Troubleshooting Piercing Problems

What is Normal? Discoloration
     Can be reddish, brownish, pinkish or purplish.
     Can remain for many months with certain piercings, such as
Swelling/Induration - localized, may be significant with oral
     piercings such as the lip or tongue, and may last several
     days immediately following the initial piercing.
Excretion - excretion of plasma, dead cells, etc. Should not
     be copious in quantity, malodorous, or green. Will form a   
     small amount of crystalline-appearing crust on the jewelry at
     the openings of the piercing.

What do I do?

I work at a piercing place in the mall. My kid brother was playing with the piercing gun, and to make a long story short it ended up getting stepped on and covered in blood. What to I do to sterilize it (beyond the usual)? After the accident I just wiped it down with alcohol wipes and used it on other customers. Now I'm wondering if it needs something extra. I don't think it's really supposed to get blood on it. Also, if I did clean it wrong, do I have to warn the customers who I used it on afterwards?

As you can see, there are a multitude of people and web sites that will be only too happy to explain in detail what is wrong with using piercing guns to put a piece of jewelry through a body part. This studio, Addicted 2 Tattoos, is totally against the use of piercing guns for any purpose. The only reason these (that use piercing guns) places exist is to sell jewelry and they are not concerned in the least with the fact that they are transferring dangerous, life threatening diseases to make a profit. They do not care for the customers or they would employ professionally trained body piercing artists to do the piercings in the correct, clean, safe, conscientious method that is in the best interest of the customer. BAN THE PIERCING GUN! BOYCOTT ANY BUSINESS THAT USES PIERCING GUNS! THIS IS THE ONLY WAY TO GET THEIR USE DISCONTINUED.

Things to consider when treating a troubled piercing or considering jewelry removal from a piercing: The majority of troublesome piercings can be resolved without the piercing being lost. Advice to simply "take it out" is likely to be met with resistance from the piercee, and if infected can lead to the formation of an abscess. Changes in aftercare and/or jewelry size, style or material may resolve the problems for the piercee/patient. Inappropriate placement can also be the cause of problems. In this case, removal is often required, and if done timely will prevent further problems. Even momentary removal of jewelry from a healing piercing can result in amazingly rapid closure of the piercing, and make reinsertion difficult or impossible. Ointments used for topical treatment are not preferred for body piercings. They prevent air circulation around the piercing and can limit oxygen circulation to the area, tending to delay healing of this type of wound. They leave a sticky residue that makes cleaning the healing tissue more difficult. If necessary, gels, creams, or other water-soluble products are preferred for topical application. Signs of accumulative allergic reaction to ointments are papules and redness of surrounding tissue.

At Addicted 2 Tattoos, we recommend H2Ocean sea-salt spray which is also an anti-bacterial, anti-microbial, anti-fungal topical treatment for new or healing piercings. We strongly advise using this product on any piercing that you are having trouble with. (Or, on any healing piercing!) We sell small sized cans in our store for $5.00. It could save your piercing if you are having problems.

Inappropriate after care is one of the most common causes of a distressed piercing. Alcohol, hydrogen peroxide, Betadine, Bactine, Hibiclens and/or ointments are all inappropriate products for body piercing aftercare. Over-cleaning can irritate piercings and delay healing. Daily mild, non-iodized sea salt or normal saline soaks and/or cleaning with a liquid anti-microbial or germicidal soap once or twice a day is suggested for body piercings. Daily mild non-iodized sea salt or normal saline rinses and/or antimicrobial or antibacterial alcohol-free mouth rinses, 4-5 times a day is suggested for oral piercings.

