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Everything you need to know, including information on aftercare
Body piercing is the insertion of an ornament into a perforation made in the tissue (1) for decorative, cultural, spiritual, or other reasons.
(1) Depending on the area of the body that is being pierced, tissue of various types will be perforated, (for example the cartilage of the ear, erectile tissue of the nipple, or mucous membrane and muscle of the tongue). Legislation sometimes excludes piercing of the ear under the definition of "body piercing," but the health and safety issues concerning body piercing apply equally to the ear and to all parts of the body. This exclusion undermines the organization's effectiveness in protecting the public health.
In a surface anchor piercing procedure, a tiny ornament is inserted into a single opening that is formed in the tissue with the same tools that are used for body piercing. This opening is the entrance as well as the exit. When properly performed by a skilled practitioner, surface anchor piercing is no more risky than an ordinary body piercing and takes no longer to perform or to heal. They are considered to be body piercings by the Association of Professional Piercers.
Surface anchor piercings are similar to "surface piercings," which are done on flat areas of the body, but successful placement options are greatly expanded. Surface anchor piercings are a viable alternative to standard surface piercings as they appear to be easier to heal and not as subject extensive scarring. Any residual scarring is apt to be limited due to the tiny size of the jewelry.
Surface Anchor piercings are much less invasive to insert and remove, and should not be confused with subdermal or transdermal implants, which are more extreme forms of body art that do not fall within the scope of the Association of Professional Piercers.
There has recently been considerable sensationalized derogatory press regarding oral piercings. Unfortunately many of the pertinent facts are not being reported. A well-informed and discerning consumer is subject to far fewer dangers. When performed by a skilled and experienced professional using appropriate sterile, disposable instruments the risks are minimal and the procedure is instantaneous and essentially painless. Proper placement and the correct style and size of inert jewelry are absolutely critical.
Also vital is the cooperation of the piercee to care for the piercing adequately. Following the piercing the use of ice, rest, and elevation (just like with any wound) drastically diminishes the aftermath. An over-the-counter non-steroidal anti-inflammatory taken according to package instructions for the first few days can also help to keep swelling down. Most piercees report little or no bleeding and a minimum of swelling for a few days. Tongue and other oral piercings heal extremely quickly and uneventfully when all aspects are handled according to accepted practice.
Highly suggested for optimal safety is to replace the initial jewelry (which has some extra room to allow for the usual amount of initial swelling) with a snugger piece which fits closer to the body. There is then less chance of contacting the jewelry with the teeth and other oral structures. Also, balls made of an approved polymer can be worn inside the mouth to minimize risk of damage to the teeth. Further, a smaller ball can be worn on the underside of the tongue to reduce contact with the sublingual portion of the oral cavity. These and other precautions can be taken which bring risk of getting and wearing oral piercings to a negligible level.
Many of our colleagues have dedicated tremendous time and effort to become highly educated and skillful specialists. To disparage us and our field offhandedly without taking the details into consideration is not an accurate or helpful response. Particularly since many individuals still desire oral piercings, and intend to get them, it is far more constructive to provide accurate information and specific guidelines on what one should look for in a piercer. Please see our informational brochure Choosing a Piercer for details.
This organization of committed professionals upholds an extremely high standard of safety and hygiene. Members' web sites can also be accessed for additional information.
If you would care to speak with a board member or if you have specific questions you would like for us to answer, please feel free to contact us.
Regardless of any local legislation being more lenient, the following is an appropriate minimum standards policy on piercing minors:
For any piercing of a minor, a parent or legal guardian must be present to sign a consent form. Proof positive, state issued photo identification is required from the legal guardian, and a bona fide form of identification from the minor. In the event the parent has a different last name and/or address from the child, court documentation is needed to prove the relationship, i.e., divorce papers, or a remarriage certificate.
Under no circumstances is it acceptable or appropriate for a piercer to perform piercing on the nipples or genitals of an individual under 18 years of age.
The APP mission is to promote and uphold minimal standards of safety and hygiene. As such, it is our official position that aseptic technique performed with clean disposable gloves is appropriate and acceptable. The above applies, except where sterile gloves are mandated by local laws. If a piercer wishes to use sterile gloves, naturally they may do so. Non-sterile gloves are the minimum required for membership.
Navel jewelry may be left in place; some women leave jewelry in during their entire pregnancy and delivery. If, during your pregnancy the piercing becomes uncomfortable, you can replace the jewelry with Tygon or PTFE, which are inert plastics (something like thick fishing line). These will bend and flex with your changing body, be more comfortable, and are safe to wear. Once your pregnancy is over, you can return to the jewelry.
Even long after the piercing is totally healed, it may or may not stay open without something in place. This varies from person to person. Wearing an inert plastic in the piercing will insure that it can be maintained.
In the event you elect to remove the jewelry entirely there is a chance it could be reinserted using an insertion taper even if the old jewelry won't go back in readily. If it cannot be reinserted it is quite likely that it can be repierced.
