A lingering fad in the 80's with an uncertain period in the early 90's when earring-sidedness implied a sexual preference, body piercing has since surged into mainstream acceptance and continues to gain increasing popularity in diverse niches - the emerging pubescents, the X'ers, the aging baby boomers, the fringe conservatives in midlife crisis.

Say hello to Generation P, the pierced generation.

Suddenly ubiquitous, body piercing has been in use since antiquity: the Mayans with its religious ritual of tongue piercing, the buccal labrets worn by Aztecs of higher caste, the Egyptian pharaoh's pierced navels as a sign of royalty, and the Roman soldiers' nipple piercing for virility and loyalty to the emperor. In the Alaskan Tlingit people, nose piercing was a status symbol. On the other end of that historical spectrum, piercing is considered taboo or unacceptable in some cultures and religions.

Today, body piercing is both protest and fashion. For some it provides a benign continuum for social protest. For most, it is a fashion statement, the accouterment of "cool" without the permanence of tattoos, from the simple and elegant to the absurd and bizarre. For some, it is the extremist expressive art form. For a few, it is a journey into its stimulatory possibilities.

Although the ear is most commonly pierced, no area is exempt. Barbells, rings, studs and labrets now dangle, decorate and pierce the common and intimate parts of the anatomic landscape: lips, tongue, eyebrows, nose, nipples, navels, the penis and scrotum, the clitoris and vaginal lips.

As popularity has zoomed, so have complications. The fad has spawned an unregulated industry of "studios," many manned by untrained "experts" with inadequate grasp of the essentials of anatomy and the gamut of potential complications. Perhaps, 50% might even be done by children on children, who after failing to get parental permission turn to their friends or pierce themselves.

The explosion in piercing's popularity was associated with an astounding rise in nickel allergy. By 1993, 25% more people had nickel allergy compared to 1985. 13% of 8- to 15-year old girls with pierced ears have nickel allergy compared to 1% in those with unpierced ears. Among nickel-allergic women, 95% have pierced ears.

IMPLANTS: AN EXTREME FORM OF PIERCING
A radical and fringe form of body piercing - implants - has emerged, and fortunately, has not caught on. It involves the insertion of small beads or 3-D art implants (rings, crosses, barbels) and a variety of transdermal implants. Beware, It is a much more complicated process requiring professional skills in a sterilized environment.

CONS AND SOCIAL CONSIDERATIONS
T Piercings has gone from "in" to "mainstream" fashion statement. And so often, fashion turns into a folly of the past. And alas, piercings leave scars and holes c reflections of your past that might hamper your employability. And with the popularity of multiple facial/ear piercings, later regrets might not be amenable to expensive plastic surgical efforts.

HEALING TIME
People heal at varying rates and healing time varies widely by site, from 3 weeks to a year: Tongues heal in 3 to 6 weeks; ears, lips and eyebrows in 6 to 8 weeks, nipples in 8 to 16 weeks; and navels and other areas because they are covered by tight waistbands or exposed to repeated trauma, may take up to nine months or longer. Piercing of the cartilage along the top of the ear heals more slowly than pierced earlobes.
 

 

TYPICAL HEALING TIMES
SITE

MONTHS TO HEAL
TONGUE

1-2
EAR
     Lobe
     Tragus
     Rim
     Daith
     Conch
     Rook

 

1-2
3-4
2-3
4-6
3-4
3-4
NOSE

2-3
LIP, CHEEK

3-4
NIPPLE

4-6
NAVEL

4-6
GENITALIA
     Penile meatus (Prince Albert)
     Glans penis
          Apadravya (front to back)
          Ampallang (side to side)
          Frenulum
     Scrotum
          Guiche
          Dydoe
     Clitoral hood
     Inner labia
     Outer labia


1-2
1-2
6-8
6-8
2-3

3-4
3-4
1-2
1-2
3-4



COMPLICATIONS
Infections
If constantly itchy, red, sore or oozing pus, the piercing is likely infected. Infectious complications are common, 10-25% in earlobe piercings, usually Staphylococcus aureus; rarely, bacteremia and endocarditis can occur. In piercings involving the auricular cartilage, Pseudomonas infections may develop and require extensive surgical intervention. Body piercing has also been implicated in the transmission of tuberculosis, hepatitis B, C and D, tetanus, toxic shock syndrome, and even HIV. Neisseria Meningitis has been implicated in a bacterial infection arising from a tongue piercing.
Allergic reactions
Probably the most common complication of piercings, presents as draining, itching and crusting around the jewelry, entrance and exit holes.

Metal allergy is usually due to nickel contained in 316L stainless steel and certain gold alloys. In such cases, titanium, stainless steel or niobium may be hypoallergenic alternatives.
Others
Keloids, scarring, migration or rejection can occur. Early consultation with a physician is suggested.

POST-PIERCING CARE
  1. Always wash hands thoroughly before handling the piercing site.
  2. Cleanse the area twice daily.
  3. Remove dried matter on jewelry and around piercing sites with a moist cotton swab.
  4 . Soaking the area in salt water can facilitate healing and help loosen crusty formations.
  5 . Avoid the use of rubbing alcohol or hydrogen peroxidetthey may discolor the jewelry, dry out the skin and delay healing.
  6 . Three times a daily, pour water over the site and apply a small amount of antibacterial soap. Gently massage into the area.
  7 . Carefully work the jewelry back and forth 5 or 6 times.
  8 . After 2-3 minutes, rinse the area thoroughly to remove all cleansing solution and dry carefully.
  9. Avoid over-use of antibiotic ointments as they block the air from the pierced area.
10. For tongue and lip piercings, use a saltwater rinse or an antibacterial mouthwash after each meal or snack.

RECOMMENDATIONS
1. Limit ear piercing to the lobe. Piercings of the ear cartilage can result in more difficult infections.
2. Because of sterilizing concerns, use of sterile disposable hollow needles is preferable to ear-piercing guns.
3. If infection develops despite post-piercing care, consult a physician for early definitive treatment.
4. Wherever possible, seek reputable, trained, certified or licensed piercers. Inexperience is associated with higher complications.

FACTOIDS
- In a pilot survey for the prevalence data on body piercing and tattooing, among 32 people with body piercing and/or tattoos, 13 had piercings and tattoos, 11 had tattoos only, and 6 had piercings only. In these 32 respondents, there were a total of 199 body piercings and 105 tattoos. Of the latter, 2 have been removed and 5 were kept covered.
- Alcohol may play a role in the decision for piercing or tattooing & shy; 28 of the 32 consumed a mean of 6 alcoholic beverages a day.
- Intimate or genitalial piercing may involve a pseudosexual relationship with the piercer.
 




SOURCES
Prevalence Survey of Tattooing/Body Piercing
Sally Kock Kubetin. Internal Medicine News. April 1, 2004
Piercing's Popularity Tied to Rise in Nickel Allergy
Internal Medicine News. April 13, 2003
The Female Patient: Body Piercing, A New Challenge
Carol Hasenyager, MD. Vol 25. July 2000. Clin Infect Dis 1998 Mar;26:735-40. 767-8.
Body Piercing: Seductions and Medical Complications of a Risky Practice
Charles Stewart, MD., Medical Aspects of Human Sexuality. July 2001
The Dangers of Tattooing and Body Piercing (Everything You Need To Know About)
Laura Reybold,
Rosen Publishing, Revised Edition 2001