A few years ago, I co-wrote this guide to HRT and piercings for transgender and gender non-conforming individuals, designed to be a simple introductory guide for trans folks and those taking HRT to understand some of the effects of these processes on getting pierced and healing piercings. Since publishing that blog post, I’ve gotten tons of awesome messages and emails with follow-up questions, primarily about the healing process as hormones affect things, but also just general questions trans folks might have about healing piercings. I’ve realized that there is a need for resources that more specifically cover the trans experience when it comes to body piercing and body modification. So, today starts a two-part series on specific aftercare considerations and healing considerations for transgender clients!
This first half of the series will be for trans-feminine individuals. We will cover how estrogen, progesterone, and similar hormones can affect the process of getting and healing piercings. We will also discuss some unique lifestyle elements such as tucking, wearing makeup, and growing out your hair, and how this can affect piercings and healing. This blog post is for anyone who sees themselves reflected in the topics discussed and who can benefit from this education, regardless of gender identity or gender presentation.
Hormones and Piercings
One of the biggest areas to discuss changes with our piercings is hormonally! HRT is an incredible medical tech that allows us to take hormones and induce changes in our secondary sex characteristics, aka a second puberty. These changes allow us to better align our bodies with our gender identity, and starting HRT can be a very exciting time! Taking HRT can result in a change in skin type, such as becoming more dry or oily, and it may also cause acne. With estrogen, we often see a thinning of the skin and a softening of skin texture. Skin can also become more sensitive to touch and temperature, and this may also mean more sensory triggers. You may find yourself needing to experiment with different styles of jewelry to find what’s comfortable for your piercings. The process of getting pierced or tattooed may also feel different once you are on E. Muscle and fat redistribution, as well as weight loss or gain, are also not uncommon. These changes may lead you to need different sizes, lengths, shapes, or styles of jewelry for some of your existing piercings, commonly navel, cheek, oral, or nipple piercings. If you notice your piercings feeling tender, or the skin surrounding them seems irritated or breaks out in acne, pop in for a visit with your piercer to have them take a look.
Breast development is a major benefit of taking estrogen, and nipple piercing can be very affected by this. As breast tissue grows, this also affects the nipple, which can change in size, shape, texture, and color over the first 4-8 years on HRT. Many clients see size changes that would necessitate wearing longer jewelry and staying on top of changing jewelry as your body changes. Migration and rejection can also be a concern with nipple piercings as this tissue changes and grows on HRT. You can learn more in-depth about specific considerations for nipple piercings with estrogen here.
Hormones cause a lot of amazing changes in our bodies when we take them, and many of these changes are focused on our skin. We must remember that when we are taking HRT, literally all of the skin on our body is receiving new messages from our hormones to change how it functions- produce less sebum, thinner hair, different collagen amounts. These changes can absolutely affect our piercings and potentially cause things to take longer to heal, be more difficult to heal, or deal with unexpected irritation or issues. We see the exact same flare-ups with cisgender clients going through puberty, pregnant clients, and clients on some hormonal medications. This is a normal part of dealing with fluctuating and changing hormones, and a good reputable piercer will be able to guide you through any issues your piercings have, and get you to healed, healthy, happy piercings!
Haircare Help
Many of my transfem clients are growing their hair out for the first time. As someone who wore their hair short from middle school till the age of 25, it can be SO exciting to have longer hair for the first time. I vividly remember the day I learned to put my hair in a bun or little double buns, and I was obsessed. There's just so much cute styling you can do with long hair! But long hair can also come with some additional responsibilities with our piercings, particularly earlobe piercings, which are also often important rites of passage for transfem clients (and there's cool history behind that too!)
I don't know about you, but for me, one of the big hassles of longer hair is washing and drying it. Particularly drying it- it takes so long! Air drying is much easier and less damaging for your hair. But leaving your hair wet is not a great idea if you have new or still-healing lobe piercings. All that wet hair can just sit behind the ear, and if you go to sleep with a wet or damp head of hair, it's often being smushed right into the piercing. That can be a recipe for very irritated piercings. This is because earlobe piercings are prone to unique moisture irritations, which I discuss in-depth here. These are large, often fluid-filled bumps under the skin behind the ear. They form when excess moisture builds up behind the ear and around the piercing, creating an environment for these irritations to develop. We almost always see them on clients with longer hair, with younger girls being the most common demographic.