As a side note, some women who lack sufficient tissue quantity or pliability for navel piercing prior to pregnancy are often well suited afterwards.
There is no special care that is required during pregnancy for healed piercings.
In our collective, massive experience, we have no awareness of even a single case of a woman who wished to breast feed and could not as a result of having had a nipple piercing. The milk ducts are a multiplicity of little pore-like ducts. Therefore, the likelihood of closing them all off from a piercing of usual size is virtually nil.
Most women do remove their jewelry for breast feeding and we believe this to be appropriate. As a result, some milk may come from the site of the piercing during nursing, which is not harmful nor problematic. Some will use an insertion taper (a tool designed for this purpose) to facilitate reinsertion or to check regularly and make certain the holes are open.
There is no special care that is required during pregnancy for healed piercings.
It is advisable to refrain from undergoing any and all body art procedures during a pregnancy, even just an ear lobe stretch. It is best to let your body focus on the important, complex and demanding task that it is handling already.
We suggest that a three month waiting period be observed following delivery in order for the body to normalize and regain physiological and hormonal equilibrium before piercing. Further, we suggest that a longer period be observed prior to nipple piercing. It is advisable and prudent to wait three months following the cessation of breast milk production before piercing of the nipples.
With the exception of a 3-month post-partum delay we do not find it contraindicated to receive piercings (with the obvious exception of the nipples) during nursing. The body is not under the same type of demands as during pregnancy.
Further, we suggest that a longer period be observed prior to nipple piercing. It is advisable and prudent to wait three months following the cessation of breast milk production before piercing of the nipples.
Studies have shown that removing piercing jewelry is generally not necessary for magnetic resonance imaging (MRI), X-rays, and many other procedures, unless the piercing is directly in the area of examination or treatment.1 High-quality metal body jewelry is non-ferromagnetic (nonmagnetic), so it will not react to the MRI equipment. Beware, however, that cheap body jewelry may indeed be a dangerous problem when getting an MRI.
If you wear metal jewelry, it will be visible on the test results, of course, but this is only a problem when the ornament obscures the area of concern. Computed tomography (CAT or CT) scan images, however, do become blurred if metal is present, so all metal jewelry in the region of the examination does need to be removed for this type of analysis.
1. Scott DeBoer et al., “Body Piercing/Tattooing and Trauma Diagnostic Imaging: Medical Myths vs. Realities,” Journal of Trauma Nursing 14, no. 1 (January–March 2007): 35–38.
Reprinted with permission from The Piercing Bible--The Definitive Guide to Safe Body Piercing by Elayne Angel (Random House/Crossing Press, May 2009).
Click here to download a .pdf of an article written by a an orthopedic surgeon about Piercings and MRIs.
It is the position of the Association of Professional Piercers that only sterile disposable equipment is suitable for body piercing, and that only materials which are certified as safe for internal implant should be placed in inside a fresh or unhealed piercing. We consider unsafe any procedure that places vulnerable tissue in contact with either non-sterile equipment or jewelry that is not considered medically safe for long-term internal wear. Such procedures place the health of recipients at an unacceptable risk. For this reason, APP members may not use reusable ear piercing guns for any type of piercing procedure.
While piercing guns may seem to be a quick, easy and convenient way of creating holes, they have major drawbacks in terms of sterility, tissue damage and inappropriate jewelry design. These concerns are addressed below.
Although they can become contaminated with bloodborne pathogens dozens of times in one day, ear piercing guns are often not sanitized in a medically recognized way. Plastic ear piercing guns cannot be autoclave sterilized and may not be sufficiently cleaned between use on multiple clients. Even if the antiseptic wipes used were able to kill all pathogens on contact, simply wiping the external surfaces of the gun with isopropyl alcohol or other antiseptics does not kill pathogens within the working parts of the gun. Blood from one client can aerosolize, becoming airborne in microscopic particles, and contaminate the inside of the gun. The next client's tissue and jewelry may come into contact with these contaminated surfaces. There is thus a possibility of transmitting bloodborne disease-causing microorganisms through such ear piercing, as many medical studies report.
As is now well known, the Hepatitis virus can live for extended periods of time on inanimate surfaces, and could be harbored within a piercing gun for several weeks or more. Hepatitis and common staph infections, which could be found on such surfaces, constitute a serious public health threat if they are introduced into even one reusable piercing gun. Considering the dozens of clients whose initial piercings may have direct contact with a single gun in one day, this is a cause for serious concern. Babies, young children, and others with immature or compromised immune systems may be at higher risk for contracting such infection.
Additionally, it is not documented how often piercing guns malfunction. Some operators report that the earring adapter that holds the jewelry will often not release the earring, requiring its removal with pliers. These pliers, which contact contaminated jewelry immediately after it has passed through the client's tissue, may be reused on multiple customers without full sterilization. Few, if any, gun piercing establishments possess the expensive sterilization equipment (steam autoclave or chemclave) necessary for such a procedure.
