Pre-piercing Instructions

The area receiving the piercing should be free of excess hair. Facial or body “peach fuzz” is fine, but, beards, pubic hair, or body hair should be removed prior to piercing.

Please do not use lotion, makeup, creams, or salves prior to being pierced. If you use a topical numbing cream prior to coming it will need to be removed prior to piercing.

Please come in showered and with the area to be pierced cleaned well with antimicrobial soap.

Wear appropriate clothing so the piercing is not rubbed, chaffed, or irritated by clothing.

The person doing the piercing is a adult male RN with many years experience in Women’s health. He does not use a chaperone. If you are uncomfortable with this and wish to have a chaperone present you are welcome to have a person come with you to act as your chaperone.

Suggested Aftercare Guidelines for Body Piercings

Cleaning Solutions
Use one or both of the following solutions for healing piercings:
• Packaged sterile saline solution with no additives (read the label), or a non-iodized sea salt mixture: Dissolve 1/4 teaspoon of non-iodized (iodine-free) sea salt into one cup (8 oz.) of warm distilled or bottled water. A stronger mixture is not better; a saline solution that is too strong can irritate the piercing.
• A mild, fragrance-free liquid soap—preferably anti-microbial or germicidal.

CLEANING INSTRUCTIONS FOR BODY PIERCINGS
• WASH your hands thoroughly prior to cleaning or touching your piercing for any reason.
• SALINE soak for five to ten minutes once or more per day. Invert a cup of warm saline solution over the area to form a vacuum. For certain piercings it may be easier to apply using clean gauze or paper towels saturated with saline solution. A brief rinse afterward will remove any residue.
• SOAP no more than once or twice a day. While showering, lather up a pearl size drop of the soap to clean the jewelry and the piercing. Leave the cleanser on the piercing no more than thirty seconds.
• RINSE thoroughly to remove all traces of the soap from the piercing. It is not necessary to rotate the jewelry through the piercing.
• DRY by gently patting with clean, disposable paper products. Cloth towels can harbor bacteria and snag on jewelry, causing
injury.

WHAT IS NORMAL?
• Initially: some bleeding, localized swelling, tenderness, or bruising.
• During healing: some discoloration, itching, secretion of a whitish-yellow fluid (not pus) that will form some crust on the jewelry. The tissue may tighten around the jewelry as it heals.
• Once healed: the jewelry may not move freely in the piercing; do not force it. If you fail to include cleaning your piercing as part of your daily hygiene routine, normal but smelly bodily secretions may accumulate.
• A piercing may seem healed before the healing process is complete. This is because tissue heals from the outside in, and although it feels fine, the interior remains fragile. Be patient, and keep cleaning throughout the entire healing period.
• Even healed piercings can shrink or close in minutes after having been there for years! This varies from person to person; if you like your piercing, keep jewelry in—do not leave it empty.

WHAT TO DO
• Wash your hands prior to touching the piercing; leave it alone except when cleaning. During healing, it is not necessary to rotate your jewelry.
• Stay healthy; the healthier your lifestyle, the easier it will be for your piercing to heal. Get enough sleep and eat a nutritious diet. Exercise during healing is fine; listen to your body.
• Make sure your bedding is washed and changed regularly. Wear clean, comfortable, breathable clothing that protects your piercing while you are sleeping.
• Showers tend to be safer than taking baths, as bathtubs can harbor bacteria. If you bathe in a tub, clean it well before each use and rinse off your piercing when you get out.

WHAT TO AVOID
• Avoid cleaning with Betadine®, Hibiciens®, alcohol, hydrogen peroxide, Dial® or other harsh soaps, as these can damage cells. Also avoid ointments as they prevent necessary air circulation.
• Avoid Bactine®, pierced ear care solutions and other products containing Benzalkonium Chloride (BZK). These can be irritating and are not intended for long term wound care.
• Avoid over-cleaning. This can delay your healing and irritate your piercing.
• Avoid undue trauma such as friction from clothing, excessive motion of the area, playing with the jewelry, and vigorous cleaning. These activities can cause the formation of unsightly and uncomfortable scar tissue, migration, prolonged healing, and other complications.
• Avoid all oral contact, rough play, and contact with others’ bodily fluids on or near your piercing during healing.
• Avoid stress and recreational drug use, including excessive caffeine, nicotine, and alcohol.
• Avoid submerging the piercing in unhygenic bodies of water such as lakes, pools, hot tubs, etc. Or, protect your piercing using a waterproof wound-sealant bandage (such as 3M™ Nexcare™ Clean Seals). These are available at most drugstores.
• Avoid all beauty and personal care products on or around the piercing including cosmetics, lotions, and sprays, etc.
• Don’t hang charms or any object from your jewelry until the piercing is fully healed.

