Skip to main content

Piercings: Techniques and Complications

  • Chapter
  • First Online:
Dermatologic Complications with Body Art

Abstract

With the increasing popularity of body piercing, not only piercers but also healthcare professionals should be aware of the potential risks of this procedure and be able to recognize and handle complications. More in particular young adolescents represent a vulnerable group of customers. Risks of the procedure are bleeding, swelling, infection, and contact dermatitis caused by nickel allergy. Blood-borne diseases can be transmitted; granuloma, scarring, and keloid formation can occur. Oral piercings can damage the gums and teeth and interfere with medical interventions. Genital piercings can cause discomfort and even lead to sterility. Public awareness, good guidelines, and uniform regulation can help to minimize complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferguson H (1999) Body piercing. BMJ 319:1627–1629

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Laumann AE, Derick AJ (2006) Tattoos and body piercing in the United States: a national data set. J Am Acad Dermatol 55:413–421

    Article  PubMed  Google Scholar 

  3. Panconesi E (2007) Body piercing: psychological and dermatologic aspects. Clin Dermatol 25:412–416

    Article  PubMed  Google Scholar 

  4. http://en.wikipedia.org/wiki/Microchip_implant_(human). Accessed 29 June 2017

  5. Armstrong ML, Koch JR, Saunders JC et al (2007) The whole picture: risks, decision making, purpose, regulations, and the future of body piercing. Clin Dermatol 25:398–406

    Article  PubMed  Google Scholar 

  6. Melles GRJ, Ververs B, van der Linden JW (2004) Cosmetic extraocular implant. J Cataract Refract Surg 30:1595. Scholarly Journal Article

    PubMed  Google Scholar 

  7. Stirn A (2003) Body piercing: medical consequences and psychological motivations. Rev Lancet 361:1205–1215

    Article  Google Scholar 

  8. De Cuyper C (2016) Vulvar body art. In: Kirtschig G, Cooper SM (eds) Gynecologic dermatology: symptoms, signs and clinical management, vol 41. JP Medical Ltd, London, pp 265–271

    Chapter  Google Scholar 

  9. Angel E (2009) The Piercing Bible. The definitive guide to safe body piercing. www.piercingbible.com/female-genital-piercings. Accessed 29 June 2017

  10. https://echa.europa.eu/documents/10162/7851171d-53e9-455a-8bb8-7ca22e89ad87. Accessed 28 Sept 2017

  11. Lidén C, Norberg K (2005) Nickel on the Swedish market. Follow-up after implementation of the nickel directive. Contact Dermatitis 52:29–35

    Article  PubMed  Google Scholar 

  12. Thyssen JP (2011) Nickel and cobalt allergy before and after nickel regulation—evaluation of a public health intervention. Contact Dermatitis 65(S1):1–68

    Article  PubMed  Google Scholar 

  13. Thyssen JP, Maibach HI (2008) Nickel release from earrings purchased in the United States: the San Francisco earring study. J Am Acad Dermatol 58(6):1000–1005

    Article  PubMed  Google Scholar 

  14. Schnuch A, Schwitulla J (2013) Decrease in nickel allergy in women after the second EU nickel directive. Contact Dermatitis 69(4):253–256

    Article  PubMed  Google Scholar 

  15. Garg S, Thyssen JP, Uter W et al (2013) Nickel allergy following European Union regulation in Denmark, Germany, Italy and the U.K. Br J Dermatol 169(4):854–858

    Article  CAS  PubMed  Google Scholar 

  16. Waugh M (2007) Body piercing: where and how. Clin Dermatol 25:407–411

    Article  PubMed  Google Scholar 

  17. www.safepiercing.org/index.html. The Association of Professional Piercers website. Accessed 29 June 2017

  18. https://www.health.belgium.be/fr/ar-reglementant-les-tatouages-et-les piercings. Accessed 29 Sept 2017

  19. Worp J, Boonstra A, Coutinho RA et al (2006) Tattooing, permanent makeup and piercing in Amsterdam; guidelines, legislation and monitoring. Euro Surveill 11(1):34–36

    Article  CAS  PubMed  Google Scholar 

  20. Armstrong ML, Fell RP (2000) Body art: regulatory issues and the NEHA body art model code. J Environ Health 62(9):25–30

    Google Scholar 

  21. https://www.aad.org/Forms/Policies/Uploads/PS/PS-Body%20Piercing.pdf. Accessed 29 Sept 2017

  22. Breuner CC, Levine DA, AAP the Committee on Adolescence (2017) Adolescent and young adult tattooing, piercing, and scarification. Pediatrics 140(4):e20171962

    Article  Google Scholar 

  23. Purim KSM, Rosario BA, Rosario CS, Guimarães ATB (2014) Piercings in medical students and their effects on the skin. An Bras Dermatol 89(6):905–910

