A cartilage piercing, also called a helix piercing, is one of the more painful ear piercings. The cartilage is thicker than the lobe, so the piercing gun or needle works a little harder to penetrate it.
The initial cartilage piercing causes a moderate amount of pain, and there is also a higher risk of infection, which also adds to the risk of pain. If the cartilage piercing becomes infected, one must see a doctor before removing the piercing and follow the doctor's orders for taking care of it. While infections in general are rare for ear piercings, there is still a level of risk.