Though slightly pointy in appearance, most ear piercing studs are quite dull. Piercings must therefore be accomplished by using excessive pressure over a larger surface area in order to force the metal shaft through the skin. The effect on the body is more like a crush injury than a piercing and causes similar tissue damage. Medically, this is referred to as "blunt force trauma." At the least, it can result in significant pain and swelling for the client, at the most in scarring and potentially increased incidence of auricular chondritis, a severe tissue disfigurement.
Occasionally the intense pressure and speed of the gun's spring-loaded mechanism is not sufficient to force the blunt jewelry through the flesh. In these cases, the earring stud may become lodged part way through the client's ear. The gun operator, who may not be trained to deal with this possibility, has two options. S/he can remove the jewelry and repierce the ear, risking contamination of the gun and surrounding environment by blood flow from the original wound. Alternately, the operator can attempt to manually force the stud through the client's flesh, causing excessive trauma to the client and risking a needlestick-type injury for the operator. How often such gun malfunction occurs has not been documented by manufacturers, but some gun operators report that it is frequent.
When used on structural tissue such as cartilage, more serious complications such as auricular chondritis, shattered cartilage and excessive scarring are common. Gun piercings can result in the separation of subcutaneous fascia from cartilage tissue, creating spaces in which fluids collect. This can lead to both temporary swelling and permanent lumps of tissue at or near the piercing site. These range from mildly annoying to grossly disfiguring, and some require surgery to correct. Incidence can be minimized by having the piercing performed with a sharp surgical needle, which slides smoothly through the tissue and causes less tissue separation. A trained piercer will also use a post-piercing pressure technique that minimizes hypertrophic scar formation.
Cartilage has less blood flow than lobe tissue and a correspondingly longer healing time. Therefore infections in this area are much more common and can be much more destructive. The use of non-sterile piercing equipment and insufficient aftercare has been associated with increased incidence of auricular chondritis, a severe and disfiguring infection in cartilage tissue. This can result in deformity and collapse of structural ear tissue, requiring antibiotic therapy and extensive reconstructive surgery to correct. Again, medical literature has documented many such cases and is available on request.
Ear piercing studs are too short for some earlobes and most cartilage. Initially, the pressure of the gun's mechanism is sufficient to force the pieces to lock over the tissue. However, once they are locked on, the compressed tissue cannot return to its normal state, is constricted and further irritated. At the least, the diminished air and blood circulation in the compressed tissue can lead to prolonged healing, minor complications and scarring. More disturbingly, the pressure of such tight jewelry can result in additional swelling and impaction. Both piercers and medical personnel have seen stud gun jewelry completely embedded in ear lobes and cartilage (as well as navels, nostrils and lips), even when pierced "properly" with a gun. This may require the jewelry to be cut out surgically, particularly in cases where one or both sides of the gun stud have disappeared completely beneath the surface of the skin. Such consequences are minimal when jewelry is custom fit to the client, allows sufficient room for swelling, and is installed with a needle piercing technique which creates less trauma and swelling.
Jewelry that fits too closely also increases the risk of infection because it does not allow for thorough cleaning. During normal healing, body fluids containing cellular discharge and other products of the healing process are excreted from the piercing. But with inappropriate jewelry, they can become trapped around the hole. The fluid coagulates, becoming sticky and trapping bacteria against the skin. Unless thoroughly and frequently removed, this becomes an invitation to secondary infection. The design of the "butterfly" clasp of most gun studs can exacerbate this problem. Again, these consequences can be avoided with implant-grade jewelry that is designed for ease of cleaning and long-term wear.
Most ear piercing studs are not made of materials certified by the FDA or ASTM as safe for long term implant in the human body. Even when coated in non-toxic gold plating, materials from underlying alloys can leach into human tissue through corrosion, scratches and surface defects, causing cytotoxicity and allergic reaction. Since manufacturing a durable corrosion- and defect-free coating for such studs is extremely difficult, medical literature considers only implant grade (ASTM F138) steel and titanium (ASTM F67 and F136) to be appropriate for piercing stud composition. Studs made of any other materials, including non-implant grade steel (steel not batch certified as ASTM F138), should not be used, regardless of the presence of surface plating.
Even though many manufacturers' instructions and local regulations prohibit it, some gun piercers do not stop at piercing only the lobes, and may pierce ear cartilage, nostrils, navels, eyebrows, tongues and other body parts with the ear stud guns. This is absolutely inappropriate and very dangerous.
Although gun piercing establishments usually train their operators, this training is not standardized and may amount to merely viewing a video, reading an instruction booklet, and/or practicing on cosmetic sponges or other employees. Allegations have been made that some establishments do not inform their employees of the serious risks involved in both performing and receiving gun piercings, and do not instruct staff on how to deal with situations such as client medical complications or gun malfunction. Indeed, surveys conducted in jewelry stores, beauty parlors and mall kiosks in England and the US revealed that many employees had little knowledge of risks or risk management related to their procedure.