    Article  PubMed  PubMed Central  Google Scholar 

  24. Müller CSL, Oertel A, Körner R et al (2017) Socio-epidemiologic aspects and cutaneous side effects of permanent tattoos in Germany—tattoos are not restricted to a specific social phenotype. Dermatoendocrinology 9(1):e1267080

    Article  Google Scholar 

  25. Kaatz M (2001) A trend and its complications: piercing. Kosmet Med 24:188–193

    Google Scholar 

  26. O’Malley PA (2013) Tattoos and piercings: reasons, risks, and reporting: update for the clinical nurse specialist. Clin Nurse Spec 27(1):14–16

    Article  PubMed  Google Scholar 

  27. Holbrook J, Minocha J, Laumann A (2012) Body piercing: complications and prevention of health risks. Am J Clin Dermatol 13(1):1–17

    Article  PubMed  Google Scholar 

  28. Handrick W, Nenoff P, Müller H et al (2003) Infections caused by piercing and tattoos—a review. Wien Med Wochenschr 153:194–197

    Article  PubMed  Google Scholar 

  29. Tweeten SS, Rickman LS (1998) Infectious complications of body piercing. Clin Infect Dis 265:735–740

    Article  Google Scholar 

  30. Ahmed-Jushuf IH, Selby PL, Brownjohn AM (1984) Acute post-streptococcal glomerulonephritis following ear piercing. Postgrad Med J 60:73–74

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Bader MS, Hamodat M, Hutchinson J (2007) A fatal case of Staphylococcus aureus: associated toxic shock syndrome following nipple piercing. Scand J Infect Dis 39:741–743

    Article  PubMed  Google Scholar 

  32. McCarthy VP, Peoples WM (1988) Toxic shock syndrome after ear piercing. Pediatr Infect Dis J 7:741–742

    Article  CAS  PubMed  Google Scholar 

  33. Mandavia R, Kapoor K, Ouyang J et al (2014) Evaluating ear cartilage piercing practices in London, UK. J Laryngol Otol 128(6):508–511

    Article  CAS  PubMed  Google Scholar 

  34. Hardee PS, Mallya LR, Hutchinson IL (2000) Tongue piercing resulting in hypotensive collapse. Br Dent J 24:57–58

    Google Scholar 

  35. Kleer de N, Cohen M, Semple J et al (2001) Nipple piercing may be contraindicated in male patients with breast implants. Ann Plast Surg 47:188–190

    Article  Google Scholar 

  36. O’Malley CD, Smith N, Braun R et al (1998) Tetanus associated with body piercing. Clin Infect Dis 26:735–740

    Article  Google Scholar 

  37. Brook I (2001) Recovery of anaerobic bacteria from 3 patients with infection at a pierced body site. Clin Infect Dis 33:e12

    Article  CAS  PubMed  Google Scholar 

  38. Rowshan HH, Keith K, Baur D et al (2008) Pseudomonas aeruginosa infection of the auricular cartilage caused by high ear piercing: a case report and review of the literature. J Oral Maxillofac Surg 66:543–546

    Article  PubMed  Google Scholar 

  39. Bellaud G, Canestri A, Gallah S et al (2017) Bacterial chondritis complications following ear piercing. Med Mal Infect 47(1):26

    Article  CAS  PubMed  Google Scholar 

  40. Javaid M, Shibu M (1999) Breast implant infection following nipple piercing. Br J Plast Surg 52:676–677

    Article  CAS  PubMed  Google Scholar 

  41. Trupiano JK, Sebek BA, Goldfarb J et al (2001) Mastitis due to Mycobacterium abscessus after body piercing. Clin Infect Dis 33:131–134

    Article  CAS  PubMed  Google Scholar 

  42. Kaur C, Sarkar R, Kanwar AJ (2003) How safe is nose-piercing? Inoculation cutaneous tuberculosis revisited. Int J Dermatol 42:645–646

    Article  PubMed  Google Scholar 

  43. Ferringer T, Pride H, Tyler W (2008) Body piercing complicated by atypical mycobacterial infections. Pediatr Dermatol 25:219–222

    Article  PubMed  Google Scholar 

  44. Meltzer D (2008) Commentary-complications of body piercing. Pediatr Dermatol 25:283–284

    Article  PubMed  Google Scholar 

  45. Dänhert I, Schneider P, Handrick W (2004) Piercing and tattoos in patients with congenital heart disease—is it a problem? Z Kardiol 93:618–623

    Google Scholar 

  46. Millar BC, Moore JE (2004) Antibiotic prophylaxis, body piercing and infective endocarditis. J Antimicrob Chemother 53:123–126