HINTS AND TIPS
JEWELRY:
• Unless there is a problem with the size, style, or material of the initial jewelry, leave it in the place for the entire healing period. See a qualified piercer to perform any jewelry change that becomes necessary during healing. See the APP website to locate an APP member, or to request a copy of our Picking Your Piercer brochure.)
• Contact your piercer if your jewelry must be removed (such as for a medical procedure). There are non-metallic jewelry alternatives available.
• Leave jewelry in at all times. Even old or well-healed piercing can shrink or close in minutes even after having been there for years. If removed, re-insertion can be difficult or impossible.
• With clean hands or paper product, be sure to regularly check threaded ends on your jewelry for tightness. (“Righty-tighty, lefty-loosey.”)
• Carry a clean spare ball in case of loss or breakage.
• Should you decide you no longer want the piercing, simply remove the jewelry (or have a professional piercer remove it) and continue cleaning the piercing until the hole closes. In most cases only a small mark will remain.
• In the event an infection is suspected, quality jewelry or an inert alternative should be left in place to allow for drainage or the infection. If the jewelry is removed, the surface cells can close up, which can seal the infection inside the piercing channel and result in an abscess. Do not remove jewelry unless instructed to by a medical professional.

FOR PARTICULAR AREAS

NAVEL:
• A hard, vented eye patch (sold at pharmacies) can be applied under tight clothing (such as nylon stockings) or secured using a length of Ace® bandage around the body (to avoid irritation from adhesive). This can protect the area from restrictive clothing, excess irritation, and impact during physical activities such as contact sports.

EAR/EAR CARTILAGE AND FACIAL:
• Use the t-shirt trick: Dress your pillow in a large, clean t-shirt and turn it nightly; one clean t-shirt provides four clean surfaces for sleeping.
• Maintain cleanliness of telephones, headphones, eyeglasses, helmets, hats, and anything that contacts the pierced area.
• Use caution when styling your hair and advise your stylist of a new or healing piercing.

NIPPLES:
• The support of a tight cotton shirt or sports bra may provide protection and feel comfortable, especially for sleeping.

GENITAL:
• Genital Piercings—especially Prince Alberts, Ampallangs, and Apadravyas—can bleed freely for the first few days. Be prepared.
• Urinate after using soap to clean any piercing that is near the urethra.
• Wash your hands before touching on (or near) a healing piercing.
• In most cases you can engage in sexual activity as soon as you feel ready, but maintaining hygiene and avoiding trauma are vital; all sexual activities should be gentle during the healing period.
• Use barriers such as condoms, dental dams, and waterproof bandages, etc. to avoid contact with your partners’ body fluids, even in monogamous relationships.
• Use clean, disposable barriers on sex toys.
• Use a new container of water-based lubricant; do not use saliva.
• After sex, an additional saline soak or clean water rinse is suggested.
Each body is unique and healing times vary considerably. If you have any questions, please contact your piercer.

* DISCLAIMER:
These guidelines are based on a combination of vast professional experience, common sense, research and extensive clinical practice. This is not to be considered a substitute for medical advice from a doctor. If you suspect an infection, seek medical attention. Be aware that many doctors have not received specific training regarding piercing. Your local piercer may be able to refer you to a piercing-friendly medical professional.

Body Piercing Troubleshooting For You

For the Piercee: Choosing a Medical Professional
Medical personnel have tremendous knowledge of the human body but often do not have specific training about this unique form of body art. As a piercee, you may have more information about the suggested care and maintenance of piercings than they do. It is up to you to make certain that your chosen medical professional has access to facts that will facilitate your treatment.
To save yourself from a bad experience, ask the following questions before settling on a doctor or other practitioner. Is this healthcare professional:

• Accepting of body piercings?
• Experienced in treating problem piercings?
• Willing to consult with a trusted expert body piercer, or seek other resources for information about piercing?

• Visit a doctor immediately if you have problems with your piercing and you:
• Experience severe redness, swelling, or pain from the piercing
• Have a large amount of discharge that is thick, green, yellow, or gray and smells bad
• Have red streaks coming from from the piercing site
• Take steroids or have a chronic illness or other health condition
• Have symptoms that last for a week or get worse
• Experience fever, chills, nausea, vomiting, dizziness, or disorientation

• When piercings are properly performed and cared for, complications such as irritation or allergy are far more common than infection.
• Even momentary removal of jewelry from a piercing can result in rapid closure of the channel, and make reinsertion difficult or impossible.
• Simply taking out the jewelry may not resolve the problem, and if an infection is present, removal can lead to a more serious problem–the formation of an abscess.
• Most piercing complications can be handled without the piercing being lost.
• Changing aftercare and/or jewelry size, style, or material often resolves problems.

