Septum Piercings: What You Should Know
A septum piercing does not go through cartilage. That is the first thing worth knowing, because almost everybody assumes it does, and the assumption is why people expect it to hurt far more than it usually does.
It passes through a thin strip of soft tissue just below the cartilage wall dividing your nostrils. Piercers call it the sweet spot. Placed there it is quick, heals well and is comparatively comfortable. Placed through cartilage instead, it hurts considerably more, heals badly and often has to come out.
Which of those you get depends entirely on who does it.
Where it Goes
Run a finger up the inside of your nose from the tip. You will feel firm cartilage. Slightly forward and below that there is a small area of softer, thinner tissue between the two nostrils, and that is where a septum piercing belongs.
The sweet spot is not in the same place on everybody, and on a small number of people it is barely present at all. A piercer finds it by feel before anything else happens, and that assessment is the whole of the job. Everything else is technique.
If you are told your anatomy does not suit one, that is a real answer rather than a brush off. It is uncommon and it does happen.
Does it Hurt?
Less than people expect, and the reaction is more memorable than the pain.
The tissue is thin and there is not much there, so the sensation is sharp and very brief. What catches people out is that your eyes water immediately and often heavily, entirely involuntarily. It is not crying, it is a reflex, and it happens to almost everybody. You may also sneeze.
Most people describe it as a strong pinch that is over before they have finished registering it. On the scale of piercings it sits at the easier end, which surprises people who have been dreading it.
If it hurts a great deal, that is a sign the placement has gone into cartilage.
Healing
Two to three months for the initial healing, which is fast compared with most cartilage piercings.
Six to eight months before changing the jewellery yourself is a good idea, though a piercer can change it earlier.
Septums are among the better behaved piercings. The tissue is thin, well supplied with blood and not constantly disturbed. Provided it is placed correctly, most heal without much drama.
What does cause problems is picking at it, twisting the jewellery, and knocking it. Colds are a genuine nuisance during healing, because blowing your nose repeatedly disturbs it and everything is damp for a fortnight.
Cleaning is sterile saline twice a day and nothing else. The inside of your nose looks after itself better than you might imagine.
Jewellery
A horseshoe, or circular barbell, is the usual starter. It is easy to clean, easy to flip up, and it accommodates swelling.
A clicker is the segment ring most people picture when they imagine a septum piercing. Beautiful, and generally not what goes in first.
A retainer is a small piece of jewellery designed to hold the piercing open while being nearly invisible. This is what people ask for when a workplace has rules.
Thickness matters. Septums are usually pierced at a slightly thicker gauge than ear work, and going thinner to fit a piece of jewellery you like is a genuinely bad idea, because thin jewellery concentrates pressure and can cause the piercing to migrate.
Implant-grade titanium for anything fresh. That is not negotiable and it is what we use.
Flipping It Up
Can I flip the jewelry up? This is the question we get asked more than any other, and the answer is yes.
A horseshoe can be rotated so both ends sit up inside the nostrils and nothing is visible from outside. Somebody looking at you directly will not see it. It is the reason a great many people choose a septum over any other facial piercing.
Two honest caveats. It takes a few weeks before flipping it up and down is comfortable, so do not plan to do it the day after. And a determined person looking up your nose will see it, which occasionally matters for very strict environments. A retainer handles those.
Who It Suits
Septums work on a very wide range of faces, and they are one of the few facial piercings that reads as either subtle or bold depending only on the jewellery.
A thin, small diameter ring in titanium is quiet and easily missed. A thicker clicker with stones is a feature. Same piercing, entirely different presentation, and you can move between them over time.
They also suit people who want a facial piercing without a permanent visible mark. If you take a septum out, the hole is inside your nose and closes with a small internal scar nobody sees, unlike a nostril piercing which leaves a visible dot.
Choosing the Diameter
Ring size is where most people get their septum wrong, and it is entirely fixable if you know what you are choosing between.
Diameter is the width of the ring, and it changes the whole character of the piercing. A small diameter sits close, hugging the underside of the nose, and reads as neat and understated. A larger diameter hangs lower and reads as deliberate and bold. Neither is more correct, and the same person can wear both at different times.
What decides the right size for you is the distance between your nostrils and how far down your nose the piercing sits. A ring that is too small pinches inward and looks strained. One that is too large swings and catches on things. A piercer will size it for your face rather than handing you a standard.
The other measurement is gauge, which is the thickness of the metal. Septums are usually pierced thicker than ear work because thicker jewellery distributes pressure across more tissue and is far less likely to cause migration. People sometimes want to go thinner so they can wear a delicate ring they have seen. It is the wrong trade and a good piercer will say so.
Stretching a septum later is possible and is done gradually with proper tapers, never by forcing a thicker ring in. If you think you might want that eventually, say so at the start and it can be planned for.
Living With One Day to Day
A few practical things that only come up once you have it.
Colds are the enemy. Blowing your nose repeatedly during healing disturbs the piercing constantly and everything stays damp. If you get a heavy cold in the first month, be gentle, clean a little more often, and expect it to be sore for a few days afterwards.
Glasses are fine. Unlike a nostril piercing, a septum sits nowhere near where frames rest.
