According to the Association of Professional Piercers (APP), there are few standards of titanium recommended for use in new and unhealed piercings. Specifically, these are:

  • ASTM F136
  • ASTM F67
  • ASTM F1295
  • ISO 5832-3

But what does this really mean? It’s important to understand that ASTM and ISO are not grades or certificates of titanium, they offer written standards for different types of titanium.

Standard for Ti 6Al-4V-ELI. Also known as Grade 23, G23, and medical-grade.

Standard for commercially pure. Also known as Grade 1 (Ti 35A) (CP4), Grade 2 (Ti 40A) (CP3), Grade 3 (Ti 55A) (CP2), and Grade 4 (Ti 75A) (CP1).

ASTM F1295
Standard for Ti6Al-7Nb. Also known as medical-grade.

ISO 5832-3
Standard for Ti 6Al-4V. Also known as Grade 5 and G5.

ASTM and ISO are companies that write specifications for different industries and materials, including titanium, enabling us to understand and trust the chemical makeup of the titanium we use and buy.

For those of you who require a more detailed understanding, continue reading.


Whether you’re a piercing enthusiast or you work in the industry as a professional piercer, there are a number of materials that are used to pierce a desired body part. Titanium is a commonly used material, but is it the best one? What other materials exist that are safe to use for piercing?

As a professional piercer, you want to provide the best service to your customers and an experience that isn’t going to lead to a nasty infection. With titanium, there are a number of terms and expressions used to describe the best grades to use, and this often divides professional piercers on their opinion on which is the most suitable.

In this guide, you’re going to learn everything there is to know about titanium piercing jewellery and how it compares to other materials available. We’ll also take a further look at the different materials available, along with the pros and cons of each.

Hopefully, by the end of the article, you’ll have improved insight as a professional piercer on whether titanium is a preferred choice. For those of you who are enthusiastic about body piercings, this should be a useful guide to help avoid establishments and piercers who may not be using the right methods or materials when piercing.


So what is titanium? In its most basic description, it’s a chemical element found in nature and is silver in colour. It has a low density and high strength, as well as being resistant to corrosion, whether that’s in seawater or chlorine.

In comparison to steel, it’s as strong as steel but less dense, making it a useful material for industries that need alloying agents. Think aircraft and spacecraft. However, titanium is also used in everyday items such as laptops, crutches, and golf clubs.

Titanium metal also connects well with bone, which has allowed it to be used successfully in surgical applications. With that being said, it only seems appropriate that it would have some use within the body piercing industry.

As a material, it’s one of the few that has been approved by the Association of Professional Piercers (APP). The APP is a California-based organisation recognised by piercers for its international health and safety guidance for body piercing. The same recognition has been given to UKAPP, which is essentially the UK’s version of this organisation.


One of the main arguments that we typically see when it comes to titanium grades and quality is, ‘What grade of titanium should be used for body piercing jewellery?"

To delve deeper into titanium piercing jewellery, we should first look at the different titanium terms, grades, and standards available. As a general rule, you should be looking at titanium that has been approved by either the APP or UKAPP.

With this in mind, here are some of the most widely talked-about titaniums.

  • ASTM F136
  • ASTM F1295
  • ASTM F67
  • Commercially Pure
  • Grade 5 (G5)
  • Grade 23 (G23)
  • Medical-Grade
  • Implant-Grade
  • ISO 5832-3

Let’s take a closer look at each one before we go into the arguments made for these titanium grades.


Contrary to popular belief, ASTM F136 is not a type or grade of titanium. Rather, it is a written specification or standard for a grade of titanium more commonly referred to as Ti 6Al-4V-ELI or Grade 23 (G23) for short. As far as its properties go, its corrosion resistance, biocompatibility, high strength, and toughness make it highly effective in the medical field. It’s suitable for implants as well as a variety of medical devices.