• Alcohol, hydrogen peroxide, Betadine, Hibiclens, harsh soaps, and/or ointment(s) are not appropriate products for the care of a healing ear or body piercing.
• Over-cleaning and using strong products can irritate piercings and delay healing.
• Mild, non-iodized sea-salt or normal saline soaks and/or cleaning with a liquid anti-microbial or germicidal soap once or twice a day is suggested for body piercings.*
• Rinsing with mild non-iodized sea salt and/or antimicrobial or antibacterial alcohol-free mouthwash, 4-5 times a day is suggested for oral piercings.*

• Discoloration: reddish, brownish, pinkish, or purplish; can remain for many months on navel, surface, and other piercings.
• Swelling/Induration: localized; may be significant with oral piercings such as the lip or tongue, and usually lasts for several days following the initial piercing.
• Excretion: exudate of interstitial fluid, dead cells, etc. that forms a small amount of crystalline-appearing crust at the openings of the piercing; should not be copious, malodorous, or green.

• They are occlusive and limit oxygen circulation to the area, which can delay healing of this type of wound.
• They 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.

• The skin between the openings is flaking or peeling, red or inflamed, and/or hard and calloused-looking
• There is 1/4” of tissue or less between the openings
• Just a thin filament of nearly transparent tissue is left, and the jewelry can be seen through the skin

• Topical or oral benadryl or other antihistamine
• Advise a change to a different jewelry material such as titanium, if nickel sensitivity is suspected, or an approved inert plastic. See the APP brochure: Jewelry for Initial Piercings.
• Discontinue current care regimen in favor of a milder cleaning product

If you feel it is necessary to see a physician about your piercing please print the section for your physicians as they may not be familiar with the treatment of piercings.

Body Piercing Troubleshooting For Your Healthcare Professional

For the Medical Professional: Troubleshooting Piercing Problems
A piercing is a unique type of wound because it is intentional, and healing must take place around a foreign object. This information is intended to familiarize you with piercing complications you might encounter, and the treatments found to be most efficacious.

IN THE EVENT  THAT YOU DIAGNOSE A LOCALIZED PIERCING INFECTION:

• Important: removing jewelry in the presence of an infection may result in an abscess. Quality body jewelry or a retainer of an appropriate size, style, and material should be left in place so the infection can drain
• Isotonic saline soaks and/or hot compresses can encourage drainage
• Bactroban (Mupirocin) cream or gel (not ointment) has been found to be effective for topical treatment of bacterial infections

• Red, itchy rash surrounds the piercing or covers a large area (up to several inches away)
• The opening to the piercing may appear significantly larger than the size of the jewelry
• Tenderness, though sometimes there is no discomfort
• Skin eruptions below the piercing (where soap suds run during bathing) clearly demonstrate contact dermatitis caused by a cleaning product

• Topical or oral benadryl or other antihistamine
• Advise a change to a different jewelry material such as titanium, if nickel sensitivity is suspected, or an approved inert plastic.
• Discontinue current care regimen in favor of a milder cleaning product

• Small, slightly elevated pustule
• Red and inflamed, but contained locally
• May be tender, itch, or burn, though some are painless
• Secretes pus and/or blood when drained or popped

• Treat as a minor localized infection
• Over-the-counter antihistamines can diminish itching and inflammation
• Warm saline soaks or hot compresses several times daily; these should be continued daily for two weeks after the problem seems resolved
• Light localized massage may help break up the pocket and prevent it from refilling
• If recurrences continue, a culture may be needed to identify the invading microorganism so you can prescribe medication to target the problem.

• The same treatments used on infants’ umbilical granulomas may be used for piercing-related hypergranulation tissue: silver nitrate, electrocautery, or liquid nitrogen; a ligature technique can be used if the lesion is pedunculated
• Some affected piercings do heal successfully, but if the problem proves intractable after treatment, the piercing should be abandoned

• Metal body jewelry will result in an opaque density on MRI and x-ray, but will not otherwise affect visibility on film
• Metal body jewelry causes visible interference and should be removed for CAT scans if in the area of examination
• Nipple piercings are unlikely to obstruct visibility of pathology on thoracic x-rays if both AP (or PA) and lateral views are taken
• Appropriate body jewelry is non-magnetic, and as such does not need to be removed for MRI procedures unless it is located in the region being examined (use a strong hand-magnet to test)
• Even momentary removal of jewelry from a piercing can result in amazingly rapid closure of the channel, and make reinsertion difficult or impossible
• Non-metallic retainers can often be used to safeguard the patency of a piercing; sterile tubing from a catheter needle can be used as an emergency retainer