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Pieces taken from the blog of Jeff Saunders (Previous President of the APP)


There is a lot that goes into making sure the tragus piercing goes well.  If the angle is off, the skin is shifted, or the jewelry choice is ever-so-slightly wrong: failure.

The first step is understanding the anatomy.

Tragus Anatomy:

The tragus isn’t really like any of the other parts of the ear, when you think about it.  Grab your tragus for a second, and roll it between your thumb and your index finger.  Notice how the skin shifts over the cartilage underneath it?  Now try that same thing on the conch, or any of the other parts of your ear that are easy to pinch.  Nothing quite feels like the tragus.  The tragus even feels a little “fatty”.  This complicates our job as piercers.

This is the hardest challenge for most piercers to contend with; the skin and connective tissue that cover ear cartilage are flexible, and can be shifted out of place during the piercing process.  That may seem obvious.  If you distort the skin during the piercing process, you permanently pin the skin out of place.  A piercing performed with this error seldom, if ever, heals.  I posit that tragus piercings that have recurring piercing bumps that aren’t obviously caused by angle or jewelry issues are likely suffering from subtle tissue distortion during the piercing procedure

Probably the two most common piercings to develop piercing bumps are the nostril and the tragus.  Piercers tend to look at the client to place the blame on them.  (Did they touch it? Did they get makeup in it?)  Much like the nostril, se need to look critically at the job we are doing and try to see if there are reasons us piercers may be the cause of these bumps. Again, pinning the skin out of place causes chronic irritation.  That chronic irritation results in piercing bumps.


The tragus anatomy is like a camel, you get one bump or two.  The discussion that you should have with any client who has “two hump” anatomy is this: “Do you think you’ll ever want a second piercing?  Which mark looks like the middle to you”? This is a big deal.  With anatomy like this, the “center” of the tragus can look vastly different from person to person.

The problem is this: to some people, the center of the tragus is a math problem.  Wherever the top of the tragus begins and the bottom ends, divide that space in two and that is the center.  Often, this placement is directly in the indent of the two “humps” of the tragus.  This means there is less cartilage on either side of the piercing, and it can also look a little awkward.  It also means adding a second piercing is impossible.

The alternative, and the preferred placement, is to place the piercing in the center of the bottom “hump”.  This way, there is enough tissue to locate the piercing in, and it allows for the client to add additional piercings in the future

Piercers sometimes struggle with depth on tragus piercings: too deep and the piercing rests on the cheek, too shallow it can migrate out. 

The tragus really benefits from a strict application of the Perpendicular Principle of piercing

The tragus must be performed as perpendicular to the anatomy as possible, which presents some challenges because tragus anatomy is seldom flat.  What piercers need to do is focus on making a perpendicular piercing, even if it takes extra time to make that happen.  While some piercers have an innate ability to achieve perpendicular, I believe most piercers should spend extra time diligently marking the anatomy.


I like to really mark up a tragus.  My first mark is a vertical line where the tragus folds.  This gives me a reference for where the tragus turns into the cheek.  Piercing any closer to this line than 1/8th of an inch (~3 mm) is probably too close.

The next mark I like to make is a vertical line on the “edge” of the tragus.  What I mean by “edge” is basically marking the transition of the front of the tragus to the back of the tragus.  I find it exceptionally helpful to make this mark, as it simplifies the next marks for me.  Again, piercing closer than 1/8th inch to this line is a bad idea, as you will almost certainly pierce just skin, not the cartilage you are aiming for.  Typically, with these two lines as a reference, you can make a dot in the center of them.

This dot should be at the center of the tragus on “one bump” anatomy, but as previously discussed, you must consult with your client on “two bump” anatomy.

At this point, I draw a horizontal line perpendicular to the edge mark I made, pointing at the dot.  Now I duplicate that line on the back side of the tragus and mark a dot exactly opposite the dot on the front.  This should yield a perfectly centered, perpendicular piercing.

Remember, though, perpendicular piercings will heal far better than angled piercings.  Which means you really need to inspect tragus anatomy.  It can be really weird!  Especially when performing double piercings, do not expect the barbells to be strictly parallel with one another.  Perpendicular is far more important!

Jewelry Selection:

The tragus is a place for straight jewelry exclusively, at least while the piercing is healing.  I can think of no good reason to start a tragus with a ring.  Even variations on rings, such as d-rings, are inferior to straight jewelry.

Straight jewelry presents us with some options, though.  We can use large disk flatbacks, small disk flatback, and barbells. 

In general, the stability of 16 gauge (1,2mm) is effective, without being too thick for what can be very small tissue.  Most tragus tissue measures out to about ¼ inch (6.35mm), so for initial piercing, using a length of 8mm is a great length.  This allows for the client to clean, and for a small amount of swelling.  Be cautious when choosing jewelry length for a tragus.  While most tragus piercings fit this description, there are some clients who have very bulbous, thick, round anatomy.  These are challenging to pierce and can require much longer jewelry.

Piercing techniques


While I know reducing tool use is popular amongst piercers, the tragus might be a great place to back up and rediscover the joys of working with tools.  Remember, one of the hardest things to do while piercing a tragus is to avoid the skin rolling over the cartilage during the piercing process, resulting in a piercing that won’t heal.  By using a clamp, the piercer effectively pins the skin and connective tissue into place against the cartilage. 

The other thing the clamp simplifies is piercing perpendicular to the tissue.  If your initial marks are good, and the clamp is aligned on the anatomy so that the dots are aligned perfectly, it should be very easy to execute a precise piercing.

It’s important when using this technique to try to hold the clamp in such a way that the normal angle of the tragus isn’t distorted.  I’ve seen people delicately place the camp in place, and then wrench the tissue out of shape to perform the piercing.  This doesn’t yield the result you want.


Tragus piercings are one of those piercings that we do so often we can forget how much goes into them to make them successful.  Think about it.  You’ve got jewelry length. Threaded/threadless end size issues. What should the back of the barbell look like? You’ve got the tremendous challenge of piercing perpendicular on round, often bulbous tissue. You need to do this all while piercing tissue that loves to shift upon itself.  There is obviously a lot going on for the piercer to process.