Infections

Infections often occur while the piercing is very fresh. Microrganisms, such as fungi and bacteria, attempt to invade the body and cause infection. The body reacts and attempts to fight off the infection by surrounding it with white blood cells. Often there is increased swelling and redness and the piercing will be sore to the touch and a thick discharge of grey, brown, or green puss will excrete from the site of the piercing. Compresses can help, if used early on.

If the infection is left unchecked, then the piercee may need anti-biotic treatment.

Avoid removing jewellery as this can trap the infection inside body and from there it can travel further inside the body, infecting important organs and tissue on its way. An infected cartilage piercing, for example, can spread in between the layers of cartilage, literally destroying the cartilage causing the whole structure of the ear to become misshapen. Infections in a female nipple piercing could travel into the mammary glands causing mastitis; which often makes the breast red, hot, painful, swollen and shiny, and there may be some pus coming from the nipple.

There are more general symptoms such as high fever, shivers, muscle aches, nausea and vomiting. These are often similar to the symptoms of flu.

Though the chances of a proper procedure causing REAL dangers are small there is a remote possibility than any problems left untreated will hinder, if not prevent, breast feeding.

Obviously there are many descriptions of infections and their grisly effects; and though it may be prudent to know them for the sake of knowledge it is suffice to say that prevention is, more often, better than cure. Knowledge, with gaps, will only let rise more confusion.

There have been countless occasions where a customer has returned to the studio with a healthy piercing, but were prompted to panic because a 'friend' had convinced them that 'they' could recognize the signs of infection.

More often than not, the cause is simply a by-product of the body's healing process. Some customers would have started a strong regime of abrasive cleansers and antiseptics; which would get rid of an infection, but in this case it would impair the healing process of the body, maybe even damaging the tissue trying to heal.

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Metal Hypersensitivity

Many people are sensitive to nickel and because this sensitivity has increased over the years, some governments have chosen to regulate the purity of metals used in Body piercing. I have believed that using hypoallergenic metals, regardless of your sensitivity, is advisable when getting a piercing.

Hypoallergenic metals put less strain on the immune system trying to heal the piercing, which increases the chances of the piercing healing well. Your body piercer should ask you about any metal sensitivity that you possess before proceeding with the piercing. Too many customers don't even know if they have metal hypersensitivity, let alone what kind of metal is in their piercing. To be honest, it is a responsibility shared by both customer and body piercer, and it is the piercer who should be the first to raise the question of sensitivity. If you, as a piercee, have ever experienced skin irritation on prolonged contact with a metal, then you can assume that you are, at least, sensitive to some baser metals.

People who react when wearing watches with metal backs, buttons on jeans or belt-buckles, can assume that they may have a nickel allergy; which is common. A European directive exists where piercing jewelry, used in the piercing initially, must contain less than 0.05% nickel, and slightly higher for jewelry used once the piercing is healed. This is true in the case of 'nickel-free' surgical steel because it contains less than 0.01% nickel and is graded 316L; whereas 'common' surgical steel can contain more than 10% nickel.

Surgical Implantation grade Titanium (6A1 4V to BS7252), like Niobium is ideal in most new piercings because the metal is biocompatible; it doesn't cause a biological reaction in our bodies. Titanium can also be coloured in a safe and biocompatible way meaning that, though the colour will fade in time, it will not react with most people's bodies. Silver is not pure. It is, like lower grades of gold, mixed with other metals, nickel in particular, and so should be avoided in a fresh piercing. Low grade gold, like 9carat gold, contains at least 15 other metals and so should be avoided in a fresh piercing, but the highest grade gold, like 24carat, is too soft to make long lasting jewelry from, thus making it a pretty frivolous item of jewelry. Some Acrylic jewelry is considered biocompatible, but acrylics can fracture more easily over time and a break in the jewelry could damage the piercing or scratches on the acrylics surface can house plenty of germs and bacteria. The same can be said for Retainer jewelry, clear acrylic worn in the piercing to make it less visible to others. Acrylic jewelry would be better viewed as temporary jewelry, though I hasten to add that problems are less likely to occur if the piercing is properly maintained and is well healed. PTFE (polytetraflouroethylene), however, is an inert plastic that is very flexible and so used in many surface piercings where rejection would be caused by tension created by stiff, metal jewelry in the skin. Its flexibility lessens tension placed on the tissue of a fresh piercing and so does not inhibit the tissue's ability to heal well. If you have been pierced and the skin around the piercing becomes red, angry, weepy, sore to the touch, dry and flaky and itchy also, then you should return to your piercer and consider changing the jewelry to a more biocompatible substance.