    Article  CAS  PubMed  Google Scholar 

  47. Hill C (2004) Comment on: antibiotic prophylaxis, body piercing and infective endocarditis. J Antimicrob Chemother 54:278

    Article  CAS  PubMed  Google Scholar 

  48. Ochsenfahrt C, Friedl R, Hannekum A et al (2001) Endocarditis after nipple piercing in a patient with a bicuspid aortic valve. Ann Thorac Surg 71(4):1365–1366

    Article  CAS  PubMed  Google Scholar 

  49. Shebani S, Miles HFJ, Simons P et al (2007) Awareness of the risk of endocarditis associated with tattooing and body piercing among patients with congenital heart disease and pediatric cardiologists in the United Kingdom. Arch Dis Child 92:1013–1014

    Article  PubMed  PubMed Central  Google Scholar 

  50. Man de RA, Bosman A, Stevens-Schretzmeijer M et al (1999) Two patients with acute hepatitis B from the same piercing salon. Ned Tijdschr Geneeskd 1143:2129–2130

    Google Scholar 

  51. Hayes MO, Harkness GA (2001) Body piercing as a risk factor for viral hepatitis: an integrative research review. Am J Infect Control 29(4):271–274

    Article  CAS  PubMed  Google Scholar 

  52. www.cdc.gov/ncidod/diseases/hepatitis/c/index.html Centers for disease control and prevention. Accessed 29 June 2017

  53. Pugatch D, Mileno M, Rich JD (1998) Possible transmission of human immunodeficiency virus type 1 from body piercing. Clin Infect Dis 26:767–768

    Article  CAS  PubMed  Google Scholar 

  54. www.cdc.gov/hiv/basics/transmission.html. Centers for Disease Control and Prevention. HIV transmission. Accessed 29 June 2017

  55. Yang S, Wang D, Zhang Y et al (2015) Transmission of hepatitis B and C virus infection through body piercing: a systematic review and meta-analysis. Medicine (Baltimore) 94(47):e1893

    Article  Google Scholar 

  56. Tohme RA, Holmberg SD (2012) Transmission of hepatitis C virus infection through tattooing and piercing: a critical review. Clin Infect Dis 54(8):1167–1178

    Article  PubMed  PubMed Central  Google Scholar 

  57. Hendricks WM (1991) Complications of ear piercing: treatment and prevention. Cutis 48(5):386–394

    PubMed  CAS  Google Scholar 

  58. Watson D (2002) Torn earlobe repair. Otolaryngol Clin North Am 35(1):187–205, vii–viii

    Article  PubMed  Google Scholar 

  59. Park SS, Hood RJ (2001) Auricular reconstruction. Otolaryngol Clin N Am 34(4):713–738, v–vi

    Article  CAS  Google Scholar 

  60. Neiburger E (2006) A large hypertrophic-keloid lesion associated with tongue piercing: case report. Gen Dent 54:46–47

    PubMed  Google Scholar 

  61. Uter W, Schmid M, Schmidt O et al (2014) Cobalt release from earrings and piercing jeweler—analytical results of a German survey. Contact Dermatitis 70(6):369

    Article  CAS  PubMed  Google Scholar 

  62. Conde-Taboada A, Roson E, Fernandez-Redondo V et al (2007) Lymphomatoid contact dermatitis induced by gold earrings. Contact Dermatitis 56(3):179–181

    Article  PubMed  Google Scholar 

  63. Mehta V, Balachandran C (2010) Persistent nodular contact dermatitis to gold: case report of two cases. Indian J Dermatol Venereol Leprol 76(4):397–399

    Article  PubMed  Google Scholar 

  64. Worm M, Brasch J, Geier J et al (2005) Patch testing with the DKG standard series 2001–2004. Results from de IVDK. Hautarzt 56:1114–1124

    Article  CAS  PubMed  Google Scholar 

  65. Casper C, Groth W, Hunzelmann N (2004) Sarcoidal-type allergic contact granuloma: a rare complication of ear piercing. Am J Dermatopathol 26:59–62

    Article  CAS  PubMed  Google Scholar 

  66. Sugden P, Azad S, Erdmann M (2001) Argyria caused by an earring. Br J Plast Surg 54(3):252–253

    Article  CAS  PubMed  Google Scholar 

  67. Hennequin-Hoenderdos NL, Slot DE, Van der Weijden GA (2016) The incidence of complications associated with lip and/or tongue piercings: a systematic review. Int J Dent Hyg 14(1):62–73

    Article  CAS  PubMed  Google Scholar 

  68. Levin L, Zadik Y (2007) Oral piercing: complications and side effect. Review article. Am J Dentistry 20:340–344

    Google Scholar 

  69. Lopez-Jornet P, Navarro-Guardiola C, Camacho-Alonso F (2006) Oral and facial piercings: a case series and review of the literature. Int J Dermatol 45:805–809