Any jewellery that meets the ASTM F136 specification will be Ti 6Al-4V-ELI, which is considered one of the best for use in the case of fresh and healed body piercings.

ASTM F1295 & F67

As we have already discussed, ASTM F136 is not a grade of titanium. The same goes for ASTM F1295 & ASTM F67.

ASTM F1295 is a written standard or specification for a grade of titanium more commonly known as Ti-6Al-7Nb. This grade of titanium was created for use in medical and surgical applications. almost identical to Ti6Al4V (Grade 5), with the main difference of having vanadium substituted out for niobium to improve biocompatability.

ASTM F67 is a written standard or specification for a grade of titanium more commonly known as "commercially pure". Commercially pure titanium includes four grades: Grade 1 (G1), Grade 2 (G2), Grade 3 (G3), and Grade 4 (G4). Grade 4 is stronger than grade 3, grade 3 is stronger than grade 2, and grade 1 is the softest.

ISO 5832-3

Just like ASTM, ISO 5832-3 is not a grade of titanium; rather, it is a written specification or standard for a type of titanium more commonly referred to as Ti 6Al-4V or Grade 5 (G5) for short. Grade 5 is the most commercially available of all the titanium alloys and is almost identical to Grade 23. However, Grade 23 titanium has lower oxygen, nitrogen, and iron. meaning that when grade 5 is put under immense pressure, it could fracture or break easier than grade 23.


There are a few materials that are approved by APP and UKAPP, which we’ll touch on again later, but implant-grade and medical-grade titanium is the one most piercers are recommended to use for initial piercings.

Implant-grade titanium is often used in the medical field to repair bone fractures. Titanium isn’t rejected by the human body, so implant-grade titanium is a great option for body jewellery. They are often referred to by professional body piercers as being the preferred choice for body piercings in general.

Until recently, medical-grade and implant-grade titanium were less commonly known as Ti 6Al-4V-ELI or Grade 23 (G23) for short. Grade 23 is the most commonly used medical implant-grade titanium alloy. With the development of Ti-6Al-7Nb, "medical-grade and implant-grade are now considered more generic terms for both types of titanium.


  • ASTM & ISO are not grades of titanium
  • ASTM & ISO do not certify titanium
  • ASTM & ISO are not certificates
  • ASTM & ISO are written specifications
  • According to the APP, titanium suitable for use in body piercings are:
    • Grade 1 (Ti 35A) (CP4)
    • Grade 2 (Ti 40A) (CP3)
    • Grade 3 (Ti 55A) (CP2)
    • Grade 4 (Ti 75A) (CP1)
    • Grade 5 (Ti 6Al-4V)
    • Grade 23 (Ti 6Al-4V-ELI)
    • Ti6Al-7Nb

Now that we have broken down the terms and understand the grades of titanium suitable for use in body piercing, let's take a deeper look.


Commercially pure titanium is unalloyed titanium that contains no less than 99% titanium. Although commercially pure titanium is accepted by the APP and UKAPP as safe to use for new and unhealed piercings due to its biocompatibility and other properties, the use of these grades of titanium isn't really mainstream.

Commercially pure titanium is more commonly used in the aerospace industry for sophisticated parts due to its formability.

Titanium in general is very hard, so maybe in the future the use of more formable titanium could produce more ornate body jewellery.

GRADE 23 (G23)

G23, or Ti 6AL-4V ELI, is often described as one of the most beneficial for use in dental and medical titanium. As a grade, it’s used a lot across both the British and American medical fields for implants.

The reason for this is that it has total resistance to attack by body fluids. As a result of this, it’s often commonly mentioned amongst body piercing forums as being a popular choice for professional piercers. The fantastic tolerance to damage is one that has made it superior to other alloy materials.

Again, titanium promotes high strength, is lightweight, and has good corrosion resistance, which makes sense that it’s used so often in dental work.

GRADE 5 (G5)

As alpha-beta titanium, Grade 5 is considered one of the best alloys for corrosion resistance and is therefore used for a variety of specifications across all product types. It’s extremely desirable within the body piercing field, and despite some differences in opinion, it’s still a great option for professional body piercers to use.

Grade 5 (Ti-6AL-4V) is a stronger and less malleable grade of titanium and is therefore used for most body jewellery. In comparison to Grades 1-4, which are most commonly used for ear piercings. You’re most likely to see all these grades used within body piercing, but it’s useful to know that Grade 5 is particularly distinguishable for all body piercing in general.


It's safe to say that Ti6Al-7Nb could do with a more catchy name. However, it is considered true medical-grade titanium. Ti6Al-7Nb was developed for medical and surgical applications, and more specifically, hip replacements. It was intended to replace grade 5 titanium for use in implants.

Almost identical to Grade 5 titanium, but with the vanadium removed and replaced with niobium to improve biocompatibility.


In the medical profession, Grade 23 and Ti6Al-7Nb are considered medical-grade titanium and are often preferred over all other metals, particularly for those with hypersensitivity problems with their skin.

As well as other medical procedures, medical-grade titanium is often referred to by professional body piercers as being the preferred choice for body piercings in general.

For those getting pierced, hearing the words ‘medical-grade’ is often going to be more comforting. You would hope that with medical-grade materials, you’re getting premium materials for your body piercings.


Titanium, like all metals, has its benefits. With this type of material being used universally across many industries, there are plenty of benefits that come with using titanium in the realm of body piercing. Let’s not beat around the bush here; here are some of those benefits.

It has the option of being anodised

One of the cool aspects of titanium is that it’s a dark metallic colour. In its appearance, it’s not only great for piercing, but it also creates that uber-stylish aesthetic that many piercing enthusiasts are after.

However, we all have different styles and preferences when it comes to our body jewellery. One flexibility that titanium has as a metal is that it can be anodized. An electrochemical process that will change the surface colour while maintaining safety. With that being said, the metal can be personalised and custom-made to the client’s requests.

As a body piercer, being able to give your clients that unique and personalised experience is priceless.

It’s nickel-free 

If you’re unfortunate enough to have a metal allergy, then you need to be careful about what metals are being pierced into your body. Nickel is perhaps one of the most common contact allergens you can get, according to the European Centre for Allergy Research Foundation.

Annoyingly, a lot of nickel can be found in body jewellery, which can be a bit like Russian Roulette for those with an allergy to nickel or other metals.

One of the great benefits of using titanium as a professional body piercer is that it doesn’t contain any nickel. You can rest assured that anyone with sensitive skin or a nickel allergy isn’t likely to have a reaction to titanium as a result.

There’s nothing quite worse than your client having a reaction to a piercing, whether that’s while they’re sitting in the chair or during their aftercare.

It’s a lightweight material

Titanium is low-density, meaning it’s relatively lightweight as a metal in comparison to others. With titanium being lightweight, it does help for those getting pierced. After all, you don’t want to get a piercing that you feel is weighing down or stretching the skin too much.

This is particularly relevant with body piercings where the skin is perhaps less elastic and more susceptible to stretching, like the earlobes, for example. The lighter the material, the less damage it’s going to do in the long run, should the client want to remove it at any point for the skin to heal.

High strength-to-density ratio

With titanium, you’ve got a material that has a high strength-to-density ratio. Unlike stainless steel, another popular metal used across multiple industries, it’s less dense. However, that doesn’t diminish its strength. In fact, it is considered to be just as strong, if not stronger.

For body piercers, a material that does well under pressure but perhaps has a little bit more flexibility is important. There are certain body parts that require that flexibility, and a material such as titanium is a good option to have available.

Durability is important when it comes to body piercing. As a professional piercer, you don’t need to worry so much about the material bending or snapping while piercing.

If you’re currently using titanium for your clients or you’ve personally had piercings using titanium metal, then chances are you’re already reaping the benefits.

