Choosing jewelry for a new piercing is obviously quite different from shopping for a ring to wear on your finger. Because body piercing jewelry is worn inside a wound and is in contact with your internal tissues, only certain products are suitable. The look of the body piercing jewelry that is placed in your fresh piercing must be secondary to aspects that affect safety and compatibility with your body.

The size, style, material, and quality of the initial piece of jewelry all affect your ability to heal. Remember that the piercing location is fixed, but the jewelry can be changed after you have successfully healed. Because the body jewelry industry is saturated with substandard products, piercers and clients alike may forget that cost alone should never be the key factor in your purchase. Consider the following when selecting body jewelry for a new piercing:


  • Must be of appropriate length or diameter for your unique anatomy and the placement of the piercing. Body Piercing Jewelry that is too tight does not allow for air and blood circulation or for the expulsion of normal secretions from the piercing. Ill-fitting jewelry increases the likelihood of swelling, embedding, and other complications if too small, or catching and excessive trauma, if too large.
  • Must be of an appropriate gauge (thickness). The body may treat jewelry that is too thin in gauge like a splinter, resulting in migration or rejection.
  • Must be of a style suited to your build and the location of the piercing. Rings are best for some areas, straight or curved bars for others, and specialty jewelry—such as a nostril screw or labret stud—for specific placements.


Of the numerous materials available, few have been proven appropriate for wear in fresh body piercing jewelry. Some metal alloys (mixtures) have been approved based on medical usage (often as medical implants) and have specific designations that represent a precise standard for the alloy and its quality as determined by the American (now International) Society for Testing and Materials Standard (ASTM) and/ or the International Standards Organization (ISO). Other materials, such as gold and obsidian (natural glass) have a long history of use in piercings dating back hundreds—and sometimes thousands—of years. The material worn in a healing piercing:

  • Should be able to withstand the heat and pressure of autoclave sterilization.
  • Should be inert and compatible with the body so it doesn’t cause irritation, allergy, or infection.

Mill test certificates (or “mill certs”) are documents that provide evidence of a specific grade of metal with an ASTM or ISO code designation. These are provided to body piercing jewelry makers by the manufacturers of raw materials. Some jewelry companies also have biocompatibility testing done by independent labs. Your piercer may have copies of these certificates available for you to review.

You don’t need to understand what the numbers mean, but the document should warrant that the metal is one of the grades listed below. It is not possible to know whether the piece of jewelry you’re buying is from the batch indicated on the paper, but the presence of documentation listing the appropriate materials means that your piercer is more likely to be purchasing from reputable sources and is conscientious about their jewelry quality.

Surgical Steel is made of a variety of alloys. Many of them are used for body jewelry, but only a few specific grades are proven biocompatible: steel that is ASTM F-138 compliant or ISO 5832-1 compliant; ISO 10993-(6,10, or 11) compliant; or (EEC [European] Nickel Directive compliant.

Titanium is a lightweight metal that is ideal for people with concerns about nickel sensitivity. This material can be anodized to create jewelry of different colors without affecting the safety. Look for implant certified titanium (Ti6Al4V ELI) that is ASTM F-136 compliant, ASTM F1295, ISO 5832-3 compliant, or commercially pure titanium that is ASTM F-67 compliant.

Niobium has been widely used by piercers with good results for many years. It is very similar to titanium, but does not have an implant-grade designation. Like titanium, niobium can be anodized to produce different colors. (And, unlike titanium, it can be anodized black.) Anodized niobium and titanium may fade due to body chemistry or when worn in friction-prone areas, but this is not harmful.

Gold (yellow , rose, or white) is appropriate for initial piercings if it is 14k or higher, nickel- and cadmium-free, and alloyed for biocompatibility. Gold higher than 18k is too soft for body jewelry because it can easily be scratched or nicked. Gold plated, gold-filled, or gold overlay/vermeil jewelry is not acceptable for fresh piercings. All of these involve coating a base metal with a layer of gold. The gold surface (which is very thin—measured in millionths of an inch) can wear or chip off.

Platinum is a heavy precious metal that is extremely inert and excellent for wear in body piercings. However, body jewelry in this material is rare and very expensive due to the high cost of the material and greater difficulty in manufacturing jewelry from it.

Glass—Fused quartz glass, lead-free borosilicate, and lead-free soda-lime glass are inert and considered safe for initial piercings. They can also be sterilized in an autoclave.


  • The surfaces and ends of body piercing jewelry must be free of nicks, scratches, burrs, and polishing compounds. Suitable pieces have no irregular surfaces that could endanger the delicate healing tissue of a fresh piercing. Metal body jewelry should be polished to a smooth, mirror finish. If you wear jewelry that has a porous or uneven surface, the new cells that form during healing grow into the irregularities. Then, when the body piercing jewelry shifts or moves, these areas tear. As this cycle is repeated, scar tissue forms and healing is delayed. A faulty finish can also introduce bacteria into the wound and cause infection.
  • Quality rings are annealed, which is a heat treatment that makes the metal more pliable. When rings can be opened or closed without the use of pliers it reduces the risk of damaging the metal. For thicker rings (especially in smaller diameters) the use of tools may be necessary. Tools should have brass jaws or be covered with tape or gauze to protect the jewelry from damage.
  • Machining of the jewelry affects how it performs. Losing your body piercing jewelry can result in the closure of your piercing. Threaded ends should be checked for tightness daily with clean hands. If they come loose often, you may have a defective piece. See your piercer for options or a replacement part. If the ball on your captive ring comes off or is loose, you may need a new ball, or to have the tension on the ring adjusted. Jewelry should fit together well. Threaded attachments should fit completely onto posts without gaps. Threads on screw-on ends and dimples on captive pieces should be centered for a proper fit.
  • Not all piercings have an entrance and an exit. Surface Anchors are very common now and the body piercing jewelry sits below the surface of the skin from a single point. The threaded top may be changed. Removing the base of the jewelry causes the loss of the piercing, so this is not normally done. See your piercer for assistance if the piece shifts or migrates.
  • Gemstone settings must be of high quality; stones should be set securely into the metal, often in a prong or bezel setting. Some manufacturers use adhesives to attach the gem. If the stone falls out, which is common with lower-priced goods, the entire piece of jewelry will need to be replaced as the hole left by the missing gem can harbor bacteria and increase risk of infection.


  • Threaded jewelry uses tiny screw threads for their closures. One side has male screw threads that fit into a female hole that is tapped (drilled out) with the matching thread pattern on the other. One or both ends unscrew.
  • Internally threaded jewelry is part of the APP standard for initial piercing jewelry: the part of the jewelry that passes through your skin is smooth, and the threads are on the removable end(s), such as balls, gems, or spikes. Internally threaded jewelry avoids any possibility of scraping your tissue with sharp threads, which is especially important with fresh piercings.
  • Alternatively, externally threaded jewelry has the screw pattern cut into the post, and this comparatively rough surface may be passed through the tissue to insert and remove the jewelry.
  • Threadless (or “press-fit”) jewelry is an acceptable alternative that uses a pin coupling on the ornamental end, and there are no screw threads at all.


*Disclaimer: These guidelines are based on a combination of vast professional experience, common sense, research, and extensive clinical practice. This is not to be considered a substitute for medical advice from a doctor. If you suspect an infection, seek medical attention. Be aware that many doctors have not received specific training regarding piercing. Your local piercer may be able to refer you to a piercing-friendly medical professional. For more information, see the APP Brochure Troubleshooting For You and Your Healthcare Professional.

Use of this brochure does not imply membership in the APP. A current list of APP members can be found at False claims of membership should be reported to the APP.
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