Printer-friendly VersionFrom the Medic: Featuring Dr. Janet L. H. Keating of the Duke Family Medicine Center
As a student health physician at Duke University, I see a number of piercings in the course of a year. Rarely is the piercing a reason for the office visit--more often the piercee is being seen for a sprained ankle or a strep throat. However, on occasion, there is a complication with a piercing that requires medical attention.
When there is a problem, it is usually infection during the healing phase of the piercing. Any type of surgical procedure, whether it is a tongue piercing or a kidney transplant, carries a risk of infection associated with it, even if sterile technique is followed scrupulously. Skin bacteria is almost always the culprit---typically not from the piercing procedure itself but from contact during aftercare. Good hand-washing is first and foremost the prevention for infection in any wound care.
The basic steps in treating wound infection include cleaning the wound, draining infected material, and applying heat to promote circulation and stimulate the body's immune response. Antibiotics are used depending on the location and severity of the infection. For an abscess, which make up the majority of secondary infections from piercing, antibiotics may not be necessary.
Cleaning and drainage generally involve irrigating the wound with a saline solution and removing debris--dead tissue, pus, dirt or other foreign material. In the case of an infected piercing, this is occasionally interpreted by a health care provider to mean removing the jewelry. It is helpful if the piercee understands and is able to discuss with the physician that the jewelry should remain in place to act as a drain. If the jewelry is too large to allow adequate drainage, it could be replaced with a smaller size by a piercing professional. In the rare cases of severe infection, where there is a lot of destruction of tissue in the area, the jewelry may need to be permanently removed and the dead material debrided (cut away) for healing to occur. This should be clearly explained to the piercee if it appears to be necessary.
Moist heat is best for promoting healing of an infected piercing, and here the standard aftercare instruction of warm sea salt solutions applied to the area would still be appropriate. Even more care about hand-washing, avoiding manipulation of the jewelry, and avoiding other trauma to the area from clothing, etc. needs to be observed. Sheets and clothing in contact with the area should be changed at least daily. Also, to again promote the best circulation to the area and the best response by the immune system, good nutrition, avoiding alcohol, and quitting smoking are extremely important, if not essential to the healing process.
Antibiotics are typically necessary if the infection has spread beyond the immediate area of the wound. This as known as cellulitis and occurs when the body can no longer wall off the infection. Redness, warmth to the touch, and extreme tenderness extending more than a half inch from the piercing site would be suspicious for cellulitis. In most cases, early treatment with antibiotics manages this infection before it becomes severe. However, if a client presents with fever and body aches in the setting of an infected piercing, the infection has begun to affect the entire body and is a risk for causing severe illness. This individual needs medical attention immediately and close observation, sometimes in the hospital, in addition to antibiotics, cleaning, drainage, and warm compresses.
One special concern with infection is piercing through cartilage, such as the nose or the upper ear. Cartilage does not have its own blood supply--it depends on the surrounding tissues to provide oxygen and nutrients by diffusion. This makes it more susceptible to infection, and harder to treat when it does occur. Destruction of cartilage by an infection can also lead to deformity of the ear or nasal contours. While most of these infections still clear well with early use of antibiotics, it is a risk that clients should know about.
Good sterile procedure, good piercing technique, and good instructions on aftercare (with regular reinforcement with a client, if necessary) prevent most infections. When an infection does occur, having a piercing-friendly physician or health care provider available to help is the best course. Know who is available in your area. And even if you can't identify someone who is clearly knowledgeable about piercing, most physicians are open to learning and are happy to discuss a case if the piercee permits it. So, don't hesitate to talk to a health care professional about the special needs of infected piercings.




Joined: 16 Jun 2008
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My tung ring got infected
Posted on June 16, 2008, 7:53 amMy tung ring got infected last year it was the worst feeling not being able to eat and the pain from it. I was making protein shakes / meal replacements and drinking from a straw for a week. The doc gave me some meds for the pain but i opted not to take them since ive seen other people end up in drug rehab for the same stuff.
