Related Terms

• Amateur piercing, belly button piercing, blood borne pathogens, breast piercing, cartilage bumps, ear piercing, ear piercing gun, earring, eyebrow piercing, fistula, genital piercing, jewelry, keloids, needle, piercer, piercing artist, tongue piercing.

Background

• Piercing is the process of inserting a needle into some part of the body's skin or cartilage in order to create a hole for the insertion of jewelry. The word piercing also applies to the jewelry that is put into these openings in the skin.

• The origin of piercing is not known. However, the practice has been documented in many cultures at different periods of time and has been practiced prehistorically as well.

• The most popular form of piercing in the United States is ear piercing. However, other parts of the body may be pierced as well, including the lips, eyebrows, tongue, breasts, and genital areas. Some individuals also pierce the skin surrounding the belly button. Piercing is available at many shopping malls and businesses specializing in the practice. Some doctor's offices may also offer piercing services.

• Piercing is generally regarded as safe in body areas with few nerve endings, assuming that proper standards of cleanliness, such as using sterile and single use needles, are maintained. The risk of nerve damage, undesired tissue damage, and infection is greater in certain areas of the body including the tongue, breasts, and genital areas.

• Ear piercing is a commonly accepted practice in most parts of the United States. Currently, piercing of parts of the body other than the ears is popular among teen and young adults in Western cultures.

Technique

• In general, it is not recommended that individuals attempt to pierce any part of their body at home. Piercing should only be performed by a qualified individual who is trained in the hazards of blood borne pathogens and the practice of universal precautions. Attempts to sterilize piercing materials at home may be unsuccessful and result in infection. Further, the chance for undesired scarring and nerve damage increases when the individual performing the piercing has not been properly trained.

• Before having any area of the body pierced for the insertion of jewelry, an individual specifies the type and location of piercing desired. Usually, specialized jewelry must be purchased along with the piercing service. This jewelry is made of metals designed to allow for the piercing to heal and to prevent infection. The individual performing the piercing should always tell the client which jewelry pieces are appropriate for piercings that are healing.

• All piercing should be done according to procedures that abide by universal precautions. Universal precautions are a series of practices that aim to minimize the likelihood of disease transmission or piercing infection.

• Before jewelry is inserted, a special sharp needle held by the piercer or by a sterile instrument designed for piercing is pressed up against or pushed through the skin. Usually, the piercer holds the skin in a manner designed to prevent slippage or undesired and unnecessary penetration into the surrounding tissues.

• While the piercing needle is still in the body, the piercer pushes the back end of the jewelry into the new opening. As the jewelry is pushed through the opening, the remainder of the piercing instrument is removed from the skin.

• However, for ear piercing, the ear piercing guns are sometimes used to create an opening in the skin and cartilage for ear jewelry. Piercing guns do not require the insertion of needles by hand.

• When the opening that was created to insert the jewelry has healed, a type of scar, known as a fistula, is permanently formed to connect the two openings of skin.

• There is no government certified body or organization for piercers, and there is also no government-endorsed training process for these individuals. However, piercers may undergo voluntary certification through piercing advocacy organizations. Most reputable studios require that piercers obtain and maintain this certification.

• Piercers must undergo a blood borne pathogens training in order to reduce the likelihood of spreading disease to and between clients. These courses are offered by organizations such as the Red Cross.

Safety

• Individuals who undergo piercing outside of a studio or designated establishment, such as in prison, experience a much higher risk of infection, nerve, and tissue damage. These types of piercings are called amateur piercings.

• Amateur piercing is not recommended. Individuals who have not received certification in a blood borne pathogens class, do not have autoclaved materials, do not have access to biohazard containers, and/or do not have training in piercing from an advocacy organization should not attempt to create openings for the insertion of jewelry at any place on their own body or any individual's body.

• Piercers should always wear gloves and sterilize the body part to be pierced. All piercing tools and materials should be cleaned in a special machine called an autoclave before using them on another client. The autoclave kills any infectious organisms that may remain on the piercing materials. All needles should be used once and then disposed of in a biohazard container. Most piercing studios have a policy that forbids the return of used jewelry in order to further minimize the possibility of spreading disease.

• Following a piercing, it is important to follow the hygiene instructions provided by the piercer. These instructions reduce the risk of infection or other piercing complications.

• The person performing the piercing should always follow universal precautions, which are a set of practices that minimizes the possibility of infection and disease for both the piercer and the recipient of the piercing. Piercing artists should wear gloves and sterilize the area to be pierced. The area that will hold the piercing instruments is also sterilized with a special medical-grade substance before the materials are placed on the surface. Usually, the surface that holds the piercing materials is a stainless steel table, similar to the type used in a doctor's office. Each piercing should be done with sterile materials. Because the skin bleeds when it is pierced, the blood should be cleaned using a disposable towel, which should not be reused for wiping multiple times..

• In addition, many individuals find it helpful to ask the piercing artist about his or her certification from a blood borne pathogen training.

• Because piercing instruments come into contact with blood and other bodily fluids, there is a high risk of spreading disease and causing infection unless all pathogens, such as bacteria and viruses, are cleaned from all piercing tools. Single use piercing needles and other measures prevent the spread of blood borne pathogens during the piercing process. For all types of piercing, it is important to sterilize the skin and piercing instruments before beginning the piercing process.

• Infections that can be spread from one person to another by blood and other body fluids are called blood borne pathogens. Blood borne pathogens that may be transmitted from one person to another by using unsterilized piercing equipment include surface skin infections, fungal infections, herpes, tetanus, bacterial infections, HIV/AIDS, and some forms of hepatitis.

• In some cases, excessive scar tissue may form around a piercing, and the skin may appear bumpy or swollen. Cartilage bumps and keloids are two of the most common forms of this scar formation. Individuals who suspect that they have cartilage bumps or keloids should consult a qualified healthcare practitioner.

• It is important to follow the directions provided when caring for the piercing in order to prevent undesired scarring, infection, or other complications.

Author Information

• This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Association of Professional Piercers. www.safepiercing.org.

2. Centers for Disease Control and Prevention. www.cdc.gov.

3. Jones R, Kingston A, Boag F. Post-coital bleeding due to penile piercing. Int J STD AIDS. 2007 Jun;18(6):427-8. View Abstract

4. Kloppenburg G, Maessen JG. Streptococcus endocarditis after tongue piercing. J Heart Valve Dis. 2007 May;16(3):328-30. View Abstract

5. Maheu-Robert LF, Andrian E, Grenier D. Overview of complications secondary to tongue and lip piercings. J Can Dent Assoc. 2007 May;73(4):327-31. View Abstract

6. National Institutes of Health. www.nih.gov.

7. Occupational Safety and Health Administration (OSHA). www.osha.gov.