Considering that a large proportion of gun piercers' clientele are minors or young adults, it is not surprising that few gun piercing complications are reported to medical personnel. Many clients may have been pierced without the knowledge or consent of parents or guardians who provide healthcare access. Therefore, the majority of the infections, scarring and minor complications may go unreported and untreated. Furthermore, because of the ease of acquiring a gun piercing and the lack of awareness of risk, many consumers fail to associate their negative experiences with the stud gun itself. They believe that, since it is quicker and easier to acquire a gun piercing than a manicure, gun piercing must be inherently risk-free. Often it is only when complications prove so severe as to require immediate medical attention that the connection is made and gun stud complications get reported to medical personnel.
Despite these pronounced risks associated with gun piercing, most areas allow gun piercers to operate without supervision. Recent legislation has begun to prohibit the use of guns on ear cartilage and other non-lobe locations, and the state of New Hampshire has made all non-sterile equipment illegal, but these changes are not yet nationwide. It is our hope that, with accurate and adequate information, consumers and the legislatures will understand and reject the risks of gun piercing in the interests of the public health.
As an association of dedicated, educated, highly experienced piercing professionals we are adamant that piercing kits for sale to the general public represent a serious potential health hazard. Much piercer education and training is necessary in order to perform a safe, sterile, accurate piercing. Simply providing such tools to an inexperienced consumer is a dangerous act of negligence.
The use of these piercing kits by untrained consumers results in significantly greater potential for the transmission of bloodborne pathogens and diseases than do piercings performed by skilled professionals.
An area of particular concern is that of underage individuals performing body piercings on themselves and their friends using readily available piercing kits sold through mail order, on the Internet, or by calling a toll free telephone number. Young people are particularly at risk because, without parental consent, minors are denied professional piercing services in virtually all states where legislation has passed. However, they can still obtain the kits and get pierced without their parents' consent or knowledge. Should an infection or other complication occur, no responsible adult will be on hand to oversee the situation or provide access to appropriate medical care.
Also of great concern is the possibly deadly potential for the contaminated needle to be reused on multiple people. Further, there are dangers of accidental needle sticks to others, since limited or no instructions are included for appropriate disposal of the used needle.
Through legislation, many states allow body piercing that is performed only by a trained, licensed professional in an environment that provides hospital sterilization and submits itself to health department inspections. Most states (43) currently have legislation regarding personal criteria for the piercer, requirements for the piercing establishment, and highly specific laws necessitating parental consent for the piercing of minors. The laws and guidelines, along with the efforts of the professional body piercing community provide those interested in receiving a body piercing with a safe, clean environment to do so, and with a piercing technician who has appropriate training and sufficient experience to be hygienic and proficient.
The nature of the piercing kits do not allow for any of these safety measures to take place. The kits can be purchased by anyone, which is the most relevant aspect of the eminent danger of piercing kits. Piercing kits are not purchased by licensed, experienced professional piercers, who already have access to such items and equipment through legitimate industry sources. Instead, they are purchased by those who either do not have access to an experienced piercer, or who do not have sufficient understanding of the issue to appreciate that sterility, skill and education are an integral part of the piercing procedure.
As professional piercers we want to keep the art of body piercing safe for all who give and receive piercings. We take our field seriously and understand that the risks can be substantially minimized with proper training, equipment, and sterilization. Over-the-counter piercing kits undermine all the work we and our legislators have done to protect the public health while allowing our art form to flourish.
Just say NO to piercing kits and those who sell them or use them
Genital piercings are often assumed to be the most painful and easily infected of body piercings. Both the piercers who perform them and the clients who request them are sometimes reported to operate in questionable hygienic and ethical territory. However, these perceptions need not be reality. Due to the elastic and resilient nature of much of the genital tissue, as well as the protection from contamination offered by clothing, genital piercings often heal more quickly and with fewer complications than do other piercings. Furthermore, the act of piercing the genitals is for many clients a conscious act of reclaiming and redefining their bodies as a source of pleasure rather than of misplaced shame. Because genital piercings represent an integral facet of sexual freedom, it is important that they be available to adults who seek them. However, it is equally important that they be provided by an experienced, reputable professional in a clean, safe environment.
In the interest of public safety, the Association of Professional Piercers would like to clarify the facts about genital piercing and its risks. Our comments are based upon twenty years of professional experience, research and extensive clinical practice by several hundred exemplary piercers. While we are not ourselves doctors, we do work in conjunction with medical practitioners and researchers. We trust that our comments will be taken in the spirit intended, as an effort to round out the existing dialogue. With full and appropriate information, it is our hope that consumers will be better able to make educated choices about their bodies and the ways in which they choose to celebrate them. It is also our hope that those who seek to protect and regulate the health of the public do so circumspectly, without unduly limiting or denigrating free bodily expression in its many forms.
