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Body Piercings, Teens & Potential Health Risks: AAP Report Explained

​​​The earlobe is the most universal site for body piercing—but it's definitely not the only option out there. A 2010 Pew survey found nearly 25% of teenagers have a piercing somewhere other than an earlobe. The tongue, lips, nose, eyebrows, nipples, navel (belly button), and genitals can all be pierced. 

Among people who get a piercing other than the earlobe, about 1 in 3 end up having a complication. 

The American Academy of Pediatrics (AAP) clinical report Adolescent and Young Adult Tattooing, Piercing, and Scarification​ encourages parents and teens to consider the risks involved and details the adverse outcomes associated with body piercing.

Complications from Body Piercing:

  • Infection at the pierced site. Whenever the skin's protective barrier is broken, local skin infections from staph or strep bacteria are a risk. Of all the body sites commonly pierced, the navel is the most likely to become infected because of its shape. Infections can often be treated with good skin hygiene and antibiotic medications. With this type of infection, jewelry generally does not have to be taken out. This helps prevent the hole from closing and promotes drainage of the infected area.

  • Bloodstream infections. With any piercing, there is the danger of this type of infection, including the hepatitis B or C viruses and tetanus. These types of infections are commonly caused by contaminated piercing equipment. It is important to be up to date on immunizations, especially hepatitis B and tetanus, before having anything pierced.

  • Dental trauma. Tooth chipping (or fracture) is the most common dental problem related to tongue piercing. Lip or tongue jewelry can also cause gum problems and damage to the enamel; the jewelry can also become loose and be swallowed. Researchers have also found that, in some cases, the jaw bone may be affected requiring oral surgery to preserve the teeth. Infection of the mouth or lips may cause speech, chewing, or swallowing problems or swelling that can block the throat.

  • Allergic reactions. Nickel allergy is a very common and a potentially serious risk of piercing. Therefore, jewelry containing nickel must be avoided. It is important to know that some gold jewelry contains nickel. A reaction often requires the jewelry piece to be removed. Steroid creams can then be used to help stop the reaction. Poor quality jewelry can also cause the same problems as nickel. And teens are frequently on a tight budget, which means they may buy jewelry that is poor in quality.

  • Other jewelry-related problems. Jewelry absolutely must be new and never used by anyone else. It should also be the right size for the body part being pierced. If it is too big it could lead to large scars or tissue damage. If it's too small, it could cut the skin or break off. Prolonged wearing of heavy jewelry also may result in an elongated or deformed earlobe.

    • Jewelry in the genital area may cause injury and can cause a condom to break or a diaphragm to dislodge—increasing the risk of pregnancy and exposure to sexually transmitted infections.

    • Jewelry in the navel can get caught on clothing and linens. This constant irritation can delay healing. Navel piercings can take up to a year to heal completely.

    • Pointed earring posts may cause pressure sores or skin irritation when worn during sleep.

  • Tearing/accidents. Cuts and tears are common to pierced ears and may occur after falls, motor vehicle crashes, contact sports, person-to-person violence, or accidental pulling of an earring. To prevent scar tissue from forming and/or permanent deformity, tears should be repaired within 12 to 24 hours. 

  • Keloid formation. Keloids are overgrowths of fibrous tissue or scars that can occur in some people after even minor trauma to the skin—no small deal! In addition to aesthetic concerns, patients with keloids may have itching and tenderness.  Treatment options for keloids include: surgical excision, corticosteroid injections, cryosurgery (freezing), pressure dressings, radiation, and laser therapy. Those prone to keloid formation should probably not get piercings. Teens with a chronic medical condition or those who take daily medication (e.g., those with diabetes mellitus or taking corticosteroids) may be at a greater risk of complications from body piercings and should check with their pediatrician before getting pierced.  

Frequently Asked Questions About Teen Body Piercing:

Can a teen under the age of 18 (a minor by the law) unaccompanied by his or her parent, walk right into a piercing studio and get a piercing? 

  • That's a complicated question, as it depends on the state. At least 38 states have laws prohibiting minors from getting piercings without parental permission. New Jersey and Delaware require written parental consent, while Pennsylvania requires a parent to be present.

I've heard that pediatricians can pierce ears, etc. Is that true?

  • Because piercing studios are unregulated in many states, some pediatricians may choose to perform body piercing procedures in their own office setting. However, not all pediatricians offer this service and it is not covered by insurance. 

What questions should I ask about a piercing studio's process before my teen decides to get it?

  • Does the person doing the piercing wash his or her hands with a germicidal soap, wear fresh disposable surgical gloves, and use sterilized instruments or instruments that are thrown away after use? Although earrings may be sterilized before use, most piercing "guns" are not sterilized between procedures. Ear piercing systems using disposable sterile cassettes are available but are not always used. The professional piercer should be observed putting on new disposable gloves and removing new equipment from a sterile container. Click here to see a list of the Association of Professional Piercers' approved artists in your area.  

I think my daughter's piercing is infected. What are the signs? What should I do? 

  • Excessive redness, tenderness around the piercing site, prolonged bleeding, or change in skin color around the piercing area, are all signs that the piercing may be infected. If this is the case, or if there are other problems, such as excessive swelling or bleeding, call your pediatrician. Depending on the symptoms, he or she may recommend seeking emergency medical care. See Is It a Medical Emergency, or Not?.

Body Piercing Deserves Healthy Conversation:

Understanding the complications associated with piercing can help parents and teens make the right choices together. Sometimes, it's helpful to discuss any issues behind a teen's desire for a piercing and changing his or her appearance. Honest and open conversations between parents and teens—discussing the pros, cons, and underlying intentions—are essential.

Additional Information & Resources: 

Last Updated
9/18/2017
Source
Committee on Adolescence (Copyright © 2017 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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