Body Piercing
The piercing of body parts, also known as "body modification," has been practiced since ancient times, often to exhibit virility and courage, and frequently associated with royalty. For example, Egyptian pharaohs had their navels pierced as a rite of passage into manhood, and Roman soldiers pierced their nipples as a sign of masculinity and bravery. In Victorian times, members of royal families, both male and female, were known to have their genitals or nipples pierced. Current time-honored body piercing traditions include adorning the nose, lips, and navel, and some Native American tribes use body piercing in religious ceremonies. Not only limited to certain cultures, body piercing has become more common and widely accepted in the general population during the last part of the twentieth century. A piercing boutique in Los Angeles reported performing 18,000 piercings in 1993 alone.
In body piercing, the procedure is completed without anesthesia as a hollow needle is passed quickly through the body part which has been marked and cleaned with antiseptic by the piercer. The most common site involves the earlobe or ear cartilage. Other sites that may be pierced include the lip, eyebrows, nose, nipple, navel, and genitals. After the part is pierced by the needle, a piece of body jewelry--often a ring, barbell, or curved barbell known as a clamp--may be inserted in the resulting hole. Piercing of the tongue, the most common intraoral site, requires a slightly different procedure. The tongue is connected to the floor of the mouth by a hole made in the midline and anterior of the median fold. Initially, a large barbell is used to keep the hole open and accommodate any swelling; then, as this subsides, a smaller barbell is put in its place. With all piercings, it is important that jewelry made of surgical-grade stainless steel or solid 14-karat gold, niobium, or titanium is used. Brass-plated cosmetic jewelry can lead to allergic reactions or infection. Some bleeding may be expected after any body site is pierced.
Once the piercing is complete, it is essential that the site be properly cared for. It is recommended that the newly inserted stud be rotated or moved frequently to avoid sticking, and alcohol or an antibiotic ointment be used on a regular basis to keep the site clean and free of bacteria. The stud will remain in for the length of time needed for the hole to form; it will not be removed during the initial phases of healing due to the difficulty of reinsertion. While a pierce through the ear is relatively pain free due to its cartilage consistency, piercings in softer tissue, such as the tongue, lip, and navel hurt more due to the wound it causes on the flesh. An ear piercing takes four-to-eight weeks to heal, while flesh piercings take much longer, with the healing of a navel piercing taking up to a year.
With any type of body piercing there are risks involved. The best way to avoid complications is to have the procedure performed by an educated and trained piercer. Although nationwide training requirements do not exist, those who are licensed or certified know best how to properly complete the procedure, and of the anatomical dangers such as nerve damage that may occur due to improper placement of jewelry.
In 1999, the American Academy of Dermatology officially discouraged body piercing, pointing out that the practice can lead to chronic infection, nickel allergy problems, formation of granulomas (masses of chronically infected tissue), and other skin problems. In order to follow the necessary health and safety standards, parental consent should be required for anyone under the age of 18 wishing to pierce any part of the body except the earlobes--which is a requirement of most piercers, in addition to demanding that a parent or guardian be present during the procedure. Never pierce a body part yourself, or allow it to be done by a friend or amateur piercer.
By perforating the skin—one of the body's principal protections against disease--piercing can cause life-threatening or disfiguring infections if not conducted safely. According to the U.S. Centers for Disease Control, AIDS, hepatitis B virus (HBV), and other blood-borne infections may be transmitted if blood-contaminated instruments are not properly sterilized or disinfected. HBV is the greatest health threat due to its ability to survive on blood-contaminated surfaces such as door knobs or instruments, and HBV can be transmitted in as little as 0.00004 ml of blood. The risk of infection, especially to HBV, is so high that the American and Canadian Red Cross refuse the donation of blood from anyone who has undergone body piercing (or a tattoo) during the previous year.
Pain, bleeding, infection, and scarring are all possible with any type of piercing. Examples of complications by site include: a torn or split ear lobe of the most popular piercing site, the ear; scarring or deformities of the rim of the ear due to the lack of blood supply to the site; embedded jewelry in subcutaneous tissue and, more seriously, endocarditis from piercing of nose cartilage; airway obstruction from a swallowed piece of jewelry or from swelling, teeth fractures, damaged cheek tissue, and loss of taste from tongue piercing; and breast abscess, and constricted ducts during lactation which could limit the ability to breast feed due to nipple piercing. Genitalia piercing of the foreskin, penis, scrotum, clitoris, labia majora, and labia minora are all at greatest risk of infection during intercourse while the wound is still healing.
In order to address the multiple concerns related to body piercing, a subcommittee of the National Environmental Health Association (NEHA)--a group of medical, nursing, environmental, and sanitation experts--recently developed the Body Art Model Code. Created to improve the conditions and practices of the body art industry, with emphasis on piercing and tattooing, the Body Art Model Code's goal is to establish a comprehensive and uniform public health guideline.
Anyone considering body modification should talk with friends who have undergone a similar procedure, and should visit either their physician, or a number of piercing salons, observing the cleanliness of the establishments and asking about infection control. Reputable piercers take pride in their sterilization practices and equipment. They should be happy to answer your questions. If a piercer refuses to discuss safety issues, go somewhere else.
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