Piercing Infections and Other Problems

In this segment, I will address some common issues, causes, and treatments for Infections and other problems. I want to emphasize that this blog and any information on the internet should not be used as a substitute for consulting a well-trained and experienced piercer or a Medical Professional. I say piercer first only because a well-experienced piercer has a good working knowledge of dealing with infections and other problems. Additionally, an ethical piercer will be the first to admit, "This is beyond my help; you need to see your doctor." That said, if the problem doesn't seem to be improving within a week or so, see your doctor regardless of what your piercer says.

 Several significant problems and causes could lead to a healing piercing becoming infected or developing other issues. Sometimes, out of no fault of the piercer or piercee, a healthy piercing will suddenly have problems. We are dealing with the human body, and a vast number of things can happen during the healing process. In some cases, the body rebels against the piercing and is unwilling to accept it. 

The most significant factor in healing a piercing with minimal problems is a thorough aftercare program. This will involve removing the discharge with a sterile saline spray, such as Neilmed Piercing Aftercare, twice daily, and rinsing the piercing under running water at the end of your shower. There will always be an ongoing debate about which products are best. Still, the primary purpose behind cleaning the piercing is to remove the discharge. 

Cleaning off the discharge from the piercing helps keep the piercing holes unblocked, allowing the body to discharge byproducts of skin production, foreign objects, and pathogens. One of the most common causes of infection or other problems is the failure to remove the crusted discharge from the piercing holes or jewelry that is so tight it prevents the discharge from occurring. For this reason, I cannot stress enough the importance of keeping up with the cleaning until the piercing is no longer an open wound. 

Nothing can reduce the likelihood of infections as effectively as preventing cross-contamination and maintaining good health. Even when you make mistakes, your body's immune system usually fights off the foreign pathogen without needing any antiseptics, antimicrobials, or disinfectants. In many cases, the use of these harsh products can cause additional issues with the piercing and do very little to avoid or stop an infection.

Now, often piercings will react in a way that seems similar to an infection, but only show one or none of the signs of infection. In a nutshell, it may not be infected, but it is by no means healthy. So I divided this into two parts, Infected Piercings and Affected Piercings. Infected Piercings often require time and additional help to fight off the infection, and depending on the severity of the infection, may also necessitate medical treatment. Affected piercings, on the other hand, are often the result of the body reacting to improper cleaning, foreign objects, abuse, improper placement, or improper jewelry. Once the problem is identified and removed, they will often heal with little additional care. It can be confusing, to say the least, but regardless, neither an infected nor an affected piercing will become healthy without first identifying the cause and removing it. 

For years, I've been dealing with problems with piercings. A significant portion of the verbal version of my aftercare and consultation is based on past experiences and aimed at preventing future problems. Even with covering all the possible causes of complications that may arise during healing, there is always something new to learn. When someone comes in with a problem, I often review a list of possible causes. This can sometimes feel like an interrogation, and it's easy to become defensive. Many of the questions I would ask someone with a problem were addressed in the aftercare or seem pretty self-explanatory, but they are key to the problem-solving process. The key is to be honest. The piercer is on your side, but if you've made a mistake, they need to know about it, and that embarrassing information may be the key to solving the problem. Sure, it is frustrating as a piercer when you take the time to explain how to take care of the healing piercing, but it's even worse when the client is unwilling to give information that could lead to a solution because they screwed up. Now do not get me wrong, there is a small percentage of piercees that do everything right and still have problems. 

Infections:

Infections are caused by contact with bacteria, fungi, and/or other pathogens. This can be caused by contact with dirty hands,. Oral contact (including your saliva). Exchanging of bodily fluids, hair, cosmetics, oils, unwashed clothing/towels/bedding, and/or submerging the piercing into Natural waters. Hot tubs. Swimming pools and/or unclean bathtubs. The body will then attempt to eliminate the foreign pathogen and expel the infected tissue and fluids from the body.

Additionally, the body will exhibit several signs in the infected area that it is fighting off an infection. These signs are usually a combination of two or more of the following: Redness, discoloration, swelling, heat/fever, on or around the piercing, tenderness to touch in the piercing area, pain that is throbbing and/or shooting/travels, pus and/or discharge that is unnatural in color, like grayish. Yellowish and/or greenish.

Now I think it is important to point out that many of these signs will also show up during the first few weeks after a piercing is done. If you got your piercing a few days ago, do not panic; it is your body's way of making you aware of the piercing and informing you that it wishes you to remove it. This will go away once the body accepts the piercing and begins to produce tissue around the jewelry.

The key to addressing an infection is not to delay treatment. The body may require additional support in resolving the infection, and delaying treatment could lead to severe medical complications, including the infection becoming systemic.  Which, left untreated, could kill you. Additionally, the longer you delay addressing the problem, the more likely it is that the infection will worsen and spread, making it much more challenging to resolve. 

Additionally, it is crucial not to remove the jewelry without first seeking additional treatment or until all signs of infection have cleared. The reason is that if the body has no way of expelling the infected fluids and tissue, it will essentially quarantine the area, forming an abscess or cyst. Which, if left untreated, can cause further health problems. Only remove the jewelry if you are under the care of a medical professional. Understand that since an allergic reaction will often produce the same signs as an infection, a medical professional will treat an issue with a piercing as both an infection and an allergic reaction by prescribing medication and telling you to remove the jewelry. They are trying to cover all the bases. 

Often, the best course of action for an infection is to give your body extra help in fighting it off. One of the best ways to do this is to make sure that the piercing holes are free of discharge. This will make it easier for your body to expel the infection. To do this, spray a sterile saline solution onto both sides of the piercing and allow it to remain in contact for at least 5 minutes. Then rinse the piercing area under running water. If you are having issues removing the discharge, see your piercer and have them clean it for you. If the jewelry has a large end that may be blocking discharge, consider discussing with your piercer the option of changing the end to something smaller.

Over-the-counter, topical creams( bacitracin, neomycin, or polymyxin B) can help. Make sure to read the packaging carefully to make sure they can be used on a puncture or deep wounds. Do not use OTC petroleum-based ointments. This will cause the piercing to become blocked and unable to discharge. 

There are several home remedies that Mom taught us to use, but often they are too harsh and may prolong the infection or lead to additional problems. These would include Alcohol. Witch Hazel. Hydrogen Peroxide. Hibiclens. Betadine. Listerine(or other alcohol bases mouthwashes) and Tea Tree oil. 

For pain, fever, and swelling, you can also take an anti-inflammatory such as ibuprofen or acetaminophen.

If the swelling is exceeