In the fall of 2000, seven American youths were infected with a dangerous bacterium after having their upper ear cartilage pierced at a local mall.
Five were hospitalised, and three others had to undergo reconstructive surgery to fix deformities in their ears.
Complications never counted
The surprising thing was not that the youths, aged 10 to 19, became infected, but that the public even heard about the cases.
"A lot of people might encounter complications [from body piercing], but they're never counted," says Myrna Armstrong, a professor in the school of nursing at Texas Tech University in Lubbock.
Naval and ear piercing risky
Armstrong's research has revealed a 45 percent infection rate from navel piercing. And she's discovering even more problems with "high rim" - or ear cartilage - piercing.
Although it's notoriously difficult to track the complications resulting from this form of body art, interviews with experts indicate that problems are common and sometimes even life-threatening.
Hazards to take note of
One person had a near-fatal haemorrhage requiring multiple transfusions as a result of a tongue piercing, says Dr Lester Mayers, director of sports medicine at Pace University in New York. Another person with a freshly pierced tongue contracted an infection that closed the airways and forced a lengthy hospital stay.
The risk of contracting hepatitis B or C is also very real, says Dr Sandra Kemmerly, an infectious disease specialist at the Ochsner Clinic Foundation in New Orleans. Presumably, HIV transmission is a risk as well, she adds.
Piercing is increasingly popular
Despite the hazards, body piercing is increasingly popular.
An article in the February 2001 issue of the Journal of School Nursing found a 283 percent rise in the number of body art studios in Texas between 1994 and 1998.
And a survey by Mayers of 454 students found that 60 percent of female students had one or more piercings in places other than their earlobes, and 42 percent of males had piercings in their earlobes and elsewhere.
Tongue piercing has serious complications
"We're talking about a very large number of people," Mayers says. "Even if it's a small percentage of complications that can be a large number because of the huge number of people who have the procedures."
Some of the most serious complications have resulted from tongue piercing.
"That's where we see the biggest problems," Kemmerly says. "I've seen cases that required antibiotics for long periods of time. The tongue was all swollen. The person couldn't eat. It was just gross."
A portal of entry for bacteria
The reason is the preponderance of bacteria that inhabit the mouth.
"We have provided a portal of entry for bacteria into the body," says Dr Matthew Messina, a spokesman for the American Dental Association. "We've basically said, 'Come on in.' We've intentionally opened a wound and are not permitting it to heal, so find me a reason why this is good."
The American Dental Association has issued a statement opposing oral piercing. One reason: Infections can close off the airway, potentially resulting in death.
And don't forget damage to teeth, including chipping, fractures, gum abrasion and tartar and plaque build-up, the ADA says.
"In life we make decisions and balance the risks and benefits and this is a procedure with some serious and potentially life-threatening risks which I have yet to see a benefit to," Messina says.
Nasty abdominal infections
Travelling south, the belly button is another area prone to infection. "It's close to the abdominal cavity," Kemmerly points out. "I've seen some nasty infections that required lancing - opening up the area and taking out the belly button ring."
The belly area also takes longer to heal from a piercing - some six to nine months, compared with two to three months in other areas, according to Mayers. And it's an intrinsically dirty area.
Ear cartilage – a different story
Ear lobes, of course, present fewer problems than other parts of the body. But ear cartilage is an entirely different story. Because this area doesn't have much of a blood supply, any infection that does develop will not heal as well or as quickly.
The Oregon case is instructive. Here, two things had gone wrong.
First, the cartilage had been pierced with spring-loaded "guns," which are prohibited for that use in many states, including Oregon. Second, the piercing booth, located within a mall, had inadequate sterilization procedures. One of the workers had sprayed the sterile gun with a commercial disinfectant that had the bacterium flowering in it.
The safe way of doing it
Is there such a thing as safe body piercing?
"There is a way to do it right," Texas Tech's Armstrong says. "The biggest thing is to have a knowledgeable artist that is in a clean environment that is concerned about adhering to regulations."
The main rules: Don't do it yourself and don't go to the local mall.
"I would recommend the body piercing studios before I would even go to the mall," Armstrong says. "They have fewer problems because they're in the business of doing this as opposed to 14- and 16 year-old girls who are doing it in the mall with no training and no concern for what they're doing."
Which doesn't mean you're home free, even if you go the studio route.
"For a lot of people who get this now, there seems to be a sense of self-expression," Mayers says. "If you want to do it, you should do it with as little risk as possible. But there's nobody who can tell you there's no risk at all." – (HealthScout News)
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