Jewelry Materials Acceptable materials for wear in body piercings include:
High quality surgical implant grade stainless steel (specifically 316LVM ASTM F-138), Niobium (although some people have had problems with this material in fresh piercings), Titanium (specifically Ti6A4V ELI, ASTM F-136), solid 14k or 18k white or yellow gold (although this does contain nickel which is known to cause problems with healing piercings - this applies to sterling silver also which contains nickel), solid platinum. Dense, low-porosity plastic such as Tygon or PTFE. Appropriate jewelry has no nicks, scratches, burrs or irregular surfaces that might endanger the tissue. Safety pins and other household objects are never put into piercings by professional body piercers. Some piercers use inferior jewelry that contains too much nickel or other irritating alloy resulting in a "metal allergy." Sutures are not an appropriate size or material for wear in body piercings.
Jewelry Sizes & Styles Click here for a chart of piercings and jewelry sizes.
Jewelry in a healing piercing should be of appropriate length and diameter. Too tight/small jewelry will not allow for air and blood circulation, some movement during cleaning, and for the expulsion of normal bodily excretions from the wound. It may imbed, and can increase the possibility of swelling and other complications. Jewelry in a healing piercing should be of an appropriate gauge (thickness). Too thin of a gauge, and the jewelry may be perceived by the body as a splinter, worked towards the surface and eventually ejected.
Jewelry: X-rays, MRI's and CT Scans Metal body jewelry will result in an opaque density on x-rays, but will not otherwise affect visibility on film. Nipple piercings are unlikely to obstruct visibility of any pathology on thoracic x-rays if both frontal and lateral views are taken. Appropriate body jewelry is non-magnetic, and as such does not need to be removed for MRI procedures unless it is located in the region being examined. Gold jewelry is much more thermal-conductive than steel. There is no need to cut body jewelry for removal. Even momentary removal of jewelry from a healing piercing can result in rapid closure of the piercing making reinsertion of jewelry difficult or impossible.
Placement PROBLEM: Piercing is placed too shallow or the jewelry is too small
CAUSE: A result of poor initial piercing placement or inappropriate jewelry selection (length/diameter).
RESULT: Body will work the jewelry towards the surface and eventually be ejected. This is referred to as migration.
INDICATIONS: Jewelry can be seen through the tissue.
Jewelry encompasses less than 1/4-5/16" of tissue or skin
Tissue is red and indurated across the entirety of the piercing and its placement very superficial.
TREATMENT: Removal of jewelry prior to ejection is preferable. If jewelry is removed, the holes close up and scaring is minimized. If the jewelry is allowed to come through the surface by itself a split scar may remain.

PROBLEM: Piercing is placed too deep or the jewelry is too small (length/diameter).
CAUSE: Result of poor initial piercing placement (most common). Delayed complication of swelling. Poor/inappropriate aftercare. Inappropriate jewelry selection (length/diameter).
RESULT (includes but is not limited to): Prolonged healing time. Impossible to heal. Unnecessary/unusual scaring
INDICATIONS: (with ring) Ring is unable to lay flat comfortably. The tissue takes up more than 1/3 of the ring's circumference.
INDICATIONS: (with barbell) Bar post can't be seen at either end of the piercing. Beads/Ends of the jewelry pinch or are actually imbeded in the tissue.
TREATMENT: Replacing of small jewelry for appropriately sized jewelry. Removal of jewelry to allow healing of too-deep piercing. Can be repierced at a later date.

