Piercings

Body piercing is popular among both men and women. While it is often associated with young people, body piercing has been practiced for thousands of years in different parts of the world. In recent years it has become a popular alternative to more permanent forms of body modification such as tattoos.

Most people are familiar with ear lobe piercing. Other body parts that can be pierced include the upper ears, nose, lips, cheeks, nipples, navel, tongue, eyebrow and genitals. Rings, studs, dumbbells and bars are some of the types of jewelry that can be used.

Poor practices during a piercing procedure can lead to infection and other harm, including nerve damage. Always choose an experienced piercer whose premises are registered with the relevant local authority. Piercing yourself, or getting a friend to do it, is extremely dangerous and is not recommended.

Things to consider before having a piercing#

If you are considering a body piercing, think about the following:

• Piercing may be fashionable now, but trends change. How will you feel about it a few years from now?
• Piercing is painful, and the site is usually sore for some time afterwards.
• How will your family and friends feel about it, and could it affect your relationships?
• Does your school have a policy on body piercing? You may be required to cover or remove facial or tongue piercings during school hours.
• A visible piercing may be an issue in some workplaces and could affect your employment opportunities. In some industries, an exposed piercing may be a health and safety concern.

It can help to ask friends with piercings about their experience and to notice how other people manage theirs.

Laws and age limits#

Laws relating to body piercing differ from place to place. In many areas it is illegal to perform intimate piercings, such as of the genitalia, anal region, perineum or nipples, on minors, regardless of whether consent is given. Minimum ages and parental-consent requirements also vary by location.

Some piercers set their own age restrictions and may ask for parental consent below a certain age, even when local law does not require it. Check the rules that apply where you live before going ahead.

Choosing a piercing provider#

Choose an experienced provider whose business is registered with the relevant local authority. Do not be afraid to ask questions about the piercer’s experience and procedures. If they will not answer your questions, or you are not satisfied or comfortable, do not feel pressured – take your business elsewhere.

To comply with health and hygiene standards, a good piercing premises should:

• be kept clean and hygienic
• use sterile instruments, needles and jewelry
• have an operator with no exposed cuts or wounds and clean clothing
• provide accurate health information before any procedure
• have benches, floors, shelving and furniture that are easy to keep clean
• cover items that may be touched (such as spray and ink bottles) with single-use plastic bags so that only the nozzles are exposed
• have a hand washbasin, good ventilation and lighting, and a separate area for cleaning, disinfecting and sterilizing instruments.

When piercing your body, the operator should wash their hands at the start and end of the procedure, and whenever they take a break (for example, to answer the phone). They should give you information on how to care for your piercing beforehand, and be able to explain how the equipment is sterilized – ideally with a steriliser on the premises, or evidence that equipment is sterilized offsite.

Sterilization and avoiding cross-contamination#

To make sure equipment is correctly sterilized and to avoid infection:

• All jewelry, needles and instruments must be thoroughly cleaned and sterilized before use.
• Reusable instruments should only be used if the premises has its own steriliser or a system for off-site sterilization. Once sterilized, they must be replaced if accidentally touched or contaminated.
• Sterility must be maintained at all times. It is preferable for operators to use pre-sterilized, single-use needles and instruments, which must be disposed of into a sharps container kept out of reach of children.

Gloves must not be reused. If the operator is interrupted during the procedure, they must remove their gloves and wash their hands, then rewash and put on new gloves before continuing. The skin to be pierced must be clean and free from infection. Instruments can become contaminated with blood and must be properly cleaned and sterilized between clients.

Preventing allergic reactions#

Jewelry made of surgical steel, gold (18 carat and above for initial piercings) and titanium are the best metals, as they can be easily sterilized. Jewelry containing gemstones is generally not suitable for an initial piercing unless it is high quality with a solid backing, as it may not withstand sterilization. Lower-carat gold or gemstone jewelry can be inserted once the piercing has healed.

If you are prone to allergic reactions or have eczema or dermatitis, ask for jewelry that does not contain nickel.

Caring for your piercing#

How long a piercing takes to heal depends on its location, the technique used, the jewelry, how you care for it and your body’s own healing ability. Healing time can vary from around two weeks to six or nine months. Your operator should give you detailed aftercare information. Follow their advice to avoid complications, and if you have any problems, seek advice from your operator or primary care doctor.