Joined: 18 Apr 2008
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I am going to the doc soon
Posted on December 7, 2008, 12:02 amI am going to the doc soon for mine. I am fearful that the doc will have me remove the piercing. I have already had to have them redone once, and really wouldn't look forward to a third time around. I love my piercings and really do not want to lose them.
Joined: 22 Sep 2008
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Which piercing is it? If
Posted on December 7, 2008, 6:00 amWhich piercing is it? If it's infected, I don't believe that I should be removed b/c of the possibility the infection will turn into an abscess, or something like that. There was a tread on this subject recently.
Joined: 31 Dec 2008
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Here is what I have learned
Posted on January 3, 2009, 11:09 amHere is what I have learned about the medical profession that may help you feel more comfortable in speaking to your doctor. First go into the office with a well researched plan in healing the infection. Knowledge is power. Second, dress in casual business attire. You will be taken more seriously. Yes, doctors do profile people. Third, be confident. Remember the doctor is there to serve you.
Good Luck
Raymond
Raymond Visconti
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It’s hard to find
Posted on February 3, 2010, 12:36 amIt’s hard to find knowledgeable people on this topic, but you sound like you know what you’re talking about! Thanks
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If the jewelry is too large
Posted on February 6, 2010, 6:25 amIf the jewelry is too large to allow adequate drainage, it could be replaced with a smaller size by a piercing professional.
Joined: 31 May 2010
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Thought I'd share my
Posted on May 31, 2010, 6:42 pmThought I'd share my experience with my piercings for those who may have this problem. I have a nickle allergy, and while I, after many years of dealing with the itching and sometimes crusties with my childhood ear piercings, finally switched to anodized titanium earrings you find at Hot Topic, I never thought of the allergy when i got my first belly piercing, and later, my tongue. My belly got infected after about 6 days. I thought I just wasn't taking care of it right, so my boyfriend at the time tried to help me save it since he was well versed with piercings after having up to 40 prior to the Navy. No luck so i took it out and let it fully heal. I later got my tongue done, and within the week, it got infected. It looked like my tongue was trying to devour the top ball, and pus came out. To keep it from going straight through, i cut a sliver of the end of an ear plug and used to to anchor the barbell over the hole, cause the end that didn't go in the ear had a hole in it for string. I later talked to a good friend of mine about it, and she asked me if i had a nickle allergy. I said yeah, and she said that was my problem. That surgical steel has a small amount of nickle. So I looked it up and sure enough, it did. She recommended i get either titanium or acrylic piercings anytime i had them done. So, not being able to find those at any of the shops in my city, let alone the place where I got my belly done, I switched to the plastic barbell and was forced by my roommate to taker her antibiotic. Oh and when i asked the guy who did my belly about the types of metals and my allergy, he replies, " I've never heard of that, have you ever had surgery?" Yeah I had my wisdom teeth pulled but that's not the same as having the offending material sitting on an open wound 24/7 ( idiot). My tongue healed and now i have a 10g, which is my original piercing jewelry. I just recently got my nose, and my belly redone, knowing what to expect. But my new piercer didn't have the type of jewelry I needed. So she recommended I switch to the plastic only if needed. I did..a little too late, and after trying to head off the allergy with an antihistamine, which prolonged to onset of infection from 1 week to 2, i'm on an antibiotic again, with plastic jewelry in the holes. They're healing up right nicely, and I have 2.5 weeks left for the healing window. My belly piercing gave me the hardest time however, with a lot of pain before getting better. So now, if i decide to get anymore, i'm buying my own starter jewelry in titanium first, but still taking an antihistamine, just in case. So, surgical steel IS NOT PURE. It does have nickle, and if you have even the slightest allergy to it and you want piercings, ask for titanium, acrylic or bioplast starter jewelry, or buy your own and take it with you. Sorry for the long story, but I really thought someone could learn from my experience.