Some criticism of genital piercings focuses on the perceived risk of piercing nerve-laden genital tissue. There is also concern that genital tissue may be more susceptible to infection than are piercings of other body parts. Furthermore, it is possible that sexual contact can increase the threat of complications. When performed by a conscientious professional piercer using proper aseptic technique, the risks of complications from the piercing itself are minimal. When these conditions are paired with appropriate and thorough aftercare on the part of an educated client, negative consequences are extremely rare.
As with all piercings, genital piercings should only be performed on consenting, sober adults by a skilled and licensed (where applicable) practitioner. All piercing studios should be designed to provide a sanitary, controlled environment that conforms to appropriate local and state regulations, as well as to OSHA Bloodborne Pathogens standards. All tools, needles and jewelry must be sterile, and all needles must also be single-use. The practitioner must have specific knowledge of both aseptic technique and of the procedure at hand. He or she must also make every reasonable effort to maintain the physical and psychological comfort and safety of the client.
It is unquestionably true that some genital tissue contains much higher concentrations of nerve tissue than many other areas of the body. However, it is also true that this same tissue is physiologically designed to take increased abuse from friction, pressure and manipulation. Due to the rigors of childbirth, women's genital tissue is by necessity well equipped to stretch, give and quickly repair itself, often with little pain or consequence. Both women and men describe the pain of the most common genital piercings as being similar in intensity to other body parts, and sometimes less so. The more advanced genital piercings (such as clitoris and ampallang) may be more intense, but these are usually performed only by the most experienced piercers who have greater technical and anatomical expertise. However, they tend to also be requested by, and are often limited to, clients who have already received and healed other piercings. Since anesthetics are not used in accepted practice, the continued existence of these piercings should attest to the manageability of the pain.
As to the risks of excessive bleeding or neurological damage from common genital piercings, these risks are minimized when piercings are performed by a skilled and educated piercer using accepted techniques. Piercing-specific anatomical knowledge coupled with inspection of the area should allow a qualified piercer to perform the common piercings without incident. Specialized tools and procedures have also been developed by industry professionals in order to most successfully and safely manage the piercing procedure. When properly employed, these further reduce the risk of unanticipated consequence.
The physiologic function of genital tissue requires that it be extremely elastic and vascular and therefore quick to heal. With few exceptions, genital piercings will heal within a month or two, while tougher tissue such as ear cartilage, navels and nostrils may take six months or longer. Because healing time is often so short, this implies a very small window of opportunity for infection to set in. Furthermore, genital tissue is not subject to frequent exposure and casual contact with the external environment and dirty hands the way other body parts may be. (Certainly an office worker lost in thought would not be toying idly with a labia ring as she might be with an earring or nostril ring.) Clothing further protects the piercing from airborne contaminants, which can be a cause of infection and irritation for facial piercings.
The predominant cause of contamination and infection for genital piercings is most likely unprotected sexual contact. Even in the case of monogamous partners, body fluids, unwashed hands and oral bacteria can easily lead to infection if introduced in a wound. Fortunately, this exposure is 100% preventable. In addition to explaining appropriate cleaning protocol, a responsible piercer will emphasize to the client that during healing, all sexual and oral contact must be made fluid safe, either through abstinence or the use of barriers such as condoms and dental dams. Furthermore, undue stress, abuse or manipulation of the piercing site and/or jewelry should be avoided during healing. Of course it is the responsibility of the client to follow through with these instructions after leaving the piercing studio. Providing the client with thorough written instructions and an invitation for follow-up care can greatly improve compliance and healing success.
In this discussion, it bears mentioning that the average genital piercing customer is a more informed consumer than the usual navel, ear or tongue piercing client. While often no more complicated from a piercer's standpoint, genital piercings are a more advanced step in the mind of the piercee. Therefore those who elect to get them have usually already received and healed at least one other piercing, and are often more informed about the piercing process and aftercare. They are more likely to do advance research than are navel or facial piercing customers, and may be more likely to follow up with the piercer should questions or concerns arise. While of course genital piercings should never be done on anyone under eighteen (even with parental consent), these piercees are generally not eighteen-year-olds who are hiding the piercing and any consequences from their parents. In fact, these piercings are just as often being done on parents and other middle-aged adults, who are looking for new ways to appreciate their bodies and their relationships.
In short, genital piercings can be done safely and healed easily, provided the clients follow through with appropriate aftercare and abstain from unsafe contact. Since these clients are often the most educated and conscientious of the piercing clientele, compliance with suggested care is more likely than it is with other piercings.
While the idea of genital piercings stirs up fears of sexual taboos and contagious diseases for some (particularly for those physicians who see only worst case scenarios), the reality is truly quite different. Genital piercings today are being performed on a wide variety of people of all ages, sexualities and professional backgrounds. When performed under hygienic conditions by ethical and educated piercers on clients who follow suggested aftercare procedures, they represent a safe and creative way to assert bodily ownership and redefine the acceptability of pleasure. It is the challenge of professional piercers and those who regulate them to assure that these piercings remain both safe and available to those who choose them.
