A "madison" piercing is a surface piercing through the skin at the center of the front of the neck, usually placed horizontally through the area with the loosest skin available. Placement is important because a madison piercing, like all surface piercings, is placed through an area of the body with relatively little loose skin. The more skin available, the less trouble you are likely to have with your madison piercing. This said, madison piercings are not considered permanent because the tension placed upon the skin by the piercing and the constant movement of the neck in daily life cause almost all of such piercings to migrate over the course of a year or more. In an informal study highlighted in The Point: The Quarterly Journal of the Association of Professional Piercers (Fall 2005), nine of twelve participants were forced to remove the jewelry from their madison piercing entirely due to piercing migration over the course of one year, while the other three reported that their piercing had not fully healed in that time. Only one of these twelve reported full healing of the piercing over the three-year study. This is significantly worse than, for instance, the rate of healing experienced with other surface piercings, such as a horizontal wrist piercing (~55% over three years) or a clavicle (collarbone) piercing (~82% over three years). In short: don�t expect your madison to last. Enjoy it while you can.

As with any surface piercing, you will find that it�s somewhat difficult to keep your madison out of trouble. Inflammation, long healing periods, and high rates of infection commonly associated with surface piercings tend to be somewhat worse with a madison, mostly because the human neck is always moving and because the neck is frequently brushed by clothing during daily activity. You should take special care in cleaning and moisturizing a madison piercing if you plan to keep it very long.

Most people find that cleaning your piercing is easiest straight out of the shower. The moisture and heat from the water tends to soften the hardened discharge that comes naturally from a piercing and that sometimes binds to your jewelry. Cleaning your piercing without softening this crust can cause minor damage to the piercing itself as you move the jewelry, so be sure to take some step to moisten the area well before you begin. Many people use a sea salt soak or saline solution even with a shower, because this soothes the tissue and helps to remove unwanted particles from the wound. With a surface piercing, it is best to apply the solution with a sterile cotton ball. Soak the ball in the solution and apply for one minute or so, agitating gently to help remove any debris. Now place a drop of antibacterial soap (perfume-free, to prevent irritation or possible allergic reaction) on another moistened cotton ball. Apply cautiously but generously to the piercing, rotating or moving your jewelry carefully to allow the soap to go where it�s most needed. Let the soap sit for about a minute, then rinse thoroughly with water. Repeat this process twice a day for the first week or so after receiving your piercing, and then once a day for the weeks after. After that, if you care for your piercing well and find that it "takes", you will probably want to clean it only once every few days, depending upon your level of activity. Be sure to keep up a cleaning regimen throughout the life of your piercing. Remember that a madison almost never heals fully, and a piercing that is not fully healed is especially prone to infection.

You must be especially sure to watch for signs of migration with a madison piercing because it is very likely to occur. If your piercing seems to be moving closer and closer to the skin, you should consult a professional body artist or consider its removal entirely. Migration can lead to rejection, in which your body expels the jewelry entirely, and full rejection almost always leaves behind an unsightly scar.