However, when it comes to titanium, there are different grades available, and it’s these grades that seem to divide opinion.


There are many people out there—as is the case with most topics that are up for discussion—who'll want to impose their knowledge on this topic. Some are right, and some are not. Just take a look at any body piercing forum.

We invested many hours of research into this article, so we're going to try and break down the common arguments to help distinguish fact from opinion.

One of the main arguments that we typically see when it comes to titanium grades and quality is the difference between ASTM F136, Grade 23, Medical Grade, and Ti 6Al-4V-ELI’.

As we’ve covered above, two of the main terms we see are ‘ASTM F136’ and ‘implant grade’ titanium. But grades 23 and 5 should never be used! Right?

However, the APP and UKAPP provide a list of safe titanium for use in new and unhealed body piercings. They are:

  • ASTM F-136 compliant
  • ASTM F1295 compiant
  • ISO 5832-3 compliant
  • ASTM F-67 compliant

According to AZoM, the leading online publication for the Materials Science community, they state:

"AZoM educates and informs a worldwide audience of researchers, engineers, and scientists with the latest industry news, information, and insights from the Materials Science industry."

They’ve covered titanium grades, in particular the ‘Grade 23 Ti 6Al 4V ELI Alloy’ article. Here’s a segment from the article;

‘Titanium alloys are divided into three main groups: alpha-phase, beta-phase, and alpha-beta-phase. Grade 23 Ti 6Al 4V ELI alloy is an alpha-beta wrought alloy. The ELI stands for extra low interstitial’

However, contradicting this information are the forums and Facebook pages, which state that Grade 23 is not suitable for body piercing, whereas, on the other hand, Ti 6Al 4V ELI is.

While AZoM’s article is insightful, it doesn’t answer the question: what is medical-grade titanium? It’s used in surgical implants, so surely it’s equally suitable for a body piercing?

Continuing our research, a specialist in alloys and titanium since 1912, Harrold Pihl, states medical grade titanium has a code of Ti-6AI-4V ELI..

If you take a look back at AZoM’s article, you’ll notice they use both Grade 23 and Ti-6AI-4V ELI in the same sentence. Harrold Pihl goes on to say;

 "Titanium Grade 23 is very similar to Grade 5 except that Grade 23 has less oxygen, nitrogen and iron. This makes the alloy more ductile and has better fracture resistance (but slightly less strength) than Grade 5 Titanium. Grade 23 is used, in chemical processes, medical applications and in the aerospace industry"

So it’s understood that Grade 23 and Ti-6Al-4V ELI are essentially the same things. Yes, they may be used within different fields and in a number of ways, but their properties remain the same.

Which one should be used as a medical implant?

Is there one that should be used more for medical implants than the other? A book written by Wilson Wang and Chye Khoon Poh (edited by Jan Sieniawski and Waldemar Ziaja) entitled ‘Titanium Alloys in Orthopaedics’ gave more insight into this question.

‘Ti-6Al-4V and commercial purity Ti are currently the most popular materials for implantation purposes.’

Another source, Andrew Slander from Kodak, showed clearly that G23 and Ti-6Al-4V ELI were the same tthing. Therefore,Ti-6Al-4V is the medical-grade titanium that many people seem to discuss on online forums and within the body piercing industry in general.

What about ASTM F136?

With ASTM F136 considered one of the best titanium grades for body piercing, why hasn’t it been mentioned by any medical professionals? Well, if you head over to the ASTM website, you’ll see the F136 specification:

‘Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401)’

Yes, you read it correctly—if you spotted it, that is. Titanium 6Aluminium-4Vanadium ELI (Extra Low Interstitial) or Ti-6Al-4V ELI for short.

So what does that all mean? Well, if you’ve been reading the online forums and the arguments between ASTM F136, G23, and Ti 6Ai 4V ELI, it turns out that they’re all arguing about the same thing! All three are exactly the same titanium and are suitable for medical implants, including body piercings.

