Possible body piercing health risks and complications

Body piercing as a practice may seem entirely harmless and while it is less permanent than a tattoo, there are still many factors to take into consideration.

Yes, it’s easy enough to walk into any jewellery store and request to have your ears pierced, but the fact remains that there are still risks to be aware of and look out for when inserting a foreign object through your skin.

General risks and complications associated with body piercing

There are a number of different health risks^1,2 to consider when receiving a piercing, including the following general complications:

• Pain – The first and most obvious risk is that a piercing includes some degree of pain depending on where you get pierced. If you’re not able to handle pain well, it’s important to note that both during and after the procedure, you’ll experience pain in some form.
• Infection – Infection at the site of the piercing may occur in some instances. This is usually bacterial in nature and due to unsanitary piercing practices or neglect in applying the necessary after care. Depending on where the infection occurs, a variety of issues may be experienced. Common infection complications include:
• Infection of the mouth: This may lead to difficulty speaking and eating. Swelling of the tongue may block the airway.
• Infection of the nipple: This can cause scar tissue which, in women, may complicate breastfeeding in future.
• Systemic infection: An infection that begins at a piercing site may become bloodborne and systemic, spreading throughout the body.
• Poor healing – If a piercing isn’t cared for as it should be, or the proper equipment isn’t used during the procedure, it may take much longer to heal. Or worse, not heal at all. Delayed healing may also increase the chance of infection.
• Tissue swelling – Also referred to as oedema, this can often take place after piercing. Those who get a tongue piercing are especially at risk of developing oedema³. Due to the expected swelling, a longer bar is placed through the tongue at first but will then need to be replaced once the swelling has healed. While swelling should decrease with proper care, there is a risk that excessive swelling of the tongue may block the airway, causing a medical emergency.
• Scarring – It’s impossible to tell beforehand whether a piercing will scar or not. For some, no scarring takes place at all while others have a reaction that can cause scarring once the piercing has been removed. Any splitting or tearing of the skin that takes place during piercing can cause scarring. In some, the development of keloids (excessive, thick scarring) may develop at the piercing site.
• Allergic reactions – Placing a foreign object made of metal through your skin can cause complications. Contact dermatitis (a rash due to skin irritation caused by contact with an allergy-inducing substance) is common due to a sensitivity to various metals. Stainless steel is the most commonly used metal but options like solid gold (not filled or plated), titanium and niobium may also decrease the risk of an allergic reaction and should be used in all first piercings. Metals like nickel commonly cause contact dermatitis (if you’ve had issues wearing a watch with metal clasps, jean buttons or even belt buckles in the past, you probably have a nickel allergy). It is very important to discuss any metal allergies and hypoallergenic metal options with your piercer before going ahead as if you have a reaction, it can cause infection, rash, and overall more pain than usual.
• Damage to the underlying blood vessels and nerves

Common piercing specific complications include⁴:

Ears

• Scarring of the earlobe (with the potential for keloid formation)
• Embedding of the earring in the lobe (this is common in those with fleshy earlobes where a spring loaded piercing gun is used)
• Stretching or traumatic tear of the earlobe may occur if jewellery is too heavy.
• Damage to the ear cartilage which will need to be surgically restored if this body modification is no longer desired.
• Infection

Oral Piercings

• Gum recession due to injury
• Difficulty practicing adequate hygiene which may lead to periodontitis (gum infection)
• Increased saliva and drooling
• Dental damage –The jewellery used for these piercings can lead to chipped or crack tooth enamel or may become trapped between teeth which is both uncomfortable and painful.
• Difficulty eating
• Difficulty speaking
• Infection

Nasal Piercings

• Breathing in or swallowing the jewellery
• A collection of blood within the septum of the nose (known as a septal haematoma)
• Destruction of nasal cartilage due to granulomatous inflammation (wherein a collection of immune cells form a wall to block off foreign bodies that cannot be expelled) – this condition is known as granulomatous perichondritis.

Nipple Piercings

• Abscess – a localised collection of pus (often due to a bacterial infection) that is often painful
• Sores due friction when the jewellery rubs against clothing
• Difficulty breastfeeding in future, although healed nipple piercings seem to cause no issue, any scarring that develops can.
• Toxic shock syndrome (TSS) – although this is rare.

Naval (belly button) piercings

• Delayed healing and infection: Skin maceration due to the skin in this area being exposed to moisture for prolonged periods, leading to the softening and breaking down of the tissues may occur due to improper wound care.

Genitals⁵

• Bleeding
• Scarring (with keloids developing in some people)
• Allergic reactions
• Infection
• Injuries to oneself or sexual partner (including swallowing jewellery and dental damage due to chipping or jewellery becoming lodged in a partner’s teeth)
• Condom tearing or breakage and barrier contraception (diaphragm) displacement - This may result in unwanted pregnancy and / or sexually transmitted diseases (STDs).
• Altered urinary flow
• Sexual function issues: In men piercings of the penis, depending on their location, may cause engorgement that leads to painful, persistent erections (priapism), retraction of the foreskin in uncircumcised males (paraphimosis) which is a medical emergency, erectile difficulties or dysfunction. 
  
  
  

References

<sup>1. JAMA Network. Torpy JM, Lynm C, Glass RM. Body Piercing: https://jamanetwork.com/journals/jama/fullarticle/198264 [Accessed 21.06.2018]
2. Penn Medicine, Lancaster General Health. November 2017. Body Piercing Problems: http://www.lancastergeneralhealth.org/Healthwise/Document.aspx?id=hw250805 [Accessed 21.06.2018]
3. Research Gate. Reichl RB, Dailey JC. Intraoral body-piercing: a case report: https://www.researchgate.net/publication/14249494_Intraoral_body-piercing_a_case_report [Accessed 22.06.2018]
4. American Family Physician. Meltzer, Donna I. November 2005. Complications of Body Piercing: https://www.aafp.org/afp/2005/1115/p2029.html [Accessed 22.06.2018)
5. Wiley Online Library. Anderson WR, Summerton DJ, Sharma DM, Holmes SA. February 2003. The urologist’s guide to genital piercing: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1464-410X.2003.04049.x [Accessed 22.06.2018]</sup>