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The Fierce Pierce

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April 2005
The Fierce Pierce

The perils of body piercing

An era of new fashions and the cultures of recent immigrants have popularized the piercing of body parts. Even our baby boomers have fallen for the idea, but a word of caution is offered here.

Some 50 percent of college students have had at least one body piercing experience and at least 10 percent reported to have received no aftercare instructions. In one survey of students at a university in New York, 42 percent of male students and 60 percent of female students had body piercing (excluding ear lobe piercing in females) and about 17 percent reported having experienced some form of medical complication.

Despite the potential of this practice to transmit blood borne diseases, regulations are emerging only very slowly. Since 1995, when almost no such regulations were in place, 38 states have instituted or updated legislation; but no consistent standards exist. Often, requirements are restricted to proof of identification and age and/or written parental permission for minors. Infection control training has been recommended for professionals who do piercing. One team even recommends that blood samples be drawn before body art implantation and then again after three and six months. Body art is defined as an insertion of a needle into various parts of the body to create an opening so that decorative ornaments such as jewelry can be worn. Research shows that this practice is done more for purposes of identity and self-expression than rebellion or deviancy.

The most common locations are earlobes, high-ear cartilage, eyebrow, nose, lip, tongue, nipple, navel and the genitals. More creative sites have emerged including the bridge of the nose, side of the neck, cheek, the back of the throat, and the webs of fingers.

Problems related to piercing are common and can range from local skin infection to systemic spread, which in rare situations even require hospitalization. Other infections are hepatitis B and C. Repotting of infections in the heart require extensive hospitalization and surgery of the heart valves. Brain abscesses and serious life support measures have been seen in infected tongue piercing.

Sensitivity to metal or other alloys in the makeup of the jewelry may cause minor local irritation, which will disappear with the removal of the metal ornament. An individually packaged and autoclaved needle is preferred over plastic guns that cannot be sterilized. For first time piercing, the preferred ornaments have surgical implant grade stainless steel or titanium, 14k or 18k gold, platinum and niobium. Other materials include dense and low porosity plastic, wood, bone and glass. High contents of nickel and brass can trigger allergic reactions that may require removal of the objects.

Jewelry of the wrong length or size can create problems. Very fine wires may cut through the skin. A stud of inadequate length or weight can cause enough tension and lead to swelling and compromise circulation. Tongue piercing may damage the teeth besides compromising speech to some degree. Dangling jewelry for first time piercing is not recommended because it can tangle into items and cause bleeding and injury.

A couple of days after piercing it is normal to see watery drainage, which will become thick for a week or so afterwards. Two weeks later the area will be red and by the end of the third week healing should be complete and there should be no pain. The higher ear cartilage is generally faster to heal because of lack of circulation in that region. Reports of ingestion of tongue jewelry have been reported! Severe damage to teeth and gums has been reported when these are wormed for more than five years.

Mild to moderate infections may be treated with local care using peroxide and water, local antibiotic ointments and creams. More severe infections may be treated with oral antibiotics. Sometimes the physician may advice the temporary or permanent removal of the objects. Patients with artificial heart valves and joint replacements are advised against body piercing, or this should be done in a physician's office under sterile conditions and be given prior antibiotic precautions, as done for dental procedures.

After a usual body piercing the area should be washed with soapy water or iodine and the jewelry should be rotated twice a day. Water-soluble gels and creams are ideal for freshly pierced areas. Generally, peroxide for fresh piercing will cause drying of the wound and is not recommended. Tight fitting clothing around the pierced area, especially the naval and the nipples, is to be avoided. Nose piercing is vulnerable to infections because of the already un-sterile area, and swimming in pools and bathing in Jacuzzis should be avoided till the area is healed.

The more serious infections are hepatitis C and B and your physician should be consulted for more information on that. Cases are discovered several months after the actual piercing and these are of a more serious concern to the medical community.


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