A lingering fad in the 80's with an uncertain period in the early 90's when earring-sidedness implied a sexual preference, body piercing has since surged into mainstream acceptance and continues to gain increasing popularity in diverse niches - the emerging pubescents, the X'ers, the aging baby boomers, the fringe conservatives in midlife crisis.

Say hello to Generation P, the pierced generation.

Suddenly ubiquitous, body piercing has been in use since antiquity: the Mayans with its religious ritual of tongue piercing, the buccal labrets worn by Aztecs of higher caste, the Egyptian pharaoh's pierced navels as a sign of royalty, and the Roman soldiers' nipple piercing for virility and loyalty to the emperor. In the Alaskan Tlingit people, nose piercing was a status symbol. On the other end of that historical spectrum, piercing is considered taboo or unacceptable in some cultures and religions.

Today, body piercing is both protest and fashion. For some it provides a benign continuum for social protest. For most, it is a fashion statement, the accouterment of "cool" without the permanence of tattoos, from the simple and elegant to the absurd and bizarre. For some, it is the extremist expressive art form. For a few, it is a journey into its stimulatory possibilities.

Although the ear is most commonly pierced, no area is exempt. Barbells, rings, studs and labrets now dangle, decorate and pierce the common and intimate parts of the anatomic landscape: lips, tongue, eyebrows, nose, nipples, navels, the penis and scrotum, the clitoris and vaginal lips.

As popularity has zoomed, so have complications. The fad has spawned an unregulated industry of "studios," many manned by untrained "experts" with inadequate grasp of the essentials of anatomy and the gamut of potential complications. Perhaps, 50% might even be done by children on children, who after failing to get parental permission turn to their friends or pierce themselves.

The explosion in piercing's popularity was associated with an astounding rise in nickel allergy. By 1993, 25% more people had nickel allergy compared to 1985. 13% of 8- to 15-year old girls with pierced ears have nickel allergy compared to 1% in those with unpierced ears. Among nickel-allergic women, 95% have pierced ears.

A radical and fringe form of body piercing - implants - has emerged, and fortunately, has not caught on. It involves the insertion of small beads or 3-D art implants (rings, crosses, barbels) and a variety of transdermal implants. Beware, It is a much more complicated process requiring professional skills in a sterilized environment.

• Piercing has gone from "in" to "mainstream" fashion statement. And so often, fashion turns into a folly of the past. And alas, piercings leave scars and holes—relics of your past that might hamper your employability. And with the popularity of multiple facial/ear piercings, later regrets might not be amenable to expensive plastic surgical efforts.
• Since the late 90s, estimates for body modification (tattoos and piercings) among US adolescents range from 10% to 25%. (7)

People heal at varying rates and healing time varies widely by site, from 3 weeks to a year: Tongues heal in 3 to 6 weeks; ears, lips and eyebrows in 6 to 8 weeks, nipples in 8 to 16 weeks; and navels and other areas because they are covered by tight waistbands or exposed to repeated trauma, may take up to nine months or longer. Piercing of the cartilage along the top of the ear heals more slowly than pierced earlobes. 

Typical Healing Times









Lip, Cheek






     Penile meatus (Prince Albert)
     Glans penis
          Apadravya (front to back)
          Ampallang (side to side)
     Clitoral hood
     Inner labia
     Outer labia



If constantly itchy, red, sore or oozing pus, the piercing is likely infected. Infectious complications are common, 10-25% in earlobe piercings, usually Staphylococcus aureus; rarely, bacteremia and endocarditis can occur. In piercings involving the auricular cartilage, Pseudomonas infections may develop and require extensive surgical intervention. Body piercing has also been implicated in the transmission of tuberculosis, hepatitis B, C and D, tetanus, toxic shock syndrome, and even HIV. Neisseria Meningitis has been implicated in a bacterial infection arising from a tongue piercing.
Allergic reactions
• Probably the most common complication of piercings, presents as draining, itching and crusting around the jewelry, entrance and exit holes.
• Metal allergy is usually due to nickel contained in 316L stainless steel and certain gold alloys. In such cases, titanium, stainless steel or niobium may be hypoallergenic alternatives.

