Ask Angel

Medical Conditions and Piercings Part II

by Elayne Angel

This is a continuation of my prior article in which a piercer asked about medical issues that could prove problematic for piercings. The first part covered Ehlers-Danlos Syndrome and heart conditions that would be of concern. Here I’ll discuss some others that I’ve been asked about by clients and piercers alike:

Pregnancy

I hope all piercers have enough sense to know that it is utterly inappropriate to pierce someone who is expecting. The body is already occupied with the complex and momentous task of creating and nurturing a baby. If a woman gets pierced during pregnancy, she also exposes her unborn child to unnecessary risks of infection (particularly because of changes to the immune system during gestation), allergic reaction, bloodborne disease, and effects of medication used to treat complications. It is not uncommon for pregnant piercees to find that their old, healed piercings act up during that time, too, due to hormonal changes. Just. Say. No.

Nursing

It is much less perilous to pierce a woman who is nursing. Still, I would delay for a few months post-partum (after birth) for the mother to recover before doing any piercings, and nipples should be allowed to stabilize for at least six months after ceasing to breastfeed. Childbirth is a fairly intense strain on the body, whether natural or surgical. New mothers are frequently sleep deprived and stressed, which are not ideal states for getting a piercing, so healing could be affected.

MRSA

MRSA – greatly magnified

Piercers should all be familiar with the superbug: methicillin-resistant Staphylococcus aureus (MRSA). This type of formidable bacteria is not cured by the antibiotics that are normally effective against Staph infections. The hospital-acquired variety (HA) is transmitted in the medical setting and community-acquired (CA) MRSA is contracted elsewhere.

MRSA is a major human pathogen that causes a wide range of skin and soft tissue infections, frequently in wounds. It is a leading cause of bacteremia (“blood poisoning,” bacteria in the bloodstream, which could progress to sepsis); and infective endocarditis (heart infection), which are both potentially deadly(i).

Staphylococcus aureus is a common component of skin and mucosal flora. According to the Centers for Disease Control (CDC), approximately 30% of healthy adults are colonized with it but have no symptoms(ii). One out of fifty of those people carries MRSA. The most prevalent colonization sites include the nose, vagina, and perineum, which means that these potential piercing regions might carry extra risks for Staph infections, too.

Staph transmission is often from direct contact(iii) with an infected wound, or through sharing personal items that have touched infected skin (such as clothing, towels, or razors). MRSA infection rates tend to increase if a person is in crowded places, or when activities involve skin-to-skin contact and shared equipment or supplies. Athletes, students, military personnel in barracks, and those who have recently been hospitalized are at greater risk. Additionally, community-associated MRSA often affects household contacts of infected people(iv), so a client living with someone who has a MRSA infection is a poor candidate for piercing.

Obviously, anyone with an active Staph infection anywhere on their body must not be pierced until the condition is fully resolved. It would be best to wait for several months after successful treatment is completed. The tendency for staphylococcal skin infections to recur after healing is well recognized, and is as high as 50% and in some populations(v). Individuals with human immunodeficiency virus (HIV)(vi) are 6-18 times more likely to contract a MRSA infection than those who are not immune compromised.(vii)

HIV/AIDS

HIV and acquired immune deficiency syndrome (AIDS) are leading chronic illnesses in many major cities worldwide. Fortunately, studies show that healing is successful in HIV-positive patients when their disease is well managed, and proper care is provided for the wound. Adequate nutrition is cited as being exceptionally important in these cases.(viii) If a client with any immune deficiency experiences a complication with their piercing, it is critical that they visit their physician right away.

Skin Conditions

Rashes such as eczema or psoriasis and other skin abnormalities are less severe health hazards, but can still be problematic. If the skin near a proposed piercing site is dry, scaling, flaking, or inflamed, it is best left unadorned—especially if the ailment is chronic. Skin in such states is not at all welcoming to body jewelry and healing is likely to be delayed, troubled, or worse. Additionally, the presence of a piercing (and any aftercare products, however mild) could aggravate the client’s dermatological problem.

You should always avoid piercing through moles, warts, and other such tissue abnormalities. It is probably safe to pierce as near as 1/4” from small moles, if they are stable and not raised or darkly pigmented. Send the client to a doctor for removal before considering piercing near any warts. Sometimes clients aren’t even aware that something is wrong. So if you notice any lumps, bumps, or spots that look atypical in color, size, shape, or texture, let your client know and suggest they schedule a check-up.

Scars

Overall it is best to avoid scars when piercing. Scar tissue is avascular (lacks blood supply), which is needed for optimal healing. Also, scars are weaker and more vulnerable, as they only ever regain about 80% of the strength of unaffected skin(ix). Piercing through a scar predisposes the site to complications including migration, rejection, or delayed healing.

The concept of piercing behind scar tissue (as when repiercing) makes sense primarily because going in front of it is apt to be too superficial. However, this isn’t as effective as it is rumored to be for “holding a piercing in.” If you intend to pierce behind a scar, know that it most definitely is not stronger than regular tissue, so do not give clients false hopes of success.

Stretch marks regularly surround navels and they are a type of scar. Whenever possible, place piercings to avoid stretch marks.

True keloids can be enormous, unsightly, and incurable. They are very difficult to treat, tend to recur, and can be itchy or painful. If there is a confirmed history of keloid formation, I’d say that the risks of piercing are unacceptable.

In Conclusion

Any time you’re concerned about a medical matter, it is appropriate to require that the client get a signed doctor’s note before proceeding. The Association of Professional Piercers’ Procedure Manual(x) contains a sample “Physicians Acknowledgement Form.” The doctor need not endorse the piercing, but simply agree to provide medical care if it becomes necessary. It is crucial to have your attorney review all of the forms that you use in your studio, including your release/waiver because relevant laws vary by state and region.

Remember that as piercers, we are never to diagnose (or treat!) any ailments (including migraines or anxiety—the myths surrounding daith and tragus piercings notwithstanding). But when a client divulges that they have a health concern, we need to be knowledgeable enough to determine a suitable course of action. Sometimes we can proceed if piercing is minimally risky and likely to be successful. For other issues, a doctor should be consulted first. When a condition is significant enough, it will warrant politely declining to pierce after explaining the concerns. Never be afraid to say, “No,” when it is appropriate to do so.


(i) https://academic.oup.com/cid/article/48/Supplement_4/S231/293013
(ii) https://www.cdc.gov/mrsa/community/index.html#how2
(iii) https://www.ncbi.nlm.nih.gov/books/NBK441868/
(iv) https://academic.oup.com/cid/article/60/5/753/291617
(v) http://www.patientcareonline.com/community-acquired-mrsa/prevention-recurrent-mrsa-skin-infections-what-you-need-know
(vi) https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.100558
(vii) https://www.ncbi.nlm.nih.gov/books/NBK441868/
(viii) https://www.researchgate.net/publication/258046797_A_critical_review_of_HIVAIDS_and_wound_care
(ix) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174176/
(x) https://www.memberleap.com/members/store.php?orgcode=AOPP#cat117 Available by digital download or hard copy

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