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Ask Dr. Sue
BODY PIERCING
Dr. Sue,
My teenage daughter has wanted to get
a belly button ring for a long time now. Several
of her friends have them. I'm thinking of giving
in, since it seems like she could be trying things that
were a lot worse. Are there any actual dangers of
piercing different parts of the body, as long as she
uses good hygiene?
Dear Mom,
There are a number of possible health risks related to
body piercing. I'll describe some of these, and
then discuss some ways to minimize your daughter's risk
if she has it done anyway!
The most common sites that are pierced are the ear,
nose, nipple, navel, tongue, lip and eyebrow.
Many of the possible complications vary depending on the
site pierced, while some apply to all. The most
worrisome risk is the possibility of exposure to
Hepatitis B. This virus can be transmitted in a
TINY amount of blood, and is not killed quickly by
contact with the air. The threat of Hepatitis B is
great enough that your daughter won't be allowed to
donate blood for a year after having the procedure done.
I would insist that your daughter be fully immunized
against Hepatitis B before even considering piercing.
HIV can also be transmitted, though it is less likely
since it is a less hardy virus.
Any of the sites can become infected after the
procedure. Local infection can range from a
temporary minor red area to a full-blown abscess, and
can even lead to bacterial infection
in the bloodstream, or bacteremia.
Complications by site:
-
EAR - If the cartilage
is pierced, it heals very slowly. The risk of
infection is increased by contact with the hair and
by pressure put on the area during sleep. The
ear lobe heals much more quickly, but the lobe can
sometimes be torn through if infection occurs, or if
the earring is caught on something.
-
NOSE - The ring can become
embedded in deeper tissues. Infection is a
problem because of the huge number of bacteria
present in the nose.
-
NIPPLE - Breast abscesses can
occur, and scarring can sometimes interfere with
future breastfeeding.
-
NAVEL - Infection is more
common because this area is often moist and can be
hard to clean well. Irritation from clothing
can also be a problem. Once an infection
occurs in this area it can take up to a year to
heal.
-
TONGUE - Tongue piercing tends
to heal more quickly and may be less susceptible to
infection, due to the antibodies present in saliva.
There have been cases of tooth damage due to tongue
jewelry, and injury to the nerves of the tongue can
occur if the piercing is done incorrectly. The
tongue also tends to become much more inflamed in
the first few days after it is pierced, sometimes
with severe swelling. There have been some
reports of permanent numbness and loss of taste.
Some people find that they have developed a lisp
after their tongue is pierced - probably not the
effect your daughter is looking for! There
have also been cases in which the tongue bar has
been aspirated into the lungs, requiring
bronchoscopy to get it out.
-
LIP - Similar to tongue, but
this site has contact with the normal mouth bacteria
without being continuously bathed by saliva, so
infection risks may be higher.
-
EYEBROW - If the
procedure is done improperly (in the wrong place)
nerve damage is a possibility.
If your daughter is under 18, you will be relieved to
learn that most responsible piercers will not perform
this procedure without parental consent. The main
danger in that case is that your daughter may turn to a
friend or try to do her own piercing, thus increasing
the danger of complications. Try to keep the lines
of communication open, and try to come to an agreement
with your daughter to avoid this risk.
There are other ways to minimize risk if piercing
becomes inevitable.
-
Do your research. Some states
(including Oregon) regulate piercing salons via a
set of guidelines set forth in the Body Art Model
Code, which was put together by a subcommittee of
the National Environmental Health Association (made
up of medical, nursing, environmental and sanitation
experts). More information about the code can
be obtained by calling NEHA at (303)
756-9090.
-
Find out about the salon you are
considering. How much training do they require
their personnel to have? Some piercers go
through a training program lasting eighteen months.
Others learn the procedure by watching a video.
Considering the health risks, you want someone who
has a full understanding of each step in the
process, including all necessary safety precautions.
-
Go with her! You want to be
there to closely monitor the sanitary conditions and
how the piercing is done.
-
Make sure the site is well-cleaned
with an antiseptic solution like Betadine.
-
I would personally choose a facility
that uses disposable equipment. Some
facilities re-use their equipment after autoclaving
it, which is acceptable as long as you can ensure
that the autoclave works properly and is used
correctly.
-
The piercer should use new sterile
latex gloves. If he or she has to answer the
phone, pick up a pencil or otherwise contaminate the
gloves, they should be changed.
-
Be sure that your daughter follows
all instructions regarding skin care after the
procedure (most teens do not). The site should
be cleaned twice a day with a mild antibacterial
soap. She should leave the jewelry alone when
she is not cleaning it, as constant manipulation
increases the risk of chronic drainage and
infection.
-
Use jewelry made of surgical steel,
14K gold, niobium or titanium. Do not allow
her to choose the less-expensive nickel or
gold-plated jewelry, as the risk of contact allergy
is not insignificant.
After considering all of the potential
complications your daughter may decide that body
piercing is not for her. On the other hand, part
of being an adolescent is believing that you are immune
to all possible dangers. Your job, as her parent,
is to allow her some freedom of choice while doing all
you can to ensure her safety. For some parents,
that will mean totally forbidding piercing, while others
may simply set a minimum age that they will consider it.
The final decision depends a lot on your personal style
and your daughter's personality. Good luck with
it!
 
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