The Association of Professional Piercers is an international non-profit organization dedicated to the dissemination of vital health and safety information about body piercing to piercers, health care professionals, legislators, and the general public. Socially and legislatively, body piercing is situated within the greater body modification community. As a result, we recognize that our role extends beyond the discipline of body piercing. Our position on body art practices such as tattooing, cosmetic tattooing, branding, scarification, suspension, and other forms of body modification is as follows:
We support the right for all adults to adorn or modify their bodies in a safe, informed, and consensual manner when performed by a qualified practitioner under appropriate asepsis.While the APP does not directly regulate, perform outreach, or offer procedural guidelines on practices other than body piercing, we support health and safety organizations that do. Our most fundamental principles as expressed in our environmental criteria and ethical standards extend to the greater body modification community and its practices.
Infection is one of the most frightening and potentially serious dangers associated with body piercing. Two distinct phases are of concern: If you get pierced in unsanitary conditions, or with unsterile implements or jewelry, an infection can be transmitted during the piercing. Or, if you fail to care for the wound properly throughout its healing period, you can get an infection after the piercing is done. Studies show that the risk of infection increases when either the piercer’s technique or the aftercare is poor.
The incidence of infection is difficult to calculate because there is no reliable information about how many piercings are actually being performed. Some smaller studies done on college campuses usually reveal more about the quality of nearby piercers than they do about the rate of infection for body piercing in general.
Our world is full of microorganisms (germs, including bacteria, fungi, and viruses). Many of these are harmless—or even beneficial—to us, but some are pathogenic (capable of causing infection or disease). We are all routinely exposed to countless germs, but many complex factors impact how they affect us, including the potency and amount of an organism entering the body, and how it gets in, as well as the strength of the immune system.
The viruses hepatitis B and C and HIV are examples of bloodborne pathogens (micro- organisms that can cause disease when present in the blood). They are of particular concern because if the needles or jewelry are not sterile, there is potential for these serious bloodborne diseases to be transmitted during piercing.
HIV, the virus that causes AIDS, is quite fragile and dies quickly when exposed to air; there have been no documented cases of HIV transmission through piercing. The hepatitis virus, however, is easier to transmit because it is quite hardy. Studies show that hepatitis B can live on a dry surface for at least seven days! Even though the virus is robust, improperly performed body art accounts for a very small proportion of hepatitis transmissions.
Bacterial infections can range from minor skin eruptions to deadly infections of the brain or lining of the heart. Never ignore a suspected infection: left untreated, certain kinds that start out as trivial can become lethal. Local bacterial infection (at the site of the piercing) is the most common sort, and deeper, larger, or systemic infections in healthy piercees are fairly rare.
The medical field has developed specific infection-control practices, called Standard Precautions (formerly Universal Precautions), for dealing with blood or other potentially infectious body fluids and any equipment that could be contaminated with them. Safe piercers are educated about these procedures and adhere to them meticulously.
Certain medical conditions make piercings riskier, and in some cases inadvisable. Health problems that weaken your infection-fighting defenses, including diabetes, lupus, HIV/AIDS, and other immune system disorders, can make you slow to heal. You might be more vulnerable to infection, and if you do contract one, it could be more severe and harder to cure.
Some heart disorders make you susceptible to infective endocarditis (a potentially deadly infection of the lining of the heart or heart valves, previously referred to as bacterial endocarditis). If you have a history of this illness or serious cardiac problems like a valve replacement, an ethical piercer will require proof that you have consulted with your doctor before proceeding. If you ordinarily must take antibiotic prophylaxis (preventive treatment) before dental procedures, your physician may recommend this before piercing. Cardiac ailments are one of the few preexisting conditions that can increase the risk of a fatal outcome: if you are advised against piercing due to your health, heed your doctor’s word!
Rashes such as eczema or psoriasis, scars such as keloids, and other skin abnormalities are less serious health issues. If you are considering a piercing in an area affected by one of these conditions, seek an evaluation by an experienced piercer and a piercing-friendly doctor.
Some states have regulations that require piercers to ask clients specific health-history questions on the release form before piercing, whereas other states have laws that prohibit piercers from asking certain health questions. Be honest about your medical history and respect a piercer who has the principles to decline to pierce you if the risk is unacceptable.
All sorts of bumps, lumps, and skin irritations can crop up around a piercing, coming and going as healing progresses and occasionally remaining permanently. Some of these are caused by mechanical stress against the piercing; others are caused by a cleaning product or jewelry material. Skin disorders can be difficult to diagnose, even for dermatologists, so experimentation is needed at times to identify and correct a problem. Conditions can also have a combination of causes, which further complicates diagnosis and treatment.
