some point. Wearing jewelry in the piercing,
which is necessary to maintain the piercing, also
establishes circumstances for HYPERSENSITIVITY REAC-
TION and INFECTION. Long-term complications of
piercings can include deformity of the tissues at
the piercing site and the risk for systemic infection
such as HEPATITIS.
Hypersensitivity Response
Contact DERMATITIS, often as a hypersensitivity
reaction to the nickel in stainless steel, is the most
common dermatologic complication of piercings.
In contact dermatitis, the skin at the piercing loca-
tion becomes red (erythema) and inflamed. It may
itch or hurt. The piercing may swell, causing the
tissue to close around the jewelry. Removing the
jewelry and cleansing the site with an antiseptic
solution made for this purpose helps soothe the
irritated tissues and reduce INFLAMMATION.
Infection
Infection is a common problem that may develop
as a complication of contact dermatitis, as a result
of contaminated piercing needles and devices, or
as a consequence of improper cleansing after
piercing. Contamination is a significant risk with
self-piercing. Early detection and treatment is
important to prevent the infection from invading
deeper tissues. EAR CARTILAGEpiercings are particu-
larly vulnerable to infection as well as resistant to
treatment for infection, as the BLOODsupply to the
area is sparse. Navel and genital piercings also are
vulnerable to infection as a result of irritation
from clothing and moisture.
Piercing jewelry made of plastic, wood, BONE,
and other permeable materials can harbor BACTE-
RIA. Minor infections generally improve with topi-
cal ANTIBIOTIC MEDICATIONS. More extensive
infections require a doctor’s evaluation and often
require more involved treatment such as oral
antibiotic medications and antiseptic cleansing of
the piercing site.
Systemic infection such as hepatitis, and less
commonly HIV/AIDS, is a significant risk when
reusing or sharing piercing jewelry and needles.
The hepatitis VIRUS can live outside the human
body for extended periods of time. Piercings in
and around the MOUTHcarry the risk for bacterial
infection that can involve the HEART valves
because the mouth has a rich blood supply as well
as an abundance of bacteria.Deformity
Small piercings (16 gauge and smaller) will heal
closed without scarring when the person no
longer wears jewelry in the piercing to keep it
open. Larger piercings (12 gauge and larger) may
not heal closed, or may close with puckering of
the tissue. Large-gauge piercings may stretch the
tissues, such as the earlobes or lips, causing per-
manent enlargement. Infections, particularly of
the ear cartilage, can destroy tissue, requiring
PLASTIC SURGERY to restore the appearance and
sometimes the function of the tissue. Piercings of
the PENIScan damage or destroy erectile tissue,
nerves, or the URETHRA. Clitoral piercing can dam-
age nerves and cause structural damage to the CLI-
TORIS and surrounding labia, particularly as a
consequence of infection.Preventing Piercing Complications
Basic hygienic methods can prevent most piercing
complications. These methods include- having piercings done by reputable, experi-
enced professionals who use only disposable
needles and equipment - daily cleansing of piercing sites, such as wash-
ing with gentle soap and water during regular
showering or bathing, or using a commercially
available antiseptic cleansing solution for pierc-
ing sites - frequently changing and cleaning piercing jew-
elry - not sharing piercing jewelry
- wearing piercing jewelry made of impermeable
materials such as metals
See alsoTATTOOS; VALVULAR HEART DISEASE.pilonidal disease A chronic condition in which
HAIR-filled cysts form at the base of the spine. The
cysts typically originate when the SKINcloses to
form saclike structures with hair trapped inside.
The sac fills with fluid, cells, and other debris.
Often there are indentations or pits over the tops
of the cysts, and sometimes the hair within thepilonidal disease 185