A "vampire's kiss" is a surface piercing of either side of the neck, so-named because the barbell typically worn in such a piercing would resemble two points on the neck. Like any surface piercing, it is difficult to care for a vampire's kiss and much more difficult to maintain it indefinitely. In fact, because of its placement, such a piercing will almost always have to be removed eventually. The term "surface piercing" refers to any piercing of skin that does not extend in a way that facilitates piercing in the way the nose, ear, or lip do. The skin surrounding a surface piercing places enough strain on the jewelry that over time it will migrate, meaning it will move closer to the surface of the skin as it heals. In the worst scenario, the jewelry may even be rejected if it is not removed. Rejection occurs when jewelry grows out of the skin entirely. It is important that you recognize migration and remove the jewelry before it becomes this severe, or the result may be an unsightly scar. Like the "madison", a vampire's kiss has a very high rate of migration or other complications. In the long run, almost none will heal fully and are removed as a result. That said, your piercing may last a year or more if properly cared for.

Taking care of a surface piercing is somewhat more intensive than normal piercing care because in most cases, a surface piercing will never fully heal. This is especially true of piercings in locations that move around a lot, like the neck. Constant movement of the skin around the piercing causes it to become irritated and possibly inflamed, leaving it at a constant risk for infection. If you do elect to receive a surface piercing, it's important that you take excellent care of it. Repeated or prolonged infection of a piercing like a vampire's kiss usually leaves only one resort: removal. As you have probably spent (or will spend) sixty dollars or more on your piercing, this is something you want to delay as long as possible.

Cleaning a surface piercing like a vampire's kiss is much like the cleaning of any body piercing, save that the tension placed upon the piercing by your skin makes the area much more sensitive and thus prone to irritation. You should be especially ginger with your piercing when caring for it, especially when rotating your jewelry.

Most people find that it's easiest to clean a piercing straight out of a shower. This is because the moisture and heat from the water help to soften your skin and any crusted discharge surrounding your jewelry. This crust can bind to the jewelry and to your skin, leading to additional tissue damage during cleaning. An additional step you can take to avoid this result is to use a sea salt soak or saline solution before you clean. For a surface piercing, it is easiest to apply the solution with a sterile cotton ball. Soak your piercing for at least a minute before proceeding, dabbing it occasionally to help remove any hardened discharge. Now use a dab of antibacterial soap (scent-free, ideally, to prevent irritation and possible allergic reaction), spreading the soap around your piercing and rotating or moving your jewelry slightly to distribute the soap where it's needed. Be especially careful when doing this to avoid irritation of the piercing. Let the soap sit for a minute or so, depending upon the sensitivity of your skin, and rinse carefully but thoroughly with water. Repeat this process twice a day for the first week and once a day thereafter, perhaps less often as your piercing heals. If you notice irritation, you may need to use less soap when cleaning or to use a different soap entirely, or you may be using too strong a solution of saline. Keep in mind that your piercing will probably never heal entirely, so you should repeat this process occasionally throughout the lifetime of your piercing to keep it clean and free of infection.