Infected Piercing PROBLEM: Piercing has been contaminated by a pathogenic microorganism(s). The most common reasons for this is not washing hands before touching the piercing and because the piercing came into contact with dirty clothes, linens, environments, or surfaces. Always wash your hands before touching your piercing, no exceptions!
CAUSES: Contaminated piercing, exposure to bodily fluids, dirty water, dirty hands, dirty linens and bed sheets, dirty surfaces, dirty environments. Piercing has been done with inappropriately sterilized tools, needles, jewelry. Piercing has been done with unclean, ungloved, and/or contaminated gloved hands.
INDICATORS: Piercing exudes thick, green, malodorous pus. Piercing and surrounding area is warm/hot to the touch (more so than other skin). Piercing site is swollen, red and painful.
TREATMENT: Increased mild sea salt soaks (for minor infections). Oral/topical antibiotics, as prescribed by a physician. Removal of jewelry in the presence of an infection may result in an abscess. In the event there is a localized, draining infection, quality jewelry should be left in place to allow for passage of matter to the surface. Removing the jewelry in most cases is not recommended.
Another method of clearing up an infection is to discontinue salt soaks, switch to hydrogen peroxide. (Due to some having sensitivity to hydrogen peroxide, these people may have to use 1/2 peroxide and 1/2 water mix.) This is only recommended for a piercing that develops an infection, has drainage, is hot to the touch and/or is red/swollen. We normally do not recommend peroxide because it kills new skin cells that are trying to heal the piercing. But, in the event of problems, use the peroxide to completely immerse the piercing for 5-10 minutes, 3-4 times a day, for ONLY 2 DAYS. After this go back to using sea salt soaks as recommended by the piercer. If after 2 days of salt soaks, the problem persists, again stop the salt soaks and use peroxide for 2 days ONLY. Then, go back to using the salt soaks. If after 2-3 cycles of using peroxide the problem persists, seek medical help. (**Any advice here is not intended to replace professional, medical services, and is only offered as a guideline for treating piercing problems. We do not have a medical license and are not giving out medical advice, just passing along what has worked for us in the past, from personal experience.)
COMPLICATIONS: Abscesses are usually site specific. An exception is the chest where the duct system can result in the abscess being formed inches away from the piercing site.
Allergic Reactions PROBLEM: Metal allergy.
CAUSE: Inferior jewelry has been used and may contain too much nickel or other irritating alloy.
INDICATIONS: Tissue appears to "retreat" from the offending metal. Patient may present with complaints of itching, burning and/or tenderness. S/he may feel virtually no discomfort, even though the piercing seems to be highly inflamed. In addition to localized dermatitis, the opening of the piercing may appear significantly larger than the size of the jewelry. Redness where the jewelry rests on the surface of the skin. Granulation tissue will be visible.
SOLUTION/TREATMENT: Change to an appropriate biocompatible jewelry such as Titanium; or a dense, low porosity plastic such as Tygon or PTFE.

PROBLEM: Product sensitivity.
CAUSE: After care products are inappropriate, or the piercee has a product allergy or sensitivity.
INDICATIONS: Delayed healing, localized irritation. Tissue surrounding (up to several inches away) the piercing is red, seeping, or contact dermatitis is present. Expansion of the piercing channel.
TREATMENT: Discontinue current care regimen in favor of milder products and/or less care.
COMPOUNDED PROBLEMS: Any one of the above problems can make additional or secondary problems more likely; i.e. an allergic reaction to an inappropriate metal can make a piercee more vulnerable to infection or a reaction to cleaning products. One should be aware when trying to evaluate a troubled piercing, that multiple causes may be affecting it. In addition, overall health and stress level can be crucial to the healing process and should be evaluated and treated as a potential cause for complications with a healing piercing.

Jewelry Removal If at all possible, return to the piercer who did the original piercing for removal of jewelry. If this is not possible, continue reading.
There are three basic styles of body jewelry and many variations of those styles. The three styles are a bead ring, captive bead, and circular barbell/barbell.

There is never any need to cut body jewelry for removal.

Even momentary removal of jewelry from a healing piercing can result in rapid closure of the piercing, making reinsertion difficult or impossible.

Removal of jewelry in the presence of an infection may result in an abscess. In the event there is a localized, draining infection, quality jewelry should be left in place to allow for passage of matter to the surface.

On a bead ring, the bead is attached to one side of the ring. To open the ring for removal, simply twist the ring open. Grasp the ring on each side of the bead, pull gently and one end will pop out of the bead. By pushing one end away from you and pulling the other end toward you to open the ring like a spiral.

On a captive bead ring, the bead is held in by the tension of the ring. Grasp the ring with one hand as close to the bead as you can and with the other hand grasp the bead. Gently pull the ring and bead in opposite directions and the bead should snap out of the ring. twist the ring a little (as in opening a bead ring) and rotate the jewelry to remove the ring.