    Article  PubMed  Google Scholar 

  70. Vieira EP, Ribeiro ALR, Pinheiro J de JV, Alves S de M (2011) Oral piercings: immediate and late complications. J Oral Maxillofac Surg 69(12):3032–3037

    Article  PubMed  Google Scholar 

  71. Kapferer I, Hienz S, Ulm C (2008) Labial piercing and localized periodontal destruction-partial periodontal regeneration following periodontal debridement and free gingival graft. Dent Traumatol 24:112–114

    Article  PubMed  Google Scholar 

  72. Ziebolz D, Stuehmer C, van Nüss K, Hornecker E, Mausberg RF (2009) Complications of tongue piercing: a review of the literature and three case reports. J Contemp Dent Pract 10(6):E065–E071

    PubMed  Google Scholar 

  73. Perkins CS, Meisner J, Harrison JM (1997) A complication of tongue piercing. Br Dent J 182:147–148

    Article  CAS  PubMed  Google Scholar 

  74. Lopez-Jornet P, Gomez Garcia F (2008) Retained lips stud: complication of labial piercing. J Eur Acad Dermatol Venereol 22:770–771

    Article  CAS  PubMed  Google Scholar 

  75. Watson MG, Campbell JB, Pahor AL (1987) Complications of nose piercing. Br Med J (Clin Res Ed) 294(6582):1262–1264

    Article  CAS  Google Scholar 

  76. Becker PG, Turow J (1986) Earring aspiration and other jewelry hazards. Pediatrics 78(3):494–496

    PubMed  CAS  Google Scholar 

  77. Dhir S, Dhir AK (2007) Intraoperative loss of nasal jeweler: anesthetic concerns and airway management. J Clin Anesth 19:378–380

    Article  PubMed  Google Scholar 

  78. Mejersjö C, Ovesson D, Mossberg B (2016) Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students. Acta Odontol Scand 74(4):279–284

    Article  PubMed  Google Scholar 

  79. Hansen RB, Olsen LH, Langkilde NC (1998) Piercing of the glans penis. Scand J Urol Nephrol 32(3):219–220

    Article  CAS  PubMed  Google Scholar 

  80. Jones SA, Flynn RJ (1996) An unusual (and somewhat piercing) cause of paraphimosis. Br J Urol 78(5):803–804

    Article  CAS  PubMed  Google Scholar 

  81. www.eadv.org/campaigns. Accessed 28/06/2017

    Google Scholar 

  82. Antoszewski B, Jedrzejczak M, Kruk-Jeromin J (2007) Complication of body piercing in patient suffering from type 1 diabetes mellitus. Int J Dermatol 46:1250–1252

    Article  PubMed  Google Scholar 

  83. Shaffer JJ, Taylor SC, Cook-Bolden F (2002) Keloidal scars: a review with a critical look at therapeutic options. J Am Acad Dermatol 46(2, suppl understanding):S63–S97

    Article  PubMed  Google Scholar 

  84. Aköz T, Gideroğlu K, Akan M (2002) Combination of different techniques for the treatment of earlobe keloids. Aesthetic Plast Surg 26(3):184–188

    Article  PubMed  Google Scholar 

  85. Jones ME, McLane J, Adenegan R, Lee J, Ganzer CA (2017) Advancing keloid treatment: a novel multimodal approach to ear keloids. Dermatol Surg 43(9):1164–1169

    Article  CAS  PubMed  Google Scholar 

  86. Jones ME, Hardy C, Ridgway J (2016) Keloid management: a retrospective case review on a new approach using surgical excision, platelet-rich plasma, and in-office superficial photon X-ray radiation therapy. Adv Skin Wound Care 29(7):303–307. https://doi.org/10.1097/01.ASW.0000482993.64811.74. PMCID: PMC4915758

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This chapter was realized with the contribution of Davy D’hollander, Tek Tik, Antwerpen, Belgium who provided piercing material illustrations.

Kim Maertens, Inksane, Roeselare, Belgium, demonstrated the piercing procedure for video recording.

Elayne Angel, Merida, Mexico provided illustrations.

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

5.1 Electronic Supplementary Material

Video 5.1

Piercing procedure (Courtesy of Dr. De Cuyper and Kim Martens, Belgium) (MP4 245684 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

De Cuyper, C., S., M.L.PC., Cullen, R. (2018). Piercings: Techniques and Complications. In: De Cuyper, C., PĂ©rez-Cotapos S, M. (eds) Dermatologic Complications with Body Art. Springer, Cham. https://doi.org/10.1007/978-3-319-77098-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77098-7_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77097-0

  • Online ISBN: 978-3-319-77098-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics