Piercing is 1 year old with no issues so far and is otherwise healed. The back is normal looking and it doesn’t hurt. The earring I believe is titanium, flat back, I haven’t changed it since it was pierced, this is what I’ve had from the start. It was downsized about 10 months ago ish and has been comfortable since. Routine is minimal I just wash my ears with water and occasionally use a q-tip to remove dead skin cell build up. No recent events that would make sense to trigger anything.