Oral complications
• Tongue piercings can chip and crack the teeth and damage the gums. Tongue swelling may occur that can interfere with chewing and swallowing.
Keloids, scarring, migration or rejection can occur. Early consultation with a physician is suggested.

  1. Always wash hands thoroughly before handling the piercing site.
  2. Cleanse the area twice daily.
  3. Remove dried matter on jewelry and around piercing sites with a moist cotton swab.
  4 . Soaking the area in salt water can facilitate healing and help loosen crusty formations.
  5 . Avoid the use of rubbing alcohol or hydrogen peroxide—they may discolor the jewelry, dry out the skin and delay healing.
  6 . Three times a daily, pour water over the site and apply a small amount of antibacterial soap. Gently massage into the area.
  7 . Carefully work the jewelry back and forth 5 or 6 times.
  8 . After 2-3 minutes, rinse the area thoroughly to remove all cleansing solution and dry carefully.
  9. Avoid over-use of antibiotic ointments as they block the air from the pierced area.
10. For tongue and lip piercings, use a saltwater rinse or an antibacterial mouthwash after each meal or snack.

1. Limit ear piercing to the lobe. Piercings of the ear cartilage can result in more difficult infections.
2. Because of sterilizing concerns, use of sterile disposable hollow needles is preferable to ear-piercing guns.
3. If infection develops despite post-piercing care, consult a physician for early definitive treatment.
4. Wherever possible, seek reputable, trained, certified or licensed piercers. Inexperience is associated with higher complications.

- In a pilot survey for the prevalence data on body piercing and tattooing, among 32 people with body piercing and/or tattoos, 13 had piercings and tattoos, 11 had tattoos only, and 6 had piercings only. In these 32 respondents, there were a total of 199 body piercings and 105 tattoos. Of the latter, 2 have been removed and 5 were kept covered.
- Alcohol may play a role in the decision for piercing or tattooing & shy; 28 of the 32 consumed a mean of 6 alcoholic beverages a day.
- Intimate or genitalial piercing may involve a pseudosexual relationship with the piercer.

Marker for Risk Taking:
A 2002 study assessed tattoos and body piercing as markers of risk-taking in 484 adolescents for behaviors as eating disorders, illegal drug use, sexual activity, and suicide. (7)
Antisocial Activity / Risk Behaviors: A review of 23 published studies suggest that body piercing may relate to high-risk behaviors and psychiatric symptoms such as suicidal thoughts. Body piercing ranged from 6.8% to 14% in the general population and from 4.3% to 51% among teenagers and young adults. Piercing was more likely in females. It was found associated with antisocial activity, with a wide range of potentially harmful behaviors: alcohol use, smoking, drug use, high-risk sex, Russian roulette and problem gambling.

Additional Sources and Suggested Readings
Prevalence Survey of Tattooing/Body Piercing / Sally Kock Kubetin. Internal Medicine News. April 1, 2004
Piercing's Popularity Tied to Rise in Nickel Allergy / Internal Medicine News. April 13, 2003
The Female Patient: Body Piercing, A New Challenge / Carol Hasenyager, MD. Vol 25. July 2000. Clin Infect Dis 1998 Mar;26:735-40. 767-8.
Body Piercing: Seductions and Medical Complications of a Risky Practice / Charles Stewart, MD., Medical Aspects of Human Sexuality. July 2001
The Dangers of Tattooing and Body Piercing (Everything You Need To Know About) / Laura Reybold, Rosen Publishing, Revised Edition 2001
Body piercing as a risk factor for viral hepatitis: an integrative research review. / Hayes MO1, Harkness GA. / Am J Infect Control. 2001 Aug;29(4):271-4
Piercing among adolescents: Body art as risk marker: A population-based survey. / Joan-Carles Suris, MD, PhD, MPH, André Jeannin, MA, Isabelle Chossis, MD, Pierre-André Michaud, MD / J Fam Pract. 2007 February;56(2):126-130.
Body Piercing: Sign of Deviance or Normal Practice? / IBTimes Staff Reporter
Piercings: How to prevent complications / Mayo Clinic

Last Update November 2014
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