Barbells and circular barbells have threaded ends which can be unscrewed. Like most threaded objects, they tighten to the right and loosen to the left. On this type of jewelry, one or both of the ends will come unscrewed.

Ring expanding pliers or external snap ring pliers can be used to spread a ring open enough to pop a bead in or out. Place the head of the pliers inside the ring and gently squeeze on the handle to spread the jaws outward, opening the ring just enough to pop the ball out.

Piercing Horror Story #1 - Real client story

Recently we had a customer come into the shop for an eyebrow piercing.  While inspecting her eyebrow, it was noticed that there were pockmarks exactly where the piercing is traditionally placed, so he asked if she had had her eyebrow pierced before.  She said that she had it pierced many years ago in a flea market tattoo shop, and had had complications.  The piercer asked about the complications and found out that she had gotten a massive infection that had damaged her liver.  Her liver now functions at only 50%.  The piercer then asked her about the actual procedure used on her original piercing.  She explained that the low priced shop had used an ear-piercing gun (like you see at Piercing Pagoda, Clair’s Boutique, et al.).  The piercer questioned her further and she said that the piecing gun was already set up when she sat down, and that was in an open space shared by several “artists” simultaneously.  (That means it probably was not sterile, as most piercing guns cannot be sterilized.) She then said they took an endless hoop out of the jewelry case (yes, an unsterilized display item), removed the piercing stud entirely, and then forced the endless hoop through.  By the next day she looked like she had lost a heavy-weight prize fight.  ( A lot of bruising and her eye swelled closed – the problem persisted for approximately 2 weeks until she could see clearly again and the bruising had faded.) A month later she was in the hospital fighting for her life. The infection went into her blood and then to her liver which was irreparably damaged because of the piercing infection.

The moral to this story is Pay attention and Pay a proNEVER EVER allow anyone to pierce you with a piercing gun.  Not only are they NOT sterile, they cannot be sterilized!  Besides that very gross problem, they also inflict far more trauma to the piercing than a piercing needle because the “piercing stud” is a blunt tip object pushed through your skin with concentrated force.  (In our humble opinion) . . . . ONLY A FOOL OF AN AMATEUR WOULD EVER PIERCE ANYONE WITH A PIERCING GUN.  Any money you might save with one of these idiots will be spent at the doctors office or hospital later tenfold.

A professional body piercer uses a sterile needle that is razor sharp (beveled inside and outside to make a clean, smooth opening in the skin) so that it goes through the skin smoothly and easily.  He or she also uses sterile jewelry and sterile tools.  All of these things (the needle, the jewelry, and any tools used during the piercing) should still be in sealed medical envelopes when you sit down for your piercing.  If they aren’t don’t walk, RUN AWAY.

You might save a few bucks going to the flea-market for your piercing (or tattoo), but is it worth the risk?!  YOUR LIFE IS WORTH MORE THAN THE FEW BUCKS YOU MIGHT SAVE ISN’T IT?! We think it is and invite you to visit the professionals at Addicted 2 Tattoos for your next piercing to get it done the right way!

What are some questionable or non-recommended piercings?

(To find out why these are considered dangerous, please refer to Elayne Angel's book: The Piercing Bible.)

The Lingual Frenulum Piercing is piercing the web under the tongue.
Lip surfaces, upper or lower, vertical or transverse.
Smiley/Scrumper and Frowny
Cheek/Dimple Piercing
Mandible or Sprung Piercing
Transverse Tongue
Lowbret or Vertical Lowbret
Lip surface or chin surface
Tongue surface
Outie Navels
Princess Albertina
Deep penile shaft
Trans-scrotal piercing
Behind bone, tendon, or other anatomical structure
Hand Web
Disclaimer: These guidelines are based on a combination of vast professional experience, common sense, research, and extensive clinical practice. This not to be considered a substitute for medical advice from a doctor. Be aware, however, that many doctors have no specific training or experience regarding piercing and may not be educated on how to best assist you.

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