Joined: 30 Sep 2010
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My navel was well on it's
Posted on October 3, 2010, 9:31 amMy navel was well on it's way to infection two days ago. I went to the shop where I was pierced and it turns out the barbell was too short for the amount of skin used, and apparently my body decided to swell more than typical. I had to get it changed to a pregnancy ring so my body would have room to swell. The piercer said the infection should be gone in a day or two.
Joined: 24 Nov 2010
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The best thing i have found
Posted on November 25, 2010, 10:11 pmThe best thing i have found for infections is an antiseptic spray called Bactine, the active ingredient is Benzalkonium, it comes in a spray bottle. My roommate recommended it after getting a mild infection in a new ear piercing. I got got a small tear on one of my guaged earlobes that resulted in an infection with a lot of swelling and pus, after switching to a smaller size plug and using bactine the infection was completely gone in less that 24 hours! Now i use it on any of my piercings if they get red or irritated to get rid of infection before it starts. Also using it twice a day to clean my new hafadas and have had absolutely no redness, swelling, or discharge at all! This stuff is the best!
Joined: 26 Jan 2009
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Check out the Bactine
Posted on November 26, 2010, 8:27 amCheck out the Bactine website: http://www.bactine.com/bactinefaq.htm
See question # 4:
Q: "Can I use on body piercing?"
A: "We cannot recommend that Bactine be used for this purpose since body piercings are considered puncture wounds. Consumers should consult their doctor for treatment of such wounds."
Life is short; enjoy your pain.
Joined: 31 Jan 2011
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Moist heat is best for
Posted on January 31, 2011, 2:32 pmMoist heat is best for promoting healing of an infected piercing, and here the standard aftercare instruction of warm sea salt solutions applied to the area would still be appropriate. Even more care about hand-washing, avoiding manipulation of the jewelry, and avoiding other trauma to the area from clothing, etc. needs to be observed. Sheets and clothing in contact with the area should be changed at least daily. Also, to again promote the best circulation to the area and the best response by the immune system, good nutrition, avoiding alcohol, and quitting smoking are extremely important, if not essential to the healing process.
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Joined: 09 Mar 2011
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I got my tragus pierced this
Posted on March 9, 2011, 6:09 amI got my tragus pierced this past saturday and I bought the wrong soap to clean it with. So now my ear is swollen and I think infected. I got the right kind of soap now, is it too late to turn it around?
Joined: 02 Aug 2011
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Hi, I desperately need some
Posted on August 2, 2011, 1:46 amHi,
I desperately need some help ASAP, My nipple piercing has got infected and pusses all the time. It doesn't hurt. I have been using salt solution, anti-septic cream and iodine, but nothing seems to work and it looks like its getting worse. The problem is, i'm in south-east asia so I can't just pop to the doctors, so does anybody have the name of either some strong antiseptic cream or anti-biotics as most things you can buy over the counter here!
Please Help Thanks
Joined: 14 Oct 2011
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I just thought I would add
Posted on October 14, 2011, 8:52 amI just thought I would add in bit of sane infection control advice.
1) it's best not to use lots of different "anti-xyz" creams lotions and potions at the same time as they can interact.
2) The main articles have got it spot on first line care is a good saline wash - using clean hands in a clean environment.
3) Just because you have white/creamy pus, does not mean you have an infection, it could be a reaction of some kind (the pus is a mass of neutrophils) rubbing xyz into this may make matters worse.
4) Okay, if I was stuck with an infected piercing out on the road, other than saline wash, I would wash my hands and the skin surrounding the infection with benzylalkamonium or a cetrimide solution, allow it to dry and then either spray with dry iodine, or swab with wet iodine so that the area is completely stained brown. Then leave it alone, and try and find medical attention if this was not working.
As a rule of thumb with infection control KISS - keep it short & simple.
The only time I would be thinking microbial agents is if I could feel localised warmth to the touch or your core temperature was being affected.
Hope that helps, and as an FYI I'm a right pain for fiddling with my own piercings while they heal, but Dr's always make the worst patients.