Ifs"
What if you drop the top? It happens. They are tiny. Always change your jewelry over a flat surface or a plugged sink.
What if it starts bleeding? A tiny bit of spotting is okay if you were a bit rough, but heavy bleeding means you’ve torn the internal pocket. Treat it like a brand-new piercing for two weeks. Saline sprays, no touching, and keep it covered with a small circular bandage at night to prevent it from shifting while it re-heals.
What if the anchor feels loose? If you can feel the anchor moving freely under the skin after you've changed the top, you've likely disrupted the tissue integration. Stop touching it. Seriously. Leave it alone for a month and hope the skin re-attaches.
Summary of Actionable Steps
Changing a microdermal is a high-stakes move for a low-stakes reward. If you're going to do it, do it right.
📖 Related: Happy Birthday Paul Pics: Why The Right Image Actually Matters
- Check the age: If it’s under 3 months old, don't touch it.
- Verify the metal: Buy implant-grade titanium tops.
- Get a grip: Use nitrile gloves for friction; never try with bare, soapy fingers.
- Stabilize: Always hold the anchor base steady through the skin before twisting.
- Clean the thread: Use saline to clear the anchor "well" before putting the new top in.
- Monitor: If the site stays red for more than 48 hours after a change, you've irritated the pocket. Go back to basic aftercare.
If you ever feel a "pop" or a sharp pain while twisting, that is the anchor moving. That is your signal to stop immediately and go to a professional piercer. They have specialized "dermal forceps" that are ultra-thin and designed to slide under the jewelry top to lock the anchor in place without damaging your skin. It is always better to spend a few minutes in a piercer's chair than to deal with a permanent scar from a rejected dermal.
Go slow. Be gentle. Your skin will thank you.