The best way to avoid this is to blow-dry your hair after washing it. It ensures there's no excess moisture behind the ears and the piercings can heal properly. Now, not everyone may be able to blow dry their hair every time, so if you aren’t going to, I suggest towel drying it to remove any excess moisture first. Then, pull the hair back- in a ponytail, a braid, a clip, or even a wrap. Something that prevents the wet hair from sitting against he back of the ear. And still be sure you dry well behind the ear. This might look like using a blowdryer to dry just the roots and hair that are closest to the back of the ear. It might also look like clipping the hair up and using a small fan to airdrop behind the ear, or gently patting with a towel behind the ear (careful of snagging jewelry!) To remove excess moisture. Whatever the case, we want to make sure we are keeping the back of the ear and of the piercing, clean and dry!
Makeup and Skincare
As a makeup fan myself, there is so much fun in the process of expressing yourself through makeup. Whether your style is subtle and natural or vibrant and loud, there's a little something for everyone when we consider makeup and skincare. But, as fun as these products are for our faces, they often aren’t the most ideal for our piercings. Especially with fresh or unhealed piercings, makeup can get into the piercing channel and cause irritation and issues. It can also get built up on the surface and setting of jewelry, trapping bacteria and debris next to your still-healing piercing. I have a guide here for makeup and piercings. And even many skincare products may have ingredients that are good for your skin but could be too harsh for a still-healing piercing.
When doing skincare, avoid applying it directly around the piercing. You can apply it everywhere else; just try to keep it off the actual piercing location. With makeup, I suggest giving the piercing a wider berth, as makeup can spread through the day. Try to leave two finger widths of space from any makeup products and the piercing. You can often use a damp beauty blender to blend the edge of your product so its less obvious that the space around the piercing doesn't have anything on it. Using a good primer and good setting spray can minimize how much your product moves during wear, keeping it off your piercing. You can find more specific tips for these two instances here for makeup and here for skincare.
Laser Hair Removal
Electrolysis (laser hair removal) and piercings don’t always play nice together. If you are planning on having laser treatment in an area you want to get pierced, it’s not a bad idea to wait until you’ve had the treatment and give your skin time to recover before getting pierced, otherwise, you may have to retire your piercing for the duration of treatment. If you already have piercings in an area that you’d like to get laser treatment, talk with your technician about what they advise and what materials are safe to wear if they allow you to keep the piercings in for treatment. Some technicians will laser right over piercings without question, some may ask to remove jewelry due to the material or practitioner’s insurance policy, and some may be fairly unaware of the nuances surrounding piercings and laser treatment. Laser treatment may darken your anodized jewelry and can create soreness and swelling at the sight of the piercing. Some patients have had success with wearing glass retainers during their laser treatment, but it’s recommended to have your piercer reinsert jewelry in the days following treatment as retainers aren’t very viable for long-term wear. Some doctors may not allow you to wear any jewelry/retainers during laser removal; seeing your piercer in the days following to have piercings tapered open and jewelry reinserted may help you maintain the piercings you love without having to get them redone!
Tucking
Tucking and genital piercings can play well, but can also play not-so-nice. For healed and established piercings, as long as you are being mindful of the material and type of tucking, you will likely be fine. For example, some adhesives might not irritate your skin but may irritate piercings, so check your piercings after to ensure that the adhesive is not causing issues. Some clients even use purely piercings to tuck (a PA and a Guiche can work together to be a very cool combo for this), or prefer tucking clothing that avoids any adhesive. But for fresh or still healing piercings, the pressure of tucking, even without tape, can cause some irritation. Tucking garments are often also made of thick, non-breathable fabric that can allow moisture to collect in the area, or even sometimes cause chafing. Be cautious with tucking with any unhealed piercings, and clean the area thoroughly after. If you start to see any irritation, wait a week or two before tucking again. You may also want to experiment with different styles and sizes of jewelry to figure out what is most comfortable for tucking. Another pro tip- medical adhesive remover on a q-tip works really well for getting stubborn adhesive off of jewelry and is skin safe!
And there you have it, folks, a brief guide to some of the unique healing considerations for trans feminine clients! I hope this blog post was able to provide some insightful and helpful information unique to your experience with piercings. Body modification has to be one of my favorite forms of gender expression and gender affirmation, and I love that we have this ability to customize our bodies.
With so much love and trans joy,
<3 Lynn
Special thanks to Venus, Robbi, and Mara who contributed to this information!