What is the difference between Ti 6Ai 4V ELI and Ti 6Ai 4V?

But let’s not stop there. Are there differences between ELI and a lack of ELI? What’s the difference between Ti 6Ai 4V ELI and Ti 6Ai 4V?

According to Mohammad Yousefieh of Semnan University;

‘Ti6Al4V ELI (Grade 23) is very similar to Ti6Al4V (Grade 5), except that Ti6Al4V ELI contains reduced levels of oxygen, nitrogen, carbon, and iron. ELI is short for “Extra Low Interstitials”, and these lower interstitials provide improved ductility and better fracture toughness for the Ti6Al4V ELI material.’

‘Ductility’ ‘Capacity of a material to deform permanently (e.g., stretch, bend, or spread) in response to stress. Most common steels, for example, are quite ductile and hence can accommodate local stress concentrations.’

Simply put, it’s slightly flexible. This is a benefit when it’s being fused to something, like bone or living tissue.

‘Fracture Toughness describes the resistance of brittle materials to the propagation of flaws under an applied stress, and it assumes that the longer the flaw, the lower is the stress needed to cause fracture. The ability of a flaw to cause fracture depends on the fracture toughness of the material.’

What he’s saying here is that a material could break if the flaws are present and it’s put under stress. Our takeaway from all of this information was that they are essentially the same.

One is slightly flexible when put under pressure, and one will break when put under pressure if there is a flaw in it. How much pressure gets put on a piece of piercing jewellery compared to an aircraft or a hip replacement? A lot less, we guess.

Interestingly, though, we did find a quote suggesting Ti6Al4V ELI is more than likely used for medical implantation (depending on the implant) due to the small risk of breakage Ti6Al4V poses when put under immense pressure.

 "Chemically they are the same but the medical cost of replacing such an implant when in a human body would not be ideal. So it is chosen more to eliminate financial loss should such an occurrence happen rather than for any medical reason."


There are a number of other materials that exist in the body-piercing world. It’s important to note, though, that if you’ve got a sensitivity to metals or a metal allergy, your best bet is to go with a hypoallergenic metal like titanium when getting any piercing.

However, if you don’t have hypersensitivity or a metal allergy, then any of the below materials are also going to be suitable for body piercing.



Niobium is a material that is often used in body piercings for a number of reasons. Here are some of the advantages that niobium has for use by professional body piercers:

As with titanium, niobium is also hypoallergenic. This is a great alternative to using titanium, and it might often be offered within some body piercing shops when visiting as a customer.

While some may not be aware of the materials used in body-piercing jewellery, it’s crucial to be able to distinguish which metals are suitable for those with metal allergies.

Can be anodized
As mentioned prior, titanium can be anodized, meaning it can be changed into a different colour while maintaining its safety. The same goes for niobium, so you may find that this material is offered to you by professional body piercers in a variety of colour options.

Lower cost
Of course, it’s music to everyone’s ears when you hear that something is low-cost. Niobium is one of the more affordable material options and, therefore, a great pick for those on a budget.

Look at unalloyed niobium that has ASTM B392 compliance.


As a popular choice, surgical steel is commonly used by many professional body piercers. What are its benefits?

As a material, surgical steel is considered affordable. This is important to many professional body piercers who are sourcing the relevant jewellery for their clients. How much the jewellery costs will reflect on how much they’re able to sell it for to their clients.

As a material, it’s a popular choice for those body piercers who want piercings that are going to last. Sometimes, investing in the right materials means you’ve got beloved pieces of jewellery that are going to be wearable for a long, long time.

Safe for most people
Of course, surgical steel does contain some nickel, but thankfully, with the low rate of transfer, anyone with sensitivity is unlikely to notice any reaction. It might be worth checking this when it comes to metal allergies, as it might be best to avoid them completely.

