“Permanently closing” a piercing hole relies on the body’s natural ability to regenerate tissue after the jewelry is removed. This process encourages skin cells to fully heal the channel that was created. The outcome is highly dependent on the piercing’s characteristics, and the ultimate success of a permanent closure, whether natural or surgical, is often measured by the final aesthetic appearance of the healed skin.
Factors Determining Natural Shrinkage
The likelihood of a piercing hole closing completely depends significantly on the structure of the piercing channel, known as the fistula. A fistula is a tunnel of epithelialized, or scar, tissue that forms around the jewelry as the wound heals. If the piercing is relatively new or has not fully matured, the tissue tunnel is thin, and the body’s repair mechanisms can quickly close the opening once the jewelry is removed.
The age of the piercing is one of the most important variables, as a piercing established for many years will have a thick, well-formed fistula that resists natural closure. For fresh piercings, the hole may begin to close in a matter of hours or days, but piercings that have been healed for a decade or more may remain open indefinitely without intervention. Location also plays a role, with soft tissue like the earlobe tending to be more forgiving and easier to close than cartilage piercings, which can take much longer to heal initially and may shrink more slowly.
The size of the piercing, or the gauge, is another factor that determines the potential for natural shrinkage. Standard earlobe piercings, typically 20 to 14 gauge, often shrink to a barely noticeable dimple or line with time alone. However, larger gauge piercings, especially those created through stretching techniques, have permanently displaced too much tissue for the body to bridge the gap without assistance.
When Surgical Intervention is Necessary
When a piercing has been stretched significantly, or the fistula is too mature and resistant to natural closure, a medical procedure is often required for permanent sealing. This intervention is typically performed by a dermatologist or a plastic surgeon who specializes in aesthetic skin procedures. The procedure involves surgically excising the epithelialized tissue lining the piercing channel.
Once the inner lining of the fistula is removed, the surgeon can bring the two edges of the fresh wound together. The surrounding skin is then sutured to ensure the tissue heals flat and the hole is eliminated. For very large or stretched earlobe holes, such as those resulting from gauging, the procedure is more complex and involves a reconstruction technique. Surgeons may use a local flap, such as a pedicle-rotation flap, to fill the large void while also attempting to reduce any elongation of the earlobe caused by the stretching.
The procedure is usually performed in an office setting under local anesthesia. Recovery involves keeping the surgical site clean and following specific post-operative instructions. Sutures are generally removed within one to two weeks, and the site must be allowed to fully heal for at least eight weeks before any consideration of re-piercing the area.
Addressing Scar Tissue and Final Appearance
Even after a successful closure, whether natural or surgical, the site where the piercing once was will always possess some form of scar tissue. For smaller piercings that close naturally, the final mark is often an atrophic scar, which appears as a small, slightly depressed dimple or a faint line. Surgical closure, by its nature, replaces the piercing hole with a linear surgical scar, which is generally designed to be as inconspicuous as possible.
Managing the aesthetic outcome involves addressing the resulting scar, and several non-surgical treatments can help improve its appearance. Silicone scar sheets or gels are a common recommendation, as they work by hydrating the scar tissue and regulating collagen production, which helps to flatten and soften the mark over time. Massaging the closed site daily with a moisturizing agent, like Vitamin E oil, can also assist in breaking down and reorganizing the underlying scar tissue.
In some instances, the closure process, or the original piercing itself, can lead to the formation of hypertrophic scars or keloids. Hypertrophic scars are raised but remain within the boundary of the original injury, while keloids extend beyond it and may require professional medical attention. A dermatologist can treat persistent or raised scarring with intralesional steroid injections, which help to shrink the excess collagen and flatten the tissue.