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Migration

Migration means, 'move from one place to settle in another'. When piercings migrate, they literally travel through the skin and settle in a different position from the original piercing.

Some people may take this to mean that a navel piercing might work its way around the body to settle in an entirely different location, like the nipple for example! This will not happen!

A piercing that migrates will usually move a few millimetres out of its original location. This is also called 'parking'. Sometimes this is because the piercee might be allergic to the metal and so should also display the signs of metal hypersensitivity. Obviously it would be wise to visit your piercer and check that a more biocompatible metal or PTFE jewelry should replace the migrating jewelry. On other occasions, migration will occur because the jewelry used in the piercing is too big and is resisting the elasticity, or 'flow', of the skin, and so the body allows the jewelry to move into a more 'comfortable' place. A good example is in navel piercings; where some clients have little or no space for jewelry in their navel. If this is the case, the jewelry cannot be expected to heal well, if at all, because of the stresses the jewelry would place on the tissue it rests in. If you notice this happening, then visit your piercer for more adequately sized, or shaped jewelry.

The weight of the jewelry can also be a factor in migration. Time is certainly an accomplice, and it can take years for a person to notice the migration of their piercing. But the weight of body piercing jewelry can contribute significantly to the 'life' of a piercing. If a piercing appears to be migrating for no discernible reason, then switching to a light weight metal, such as titanium or niobium, or to biocompatible plastics, like PTFE, might make a difference. On other occasions, migration could well be due to the gauge of the jewelry. Very thin jewelry like 1mm or 1.2mm jewelry can migrate more easily because it is thin and easier to relocate through skin. Abdominal and genital piercings are most prone to migration due to small gauge jewelry. I personally would recommend that abdominal and surface piercings be performed with jewelry no thinner than 1.6mm; and for genital piercing, no thinner than 2.4mm gauge jewelry for men, and no thinner than 1.6mm gauge for women.

Though migration itself might only be a problem because it changes the 'look' of the original piercing; if migration is left unchecked it can lead to rejection. Many piercings reject and some are more prone to rejection; especially eyebrow and navel piercings. The causes are as those for initial migration, but the result of rejection can be irritating to deal with. When rejecting from the body, the body is literally pushing the jewelry out of the body. The skin around the piercing can be a little sore but very red and you will notice the skin appears to 'thin' slightly as the jewelry reaches closer to the surface of the skin. Finally, there will be a tiny amount of skin holding the jewelry in. That tiny bit of skin thins-out so much that the weight of the jewellery helps it fall out and away. The result on the skin is usually a lot of scar tissue and an indentation, or cleft where the jewellery made its final exit. It would be better to avoid this by removing the jewellery before it falls out. That way less skin damage, or scarring, is caused by the progress the jewellery makes through the skin.

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Scarring

Skin tissue rarely heals to match the surrounding tissue. It heals in varying thickness, in different ways for different types of people, and forms different types of scarring for different kinds of 'damage'. You must appreciate that it is likely that any piercing you have worn for a significant time (months to years) will leave a scar if it were removed.

That may have been an understatement. But a lot of clients look shocked with disbelief at the notion that their skin won't heal up to suit the original 'aesthetic' of the surrounding area.

Knowing this much, for some people, will put them off being pierced. It is entirely acceptable that a person who has doubts about getting pierced for this, or any other reason, should re-examine their reason/perception before getting pierced. At the very least, come to terms with the possibility of having to live with a scar. Having said all that, the scars most people are naturally left with, are hardly noticeable. Keloid scarring can happen to anyone, though individuals with darker skin pigmentation might find that they are more susceptible. A keloid scar can appear as a large red and purple mound beside either end of the fistula (the 'tunnel' created by the piercing). It can sometimes be sore, though not always, especially if it causes slight swelling to aggravate the jewelry's position in the piercing. Keloids do not receive a good blood supply, and so prolong the healing process.

Successful treatment of keloid scarring has involved 'hot salt-water soaks' and 'compresses'. Some keloid scarring can be quite extensive, but this is not very common and a G.P can usually prescribe treatment.

Oral piercings form scar tissue that looks like a white 'O-Ring' around the site of the piercing. The scar tissue normally recedes after a month or so. If it does not recede, or as in the case of some tongue piercings, the scar tissue can grow along the length of the jewelry consult your piercer, G.P or dentist; but regular mouth-rinses using Saline solution might help.

