• When piercings are properly performed and cared for, complications such as irritation or allergy are far more common than infection.

• Even momentary removal of jewelry from a piercing can result in rapid closure of the channel, and make reinsertion difficult or impossible.

• Simply taking out the jewelry may not resolve the problem, and if an infection is present, removal can lead to a more serious problem–the formation of an abscess.Most piercing complications can be handled without the piercing being lost.

• Changing aftercare and/or jewelry size, style, or material often resolves problems.

• Alcohol, hydrogen peroxide, Betadine, Hibiclens, harsh soaps, and/or ointment(s) are not appropriate products for the care of a healing ear or body piercing.

• Over-cleaning and using strong products can irritate piercings and delay healing.

• Rinsing with sterile wound wash saline 1-3x a day is suggested for body piercings

• Rinsing with mild non-iodized sea salt and/or antimicrobial or antibacterial alcohol-free mouthwash, 4-5 times a day is suggested for oral piercings.*

• Discoloration: reddish, brownish, pinkish, or purplish; can remain for many months on navel, surface, and other piercings.

• Swelling/Induration: localized; may be significant with oral piercings such as the lip or tongue, and usually lasts for several days following the initial piercing.

• Excretion: exudate of interstitial fluid, dead cells, etc. that forms a small amount of crystalline-appearing crust at the openings of the piercing; should not be copious, malodorous, or green.

• They are occlusive and limit oxygen circulation to the area, which can delay healing of this type of wound.

• They leave a sticky residue that makes cleaning the healing tissue more difficult.

• If necessary, gels, creams, or other water-soluble products are preferred for topical application.

If the jewelry moves closer to the surface or the tissue gets narrower between the openings of a piercing, this is termed “migration.” If the piercing migrates past a point of remaining viable or comes all the way to the surface, this is termed “rejection.” For safety and longevity, a piercing should have at least 5/16” inch (almost 8 mm) of tissue between the entrance and exit holes.

A body piercing should be abandoned if the tissue between the entry and exit progressively gets smaller or thinner over time plus any of the following:

• The skin between the openings is flaking or peeling, red or inflamed, and/or hard and calloused-looking

• There is 1/4” of tissue or less between the openings

• Just a thin filament of nearly transparent tissue is left, and the jewelry can be seen through the skin

• Metal body jewelry will result in an opaque density on MRI and x-ray, but will not otherwise affect visibility on film

• Metal body jewelry causes visible interference and should be removed for CAT scans if in the area of examination

• Nipple piercings are unlikely to obstruct visibility of pathology on thoracic x-rays if both AP (or PA) and lateral views are taken

• Appropriate body jewelry is non-magnetic, and as such does not need to be removed for MRI procedures unless it is located in the region being examined (use a strong hand-magnet to test)

• Even momentary removal of jewelry from a piercing can result in amazingly rapid closure of the channel, and make reinsertion difficult or impossible

• Non-metallic retainers can often be used to safeguard the patency of a piercing; sterile tubing from a catheter needle can be used as an emergency retainer

If you experience a problem that is beyond the scope of your piercer, the following facts can assist you and your healthcare provider in decision-making about the best care and treatment.

Visit a doctor immediately if you have problems with your piercing and you:

• Experience severe redness, swelling, or pain from the piercing

• Have a large amount of discharge that is thick, green, yellow, or gray and smells bad

• Have red streaks coming from from the piercing site

• Take steroids or have a chronic illness or other health condition

• Have symptoms that last for a week or get worse

• Experience fever, chills, nausea, vomiting, dizziness, or disorientation

Medical personnel have tremendous knowledge of the human body but often do not have specific training about this unique form of body art. As a piercee, you may have more information about the suggested care and maintenance of piercings than they do. It is up to you to make certain that your chosen medical professional has access to facts that will facilitate your treatment.

To save yourself from a bad experience, ask the following questions before settling on a doctor or other practitioner. Is this healthcare professional:

• Accepting of body piercings?

• Experienced in treating problem piercings?

• Willing to consult with a trusted expert body piercer, or seek other resources for information about piercing?

These guidelines are based on a combination of vast professional experience, common sense, research, and extensive clinical practice. This is not to be considered a substitute for medical advice from a doctor. If you suspect an infection, seek medical attention. Be aware that many doctors have not received specific training regarding piercing. Your local piercer may be able to refer you to a piercing-friendly medical professional. For more information, visit www.safepiercing.org