Got a problem with your 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.

Some localized swelling or induration is not uncommon during healing stages and is not necessarily indicative of complications. Oral piercings such as tongue and lip often swell significantly for several days following the piercing.

Healing piercings normally excrete an exudate of plasma, lymph, dead cells and so on. It should not be copious in quantity, malodorous, or green. It dries on the ring at the openings of the piercing forming a small amount of crystalline-appearing crust.

Ointments used for topical treatment are not usually efficacious for body piercings. They are occlusive and can limit oxygen circulation to the area, tending to delay healing of this type of wound. Also, ointments 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.

Jewellery in a healing piercing should not be too tight; it must allow for a certain amount of air and blood circulation, some movement during cleaning, and for the expulsion of normal exudate from the wound.

Piercings must be placed at a certain depth in order to be accepted and successfully healed by the body to remain long term. Those that are placed too close to the surface (or with jewellery that is too small or thin) may be perceived by the body as a splinter, worked towards the surface and eventually ejected. If jewellery is removed the holes close up and scarring is minimized. If the jewellery is allowed to come through the surface by itself a split scar may remain. If the area has been stable for some weeks and is not red or irritated, the jewellery may stay in place.

If a piercing is shallow enough that the jewellery can easily be seen right through the tissue, or if it encompasses less than 1/4 ”-5/16 ” of tissue the jewellery may require removal. If the tissue is red and indurated across the entirety of the piercing and it is very superficial, this generally indicates a piercing being rejected by the body.

Acceptable materials for wear in body piercings include high quality stainless steel (specifically 316LVM F-138), Niobium, Titanium (Ti6Al4V ELI), solid 14k or 18k white or yellow gold, solid platinum and dense, low-porosity plastic such as Tygon or PTFE. Appropriate jewellery has no nicks, scratches burrs or irregular surfaces that might en danger the tissue. Safety pins and other household objects are not put into piercings by professional body piercers.

Unfortunately some piercers use inferior jewellery that contains too much nickel or other irritating alloy resulting in a “metal allergy.” This condition is characterized by the appearance of the tissue retreating from the offending metal. The patient may present with complaints of itching, burning and/or tenderness. S/he may feel virtually no discomfort even though the piercing seems highly inflamed. In addition to localized dermatitis, the opening to the piercing will appear significantly larger than the size of the jewellery, and granulation tissue will be visible. This can be remedied by changing to an appropriate bio-compatible jewellery, Tygon, or PTFE.

Sutures are not an appropriate size or material for wear in body piercings. Any object that is too thin has potential to damage the tissue by cutting it. (Sutures used in the usual manner are positioned much closer to the body and so they are not apt to be caught and pulled, as can happen with a loop of suture hanging from a piercing).

Metal body jewellery will result in an opaque density on x-rays but will otherwise not affect visibility in radiographic examination. Nipple piercings are unlikely to obstruct visibility of any pathology on thoracic x-rays if both frontal and lateral views are taken.