Ask Angel

The Accommodating Attitude

Hi! I’m a huge fan of yours.

I’ve recently became a body piercer, and i finnished my trainning 6 months ago and has been working ever since. I have a question :

I pierced a client 1.5 months ago, and she just messaged me saying it is infected. What is the best way to explain to her that it wasnt my fault ? Since its from improper aftercare.

Thank you

**Pain Disclaimer: The question has been printed as it was received.

Dear K.,

Thanks for writing. I’m glad that you sent me this question, as I do have some important information to share with you.

First off, I want to say that I firmly believe it is our job to help troubleshoot any piercing problem a client has—regardless of who might be responsible. My guess is that your blame-deflecting attitude stems from the coaching and viewpoints passed along by your mentor. He or she must not share my accommodating philosophy, but hopefully this will change your mind and your methods.

If a client tells you via text or phone call that a piercing is “infected,” it is best to have them come in, or send you photos at the very least. It is extremely common that piercees think they have an infection (or “migration” or “a keloid” or another complication) when there is something entirely different going on. In order to offer appropriate guidance, always evaluate the condition of the piercing to be sure about the true nature of the setback.

For example, piercees and medical professionals alike frequently see a normal, healing navel that has become irritated and pronounce it infected. Some discoloration (pinkish, brownish, or purplish), secretion of clear or cloudy fluids, and induration (hardening of tissue) can all be present in a normal healing navel piercing. A misdiagnosis of infection is especially unproductive if a course of antibiotics is prescribed: the irritation will not be resolved, and the real cause of the issue will not be addressed. Often, all a piercee needs is reassurance from a piercing professional that everything looks normal (when it does).

If a piercing has inflammation from excess trauma, advice to change up activities or clothing, etc. will be warranted. Or, curtailing an overzealous aftercare regimen might be a simple resolution to an upset piercing. Other times, an adjustment to the jewelry style or size may be required. If excess scar tissue has developed, the suggestions will differ from what you’d propose for an infection, or an overgrowth of granulation tissue. These are just a few examples of the fact that input must be tailored to the individual problem.

In my experience, actual piercing infections (invasion and multiplication of disease-causing microorganisms that have a detrimental effect) are relatively rare, and other complications are far more likely to occur.

In the event that someone you pierced does actually contract an infection, it will require prompt attention. Left untreated, an infection can worsen to become extremely dangerous and, in rare cases, life threatening.

See below for some guidelines to offer if a piercee does have an infection:

Advise the client to see a doctor right away if they have any medical history of concern, (such as diabetes or an immune system disorder), or under the following circumstances:

    • They experience a fever, chills, nausea, vomiting, dizziness, or
    • The piercing is very painful, swollen, has red streaks emanating from it, or there is a loss of function in the area.
    • They have copious pus discharge that is greenish, yellowish, or grayish.
    • The symptoms last for a week or markedly worsen.

Note that a doctor who is unfamiliar with piercings may be unsure what to advise or prescribe. For topical treatment of localized bacterial piercing infections, a prescription-only antibiotic cream or gel called Bactroban (mupirocin) is recognized as an effective medication. I encourage all piercers to cultivate relationships with local piercing-friendly healthcare professionals and educate them so that a list of competent referrals is available to share with clients in need.

Many minor (or “self-limiting”) infections are successfully self-treated. The skin will be red, swollen, and warm or hot to the touch, with localized tenderness or pain, and pus that is greenish or yellowish and foul smelling. It is possible to have an infection even if all of the symptoms are not present. Conversely, having several of them doesn’t assure that a piercing is infected.

If the condition is recent and/or mild, and the piercee does not take steroids or have a chronic illness or other health condition, you can offer the advice listed below to try for a few days. Numerous products for this purpose are readily available in drugstores.

The following suggestions are to be given for minor infections only:

    • Take ibuprofen or acetaminophen to diminish swelling and tenderness.
    • Keep the area clean and perform mild saline soaks (i) and/or apply warm, moist compresses to encourage drainage and relieve discomfort. (Instructions are below.)
    • Apply topical over-the-counter antibiotic cream or gel (not ointment) according to package directions. This type of product is not suggested for routine aftercare, but now is the time to put it to use. Topical antibiotic products usually contain bacitracin, neomycin, or polymyxin B, alone or in combination, to fight different types of microorganisms. Combinations of the three ingredients work against a broader spectrum of bacteria, but allergic reactions to neomycin are common. They should immediately stop using the product and consult a physician if redness, itching, or skin eruptions develop in the area.

Warm Compresses

Wash hands and apply a clean washcloth or gauze soaked in water that is warm to hot—not scalding. Apply the compress directly to the area until it no longer feels warm, then reheat and reapply. Covering the compress with a folded dry towel can help maintain the heat for longer periods. Repeat for fifteen to thirty minutes, a maximum of ` times per day. Use only disposable products for washing and drying, or launder washcloths and towels with bleach between each use and store them carefully to avoid contamination.

An abundance of information on dealing with complications is available in my book (ii) and my updated troubleshooting eBooklet (iii).

Note that regardless of who is at fault for a problem, as the person who performed the piercing, your name and reputation will always be affiliated with it. Ultimately, healthy, healed piercings and satisfied clients are going to promote our businesses best. And patrons suffering with troubled piercings are not going to have anything positive to say, especially if they feel accused and abandoned.

Instead of blaming your client, it is much better to offer expert counsel and assistance. If a client does have an infected piercing, (or some other healing issue), even if you didn’t cause it, your duty is still to help as best you can.

Remember, body art is a service industry. I believe that the aid we provide should extend throughout the life of a piercing—and most certainly during the healing period. I happily (and regularly) answer questions and provide advice to clients I pierced years ago—sometimes even decades in the past!

This isn’t meant unkindly, but I do believe that an “attitude adjustment” is needed and I wanted to be honest with you about my perspective. I sincerely hope you find this useful, and that you will feel inspired to provide support and guidance to the piercees who patronize you and rely upon you.