Below is my correspondence from a consultation on a woman who was having some issues with her vertical clitoral hood (VCH) piercing:
VCH Piercing Inflamed

Greetings!  Thanks for taking time to read about my concern.  I know you're an expert and was hoping you could help me.

I got a VCH piercing over a year ago.  I was pierced at a 16g with a bent barbell, but got it caught in a loofah and ripped it.  Now it's a 14g.  It's taken quite a long time to heal, although it's been fine within the last 5 months.

I've tried all kinds of jewelry with it, a CBR, a horseshoe ring, a belly button barbell, and settled on a bent barbell since it seems to interfere the least with everyday activities and sex.  I have one of those rainbow titanium barbells in it now.

I've been having irritation with it lately.  It's always been kind of sore in the middle flesh area between the top and bottom balls.  I haven't taken a picture of it, but I can if you need it, but I can feel the top and bottom ball easily and the length of the barbell seems sufficient.

Sometimes it feels like something sharp is in the middle area, I try and clean it and there's nothing there.  I never take it out because I'm afraid of losing a ball, or not finding the hole, and I always have my husband do it, I haven't even tried to find the hole on my own.

Since yesterday it got extremely irritated.  I recently lost a baby so I've been bleeding it seems like forever now, so I'm not sure if that's part of the irritation or not.  But it's so extremely sore and hurtful now I can't even touch it!  It feels like something sharp is inside and sharp on the top and bottom areas.  I've been exercising more often, and I never feel it getting pulled or anything, and I have been swimming a lot.  I don't know what's going on with my piercing.VCH from the underside
I love my piercing, the way it looks, and it was so extremely painful to get pierced that I don't want to take it out and I don't want to get it re-pierced.  I've become so aesthetically pleased with it now, that it would look odd without it. I've been suffering through these bouts of inflammation and random pain for the last two years almost.  But it's never been this bad.

Is there any sort of first aid I can do?  Natural remedies?  Have you heard of anything similar before?  I called the piercer and he just tells me to talk to my doctor, and the doctor doesn't like it so he says to just take it out.  But there are no signs of infection.

Thank you for your time and I look forward to hearing from you at your earliest convenience.
Sincerely,

My reply:

I'm sorry for your loss, and to hear you're having trouble with your piercing. Those two things could definitely be related, between hormonal fluctuations and stress levels. Stress can be very bad for piercings. Regardless of what's wrong, twice-daily saline soaks are frequently helpful. Information is here.

She responded:

We ended up getting a stainless steel curved barbell in a 14 g that had a very slight increase in length and it helped ALOT.  Once we put in the new jewelry the relief was immediate and I wasn't having troubles at all.  I think the bar has been too short and digging into the top of my hood for over a year now. I took several pics I hope they help with an evaluation.

The problem I'm dealing with right now is this weird pain in the top area.  My husband said I had a sort of indent from where the old jewelry was grinding into the top of my hood.  It can get quite painful, and I find if I push the jewelry forward and put pressure behind the skin there seems to be some sort of fluid that is accumulating back behind the piercing, but not in the actual piercing site.  It's horridly painful, feels like needles, and there is no relief until I get the fluid out.  I have no idea what this is, and my doctor will most likely suggest taking out the jewelry.  Once I get the fluid out it feels fine, till it accumulates again.  I get relief for half a day to a day.  Have you heard of anything like this?

I'm going to start salt soaks twice daily.  I was using saline to flush the area, but I find it's drying it out more than anything.  I'm wondering if it just needs time to heal from the stress and the improperly sized jewelry.  Any other home remedies you could suggest like witch hazel or anything?

I'd really hate to take it out, especially now that I'm sure the site is fine and healed, it's just this weird area, perhaps a sebaceous gland or something.  But from the pics you can tell it doesn't look inflamed or anything.

Thanks again for your time, I appreciate your expertise.

Then I wrote back:

Actually, the surrounding tissue does appear to be somewhat inflamed. Definitely try the saline soaks, and make sure to wash the solution off afterward. Please follow the instructions on that page.

I would also highly suggest you try Briotech spray. I am a HUGE fan. That page of my site gives lots of information about it.
These are some of the alternative options in my book, The Piercing Bible:

Herbal remedies: Herbs have been used in medicine for thousands of years. There is a large body of well-tested and proven herbal wisdom. When used properly, certain herbs can be beneficial to healing. Herbs can be applied on healing piercings in several ways: you can soak your piercing with an infusion (a tea that is steeped longer than usual) or topically apply diluted essential oils (concentrated liquid compounds from plants). An infusion of herbs can be used on a compress or as a soaking liquid instead of a saline solution, or in addition to it.
–  Lavender, chamomile, and comfrey are good herbs for healing piercings. Select one at a time unless you are a skilled herbalist or receive advice from one.
–  Add one to two teaspoons of dried herb per cup of boiling water to make an infusion. Let it steep for at least ten minutes before you strain it. Some herbalists recommend infusing for hours. Keep the mixture covered in the refrigerator for two to three days. Heat the tea (a microwave is fine), and use it on your piercing as described with salt soaks. Unlike saline, there is no potentially harmful residue that must be rinsed away, so you can soak with herbs after your shower.
–  Tea tree and lavender in essential oil form are popular for topical use on healing piercings. Essential oils are much too harsh for full-strength application on piercings; they must be diluted first. Since they come in varying concentrations, ask for guidance from a knowledgeable supplier before putting this type of product on a piercing. Tea tree oil is also sometimes used for trouble- shooting problem piercings.
–  An infused herbal oil (an essential oil that is mixed into an oil base) is milder and can often be used topically on a piercing at full strength

Is your new body jewelry high quality, mirror finish, and internally threaded? If not, that could be causing some problems.

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