Suggestions for caring for a body piercing include:

• Keep the piercing as dry as possible, and avoid touching or turning the jewelry unnecessarily. Always wash your hands before and after touching it.
• Do not share jewelry with friends.
• Do not remove the jewelry before the wound has fully healed, and do not remove the scab, as it protects the piercing from infection.
• Use liquid soap on the site when showering or bathing, and dry the piercing with a tissue or cotton bud rather than a towel or face washer.
• Do not use alcohol-based cleaning solutions, tea tree oil, hydrogen peroxide, skin cleansers, antiseptic solutions or creams, as these can dry the skin and prolong healing.
• Avoid swimming until the piercing has healed, as water can pose a risk of infection.
• Cover the piercing with a sticking plaster when exercising or sleeping if needed, to keep the jewelry in place.

Oral piercings can take up to two months to heal. Because the mouth contains millions of bacteria, take particular care during this time by brushing your teeth twice a day and rinsing frequently with warm salty water (1/4 teaspoon of salt in one cup of water). Avoiding smoking also helps healing.

Complications#

Unhealed piercings are a potential route for infection, including blood-borne viruses. Infection and other complications can occur during the procedure or if the piercing is not cared for properly. General complications may include:

• increased pain, redness, swelling, irritation or itchiness around the site
• thick infected discharge that may be yellow, green or gray and have an unusual odor
• problems with healing or scarring
• excessive bleeding, which needs prompt medical attention
• an abscess (a collection of pus) beneath the skin
• rejection or migration, where the body treats the jewelry as a foreign object and it moves from its original position (more likely if the piercing is poorly positioned or the jewelry is unsuitable in material or gauge)
• serious infections, including blood-borne viruses, and septicemia if infection is not treated early.

An infected piercing can be treated with antibiotics. See your doctor immediately if complications develop, and do not remove the jewelry until you have sought advice. Consult your doctor and notify the operator if you have any other concerns about the procedure.

Complications of oral piercing#

• Infection – piercing the mouth creates a wound at risk of infection from the bacteria normally found there.
• Prolonged bleeding or nerve damage – if a blood vessel is punctured, bleeding can be hard to control, and damaged nerves can cause numbness or ongoing pain (neuralgia).
• Pain and swelling – common side effects; in some cases tongue swelling can be severe enough to block the airway and make breathing difficult.
• Blood-borne diseases – oral piercings are a potential risk factor for herpes simplex virus and hepatitis B, C and HIV.
• Septicemia – oral bacteria may enter the bloodstream through the wound and travel to the heart. In susceptible people this could inflame the heart or its valves.
• Gum disease – people with oral piercings have a greater risk of gum disease, as the jewelry can injure gum tissue and cause it to recede, leaving the tooth root more vulnerable to decay.
• Damage to teeth – teeth that contact the jewelry can chip or crack, and fillings or crowns can be damaged.
• Difficulties with normal oral function – tongue piercing can make chewing, swallowing and speaking harder, increase saliva production, and alter taste.
• Jewelry aspiration – loose jewelry is a choking hazard and, if swallowed or inhaled, can cause internal injuries and breathing difficulty.

Complications at other sites#

• Nipple piercing – an infected nipple can make breastfeeding difficult, and infection can travel through the milk ducts.
• Navel piercing – infection through torn skin.
• Genital piercing – condom damage can lead to pregnancy or infection, as the piercing can be an entry point for infection.

Who should avoid body piercing#

Some people have a higher risk of infection or complications and should take extra care or avoid piercing, including those with:

• breast implants, in the case of nipple piercing, particularly implants in front of the chest muscle
• certain disorders, including heart valve disease, rheumatic fever and skin infections
• a higher risk of blood-borne viruses or allergic reactions
• medications that affect bleeding or immunity, such as anticoagulants, immunosuppressants and some corticosteroids
• chemotherapy, which reduces immunity and increases susceptibility to infection.

Key points#

• Sterility must be maintained at all times.
• The operator should comply with health and hygiene standards at all times to avoid spreading infection.
• Avoid swimming until the piercing has healed, as water can pose a risk of infection.
• Oral bacteria can enter the bloodstream through a piercing wound and reach the heart, so oral piercings carry a risk of septicemia.
• People with oral piercings have a greater risk of gum disease than those without.

Where to get help#