Relevant compliant materials in stainless steel include ASTM F-138, ISO 5832-1, ISO 10993-6, ISO 10993-10, and ISO 10993-11.

14 & 18 KARAT GOLD

Another safe option for body piercings is 14- or 18-karat gold. It’s also a more luxurious option to have when it comes to piercings. Here are a few reasons to choose this material for body piercings:

Most are nickel-free.
With 14 and 18 karat gold, most of the material used for piercings will be nickel-free. As someone who may be allergic to metals, it can be appealing to know that there are still plenty of options, despite this allergy being a nuisance for some body-piercing materials.

Most are biocompatible.
Again, if chosen correctly, most 14- and 18-karat gold is going to be biocompatible, and when it comes to body piercing, that’s what you want to hear.

Ideal for sensitivity
Sensitivity to your skin is something you want to avoid, especially when it comes to a healing body piercing. You’ll find that this material is suitable for those who have a sensitivity to metals.


If you’re willing to spend the money, then platinum is a great choice for those shopping around for body piercing materials.

More unique to come by
Of course, with this premium piercing material, you may find that it is harder to come by.

Used by top professional body piercers
In relation to it being a premium piercing material, not all professional body piercers are going to use it because it’s fairly hard to work with.

Therefore, if you come across a professional body piercer who does use it, you’ll likely be using one of the top piercers in the industry.

If you have a sensitivity to silver or gold, then the platinum material will likely work in your favour.


Plastics that are biocompatible are a useful choice for some body piercings in particular. They’re obviously a little more affordable, too.

Extra flexibility and comfort
As plastic is a more malleable material, you’ll find that this material is great when you’re looking for more flexibility and comfort in your piercings.

Helpful for those who are sensitive
With sensitive skin, biocompatible plastics are likely to be a lot more accommodating to those with these problems.

As mentioned, when it comes to plastic, it’s one of the most affordable and budget-friendly options for both professional body piercers and their clients.

Look for Bioplast, PTFE (Teflon), and Tygon Medica/Surgical Tubing for body piercing materials used by professionals.


There are a number of materials that should be avoided because they may increase the risks that you are wanting to avoid as a body piercer or person being pierced.

These are some materials to stay clear of when it comes to getting an initial piercing:

  • Gold-plated

  • Sterling silver

  • Gold higher than 18 karats

  • Gold lower than 14 karats

These particular materials will increase the likelihood of poor healing, infection, and rejection of the materials by living tissue in general.


As you’ve learned plenty about titanium piercing jewellery, we thought we’d end this guide with some general rules and guidance around the aftercare of body piercings. While most materials shouldn’t cause problems, how you look after piercings or prepare the space for piercings is important.

From both the client's perspective and that of a professional body piercer, here are some things to consider:

For professional body piercers
Remember to prep the space and to sanitise all surfaces and tools that are being used. Quality materials matter, but it’s important to note the client’s allergies or sensitivities. Always make sure you’re checking in with the client to know what they can and can’t have.

Stick with what you know and what works well for all of your clients, and if there’s any hesitation from the client regarding allergies, opt for the hypoallergenic materials.

For body piercing enthusiasts
In general, it’s important to be aware of what materials are compatible with your body and your skin’s sensitivity. Be mindful of cleanliness when approaching a body piercing shop.

A few top tips for aftercare include:

  • Avoid touching your piercing.

  • Clean it regularly with the recommended cleaning products.

  • Avoid oral or other bodily fluids from other people.

  • Avoid any lotion or makeup around the piercing.


Hopefully, you’ve gained an in-depth understanding of titanium piercing jewellery and some of the confusion that’s caused when discussing titanium grades.

The bottom line is that titanium is considered one of the best materials for safety for all clients wanting body piercings and that there are still plenty of alternatives available when it comes to cost and personal preference or style.

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Before beginning a new health care regimen or with any questions you may have about a medical condition or treatment, always consult a medical expert first.

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