A nickel allergy can be triggered by jewelry made of inferior metal. This type of allergy can be serious and irreversible, which is one reason it is critical to wear only high-quality, inert jewelry (see brochure “Jewelry for Initial Piercings,”).
Two rather distinctive piercing complications are migration (the piercing moves from its initial placement, then settles and heals in a new location) and rejection (the jewelry is expelled completely from the body). The piercing is likely to migrate when unsuitable or insufficient tissue is pierced, or if your jewelry is too small in diameter, thin in gauge, or of poor quality. Inexperienced and untrained piercers often make these errors.
Migration and rejection can also result from using a harsh aftercare product, following poor health habits, or experiencing excessive physical trauma or emotional stress during the healing period. And, unfortunately, sometimes even when everything is done properly, a piercing will migrate or reject for no known reason. This is simply a risk of placing a foreign object through your skin: it may not stay in the desired position.
A piercing has the potential to be a temporary adornment (especially when compared to a tattoo), because the jewelry can easily be removed. There is a risk, however, of irreversible changes to the body, including discoloration, a mark such as a scar, bump, or dimple, or a permanent hole.
Many piercings shrink or close quickly, but some piercings will remain open indefinitely without jewelry in them. The placement of the hole, the length of time you have worn the piercing, the thickness of the jewelry that was in it, and your individual tissue all impact whether or not your piercing stays viable after removing the jewelry.
Piercings that are stretched to large dimensions commonly leave significant voids that may be considered disfiguring; to correct them, plastic surgery is required. Stretching a piercing too quickly or attempting to expand unsuitably thin tissue leads to problems. One potential consequence of overzealous stretching is a blowout (part of the interior channel is pushed out, leaving an unsightly lip of flesh on one side of the piercing). This distortion will usually be a lasting reminder of your hasty actions unless it is surgically removed. Piercings that are stretched improperly can also suffer from thinning tissue that does not regrow. A worst-case scenario is tissue necrosis (death) and the loss of the piercing and some of the skin in the area. Jewelry that exerts excessive pressure against underlying bone can cause bone necrosis.
There are piercings that have a tendency to effect changes such as the hardening or thickening of the tissue surrounding the openings, and this can be irreversible. For example, nipple piercings are known for causing permanent enlargement, especially in underdeveloped (small) anatomy.
Scarring and tissue discoloration at the piercing site are relatively normal occurrences, especially if you have a history of darkened scars. This can happen even when a piercing is performed properly and heals uneventfully. Migration often leaves a small track of scarring or discoloration from where the piercing was initially placed. Rejection usually results in a split scar. Piercings of the ear cartilage are prone to disfigurement if a serious infection develops. The cartilage can collapse, causing a “cauliflower ear” appearance.
Excessive scarring sometimes occurs in reaction to piercing, and it can be very difficult to resolve. If you have a history of problems with scarring or keloids (large growths of fibrous tissue), piercing is generally inadvisable.
Accidents happen, and there is a risk of catching jewelry and tearing a piercing. An act as simple as taking off your shirt can be dangerous for a piercing on the torso, face, or ear. Strenuous workouts, airbags, pets, children—even sexual activities—can cause ripping or splitting. Obviously, healing piercings are more delicate and vulnerable to injury, but older piercings are still susceptible.
You must be aware of your jewelry and your movements, take steps to protect your piercing, and avoid activities that could lead to such accidents. If you engage in sports or other behaviors that pose a risk to your piercings, wear protective gear.
Jewelry that is too thin can carve through the flesh like a wire slicing a wedge of cheddar: hence, I coined the term cheese-cutter effect to describe this unpleasant (and largely preventable) occurrence. Wearing charms or heavy weights on thin-gauge wires makes trouble likely.
Somewhat less predictable incidents can take place when jewelry in oral or nasal piercings is swallowed or, more seriously, inhaled. The best way to prevent this is by wearing quality jewelry of the proper fit and checking the closure (bead or ball) daily to ensure that it is tightly affixed.
The urge to decorate the body and control one’s appearance is a universal human trait. Each of us uses clothing, hairstyle, and so on to express our individuality and to make the most of the gifts or curses—perceived or real—bestowed by nature. Nowadays we have more choices than ever to manipulate our looks. The options range from minor adjustments such as hair dye and teeth whitener to more extreme but still socially acceptable practices such as liposuction and breast implants. Although body modification is still less conventional than, say, getting a nose job, it has become prevalent in today’s world.
Piercing and other types of body modification are methods of changing the actual physical form, which is empowering in a way that may not be fully understood by those who have never participated in it. Women, in particular, are bombarded by the media’s unrealistic notions of beauty, which deeply affect self-esteem and body image. They may turn to piercing or other forms of body art to help them embrace a positive attitude about themselves. While there is no unanimous consensus about whether body jewelry enhances appearance, aesthetics is a widespread motivating factor for piercing.