When a piercing heals under ideal conditions scarring is minimal, or 'normal', because no other aggravation occurs. Obviously a fresh, or even old piercing that has been snagged or pulled with enough force to tear the skin will form extra scar tissue. There are many natural and traditional ways to deal with scarring. Some people swear by oils, like Tea-Tree oil, Germseed oil, and extra virgin olive oil to treat scar tissue; others swear by natural sea salt solutions applied regularly to the scar tissue.

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Boils and Abcesses

Boils and Abscesses are both formed when bacteria invade tissue and are being contained by white blood cells. Boils are less severe, whereas abscesses can occur within skin tissue and have the potential of rupturing, then spreading the infection further into the body. Catching boils, abscesses and infections early is the easiest way of dealing with them effectively. Abscesses are often the result of a new piercing that could not drain fluid properly (where the entry and exit points have been left crusted by blood or, more commonly, puss) and can appear as reddish-pink bumps in between the ends of the piercing. The piercing itself may feel hot, sore, swollen and appear redder in colour. More severe abscesses may also cause nausea and fever. Though abscesses can heal themselves, it's safer to have the situation reviewed by your piercer or a doctor. Most of the time, especially in the early stages, compresses can be successfully applied. More typically, a prescribed course of antibiotics can deal with the infection. But sometimes lancing the abscess with a needle will allow the fluid to drain, and give the body less infectious material to deal with. It is worth pointing out that, once this particular procedure has been performed, it would be pointless to allow the site to get dirty again! Always keep your piercing clean and dry, and especially while it is experiencing complications.

Boils are similar in appearance to abscesses, but are more likely to be found at the site of the entry or exit points of the piercing. They can occur anywhere and are highly unlikely to develop orally, but are commonly found on nostril and nipple piercings. They also tend to develop when a piercing has been snagged and torn the skin. Bacteria, usually normal bacteria on the skin surface, get trapped inside the wound by skin tissue sealing it in. The trapped puss is often close to the surface of the skin, and some people have dealt with them by popping them as they would a spot. It is better; however, to treat them with a hot compress a couple of times a day. Allow the boil to bleed but make sure that you clean and dry the site so no further germs or bacteria can invade.

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Stretching and Associated Problems

Stretching a piercing describes a process that enlarges the diameter of the fistula. This means, literally stretching the tissue that holds the piercing so that thicker (larger gauge) jewelry can be worn. The location of the piercing is an important factor in its long-term 'health' as well as the extent to which stretching the piercing will affect the tissue around the piercing.

If a piercing lies close to the edge of skin tissue, and the stretch enlarges the piercing so much that the skin at the edge thins too much, it could become so thin that no blood can pass through it. Then the tissue dies, making the skin fragile and prone to splitting. In these circumstances, it is often necessary for the piercee to visit their doctor to re-stitch the tissue together, and then hope that the skin will re-heal in a normal, and uniform fashion.

Sometimes, when a stretch is performed too soon after the previous one, the tissue of the fistula tears, and subsequent stretching can result in a 'blow-out'. 'Blow-outs' are an effect caused by stretching tissue that has not healed to its natural thickness. They appear as a flap of tissue that extends away from the fistula, like a floppy tyre, hence the name. Immediately reducing the size of the jewelry can help allow the tissue to resettle uniformly. Rubbing pure olive oil or vitamin E cream onto the 'blow-out' (combined with reducing the jewelry size, or removing it) might help the skin tissue to resettle.

Stretching is better done gradually and in accordance with the signs given by the healing piercing. If the stretch is still 'tight' and a little sore, allow it to settle down and 'loosen-up' before attempting to stretch-up the piercing. Skin tissue isn't as elastic for all people. Skin requires different times to heal and settle into its new size.

Stretching existing piercing with weights can lead to over stretching the fistula at one point, namely the point that is pulled down by the weighted jewelry. The tissue (that is being over stretched) can become so over stressed that it can tear, again, a condition that might require stitching to rectify. But the damage to the skin tissue itself (in the form of long skin tears) can hinder the ability of the skin to re-heal uniformly or even allow it to stretch to larger gauges without further damage. A stretched piercing is less likely to heal back to its original shape if it has been over-stretched, stretched to a large diameter like 12/14mm and above. This does depend on the original dimensions of the skin that was stretched.