Face masks catch it. The strap and the fabric both drag on jewellery, particularly a larger horseshoe. Flip it up if you are wearing one for hours.
Sport is straightforward with the jewellery flipped up, which keeps it away from anything that might catch.
Kissing is not a problem and people ask.
It is visible in photographs from below in a way people do not anticipate, which is worth knowing before an event where you want it hidden.
When to See Us Rather Than Wait
Come in if the jewellery has started sitting lower than it was, or if you can see more of the bar than you used to, because both suggest migration. Come in if it is still genuinely painful after the first fortnight rather than tender. Come in for the first jewellery change rather than doing it yourself, because a fresh septum is easy to catch on the way in and out.
And come in for a downsize if the horseshoe you started with now feels too large once the swelling has gone. It takes two minutes and it prevents the snagging that causes most later problems.
The Things That Go Wrong
Placement through cartilage. The main one. It hurts, heals poorly, sits crooked and often has to be removed. It happens when the piercer does not find the sweet spot or does not look for it.
Placement too far forward, which puts it through the thin skin near the tip. It looks wrong and it migrates.
Crooked placement, which is very visible on a septum because your face is symmetrical and everybody is looking at the middle of it. Ask to see the marking in a mirror before anything is pierced, and take your time with it. Any decent piercer expects this.
Cheap jewellery, which keeps the site irritated indefinitely.
A gun. Nobody should be attempting a septum with a gun. If a place offers to, leave.
The First Two Weeks, Honestly
Knowing the shape of the first fortnight stops most of the worrying.
Day one. Sore in a dull way rather than sharp. Your nose may feel blocked on one side even though it is not. The horseshoe will look larger than you expected because it has been fitted long to allow for swelling.
Days two to four. Peak tenderness, usually on day two or three rather than immediately. Some swelling. It may feel warm. Touching it will hurt, so do not.
Days five to ten. Settling. Crusting appears around the jewellery where it exits, which is normal and should be softened off with saline rather than picked. This is when people start flipping it up, and it is slightly early. Wait.
Week two onwards. Comfortable most of the time, with occasional reminders if you knock it. Flipping up and down becomes easy.
What should not happen at any point is increasing pain after the first few days, spreading redness across the nose, heat, thick coloured discharge or a fever. That is infection and it needs a doctor rather than a piercer.
Ordinary tenderness that comes and goes for a couple of months is normal and is not a sign of failure.
The Smell
Nobody mentions this and everybody discovers it.
Septum piercings can develop a distinctive smell, particularly in the first months. It is entirely normal, it is a mix of natural secretions and the body's healing process, and it is not a sign of infection. It settles down. Cleaning properly helps, and cleaning aggressively makes it worse by irritating the tissue.
If it comes with pain, swelling or coloured discharge, that is different and needs looking at.
Taking It Out, If You Decide To
Worth knowing before you commit, because it is part of what makes a septum a low risk decision.
Left out early, within the first months, the hole closes quickly and almost completely. Left out after a piercing has been settled for years, it usually shrinks to a small hole that stays open enough to reinsert jewellery for a long time, and closes gradually over months if you leave it.
Either way there is nothing visible. The scar sits inside the nose where nobody looks, which is the practical difference between a septum and a nostril piercing. A nostril leaves a small permanent dot on the outside of your nose. A septum leaves nothing anyone will see.
That reversibility is why we often suggest a septum to somebody who wants a facial piercing but is uncertain about committing to a visible mark. If you love it, keep it. If you do not, take it out and nobody will ever know it was there.
Bottom Line
A septum goes through soft tissue below the cartilage, not through the cartilage itself, which is why it hurts less than people expect and heals faster than most piercings. Your eyes will water. It will be over quickly.
Everything depends on the placement, so choose the piercer rather than the price. Ask them to show you the marking in a mirror. Expect two to three months of healing, saline twice a day, implant-grade titanium, and a horseshoe to start with.
And yes, you can hide it completely. That is why so many people choose it.
Come in and we will check your anatomy before you commit to anything.
FAQ
Does a septum piercing go through cartilage?
No, and this is the most common misunderstanding. It goes through a thin strip of soft tissue below the cartilage, called the sweet spot. Piercing through cartilage instead is a placement error.
How much does it hurt?
Less than most people expect. A sharp, brief pinch. Your eyes will water heavily as a reflex and you may sneeze, and neither is a sign of anything wrong.
How long does it take to heal?
Two to three months for initial healing, and six to eight months before changing jewellery yourself is wise.
Can I hide it at work?
Yes. A horseshoe flips up inside the nostrils and is not visible from outside. A retainer is available for stricter environments.
When can I change to a clicker?
Usually after a few months, and a piercer should do the first change. Clickers are a fixed diameter and do not accommodate swelling, which is why they are not used to start.
Why does my septum piercing smell?
It is normal, particularly early on, and it settles. Clean gently with saline. Cleaning aggressively irritates the tissue and makes it worse. Pain, swelling or coloured discharge is a different matter.
Will it leave a mark if I take it out?
The hole is inside your nose, so there is no visible external scar, which is one reason people choose a septum over a nostril piercing.
What if my anatomy does not suit one?
It is uncommon but real. A piercer will assess the sweet spot by feel before anything happens, and being told no is a genuine answer rather than a brush off.