A casual observer sitting at a sidewalk café in any college town in the United States or Europe might conclude that every college student in the world has a few extra holes in the head. However, piercing is not exclusively a youth phenomenon nor is it always a statement of rebellion. No one should assume that their doctor or banker doesn’t sport a little metal secret. I have pierced people from all professions and socioeconomic backgrounds—rocket scientists, clergy, and retired grandparents among them.
What motivates these diverse people to face their deep-seated fear of needles and pain, withstand discomfort, brave embarrassment, and endure the scorn of strangers, families, or employers and willfully undergo the needle? For piercees, the impetus to do such a thing must be very strong indeed. From the superficial to the profound, there are a multitude of reasons for getting pierced. It might be about attracting attention, the sensation of metal through flesh, or the opportunity to wear some extra “bling.” For others, piercing is a response to deep internal triggers.
There is often a marked difference in age between those who are visibly pierced above the neck and those more discreetly pierced in intimate locations below the neck. Younger people are frequently motivated by a desire to fit in with their peers or the need to establish their independence from their parents. Visible piercings offer a perfect vehicle for fulfilling these desires. Young piercees tend to be more heavily influenced by popular music, media, and fashion, and they are frequently limited in their piercing options by regulations for those under the age of majority.
Older people are obviously not subject to these prohibitions nor are they typically motivated by the same impulses. Many adults endure trauma or other life experiences that lead them to turn to body modification for self-realization and healing purposes. For working adults whose employers frown on visible piercings, torso and genital piercings are popular because they are concealed under everyday clothing.
Piercing and body modification can be used to indicate and solidify one’s cultural identity. There is a sense among many of my pierced and tattooed contemporaries that we belong to an intrinsically interconnected group. One popular piercing web- site calls itself “Tribalectic,” suggesting that its members feel connected to others as part of a contemporary tribe. Many Western piercees describe themselves as “Modern Primitives” and proudly wear ethnic and tribal jewelry made of horn, wood, and stone. Conversely, some tribal people make use of modern materials. The herdsmen of northern Kenya, for example, sometimes use the metals found in telephone wires to make lip and ear ornaments.Today, many young people use piercings to visibly align themselves with rave, goth, skater, and other subcultures. It may seem contradictory, but piercing is sometimes a statement of rebellion and conformity at the same time.
Piercing can be used as a way to restore physical and spiritual health after a trauma or to exercise some control while struggling with chronic illness or feelings of vulnerability. Many people get pierced with the intention of exchanging bad for good. This type of symbolic healing is used today when women reclaim their bodies by getting a genital piercing after childbearing or sexual assault. Through the conscious act of breaking skin and shedding blood, these people feel whole, connected with their bodies, and in control of their lives again.
Many adults are motivated to be pierced for sexual gratification. The presence of piercings and jewelry in certain locations results in increased physical stimulation for piercees or their partners. Couples sometimes use piercings to revitalize their sensual focus and reignite the flames in relationships that have lost some of their spark. Intimate piercings can bolster confidence in the bedroom and in oneself as a sexual being.Many people do not find their private parts attractive or appealing. A large proportion of men from Western nations have had their genitals altered through nonconsensual circumcision during infancy. When an individual makes a choice about the appearance of his or her own genitals by piercing and adorning them with jewelry, it can be highly liberating, and for many it inspires a harmony with their bodies that could not be achieved through any other means.
By getting pierced, people make bold statements about personal freedom and combat the impersonality and pressures of modern life. Piercing the body can be an effective way to exert control over one’s existence. Even if their modifications are not visible to the public, people working in conservative environments often use piercings to remind themselves that they are individuals despite the conventionality of their out- ward appearance. One man living in the Midwest told me,
“I was about fifty when I got my first. I live in a place where ignorance and poverty are a career choice. Almost everyone is religious, conservative, and tends to believe that everyone else shares that viewpoint. Bigotry is rampant. I needed to make a statement that said, in effect, I might be one of you, but I’m not one with you. Piercing was, and is, that statement.”Text courtesy of Elayne Angel, Author The Piercing Bible—The Definitive Guide to Safe Body Piercing
This varies by geographic location and over time. Years ago (in the 1980s when I first started piercing) the nipple was most popular, later it was navel and tongue. These days nostril piercings are incredibly popular and microdermals/surface anchors are very popular.
It depends on the type of piercing--for nipples, it may be about 50/50, But more women get navel and nostril piercings. Perhaps more men get eyebrow piercings, and so on.
Nearly 50 percent of Americans ages 21-32 have at least one tattoo or piercing in a body part other than the ear, according to a 2006 survey by researchers at the University of Chicago and Northwestern University. Among people 18-50, 24 percent had a tattoo and 14 percent a body piercing.
Nearly one in four 18- to 29-year-olds has a piercing somewhere other than an earlobe and four in 10 sport a tattoo, according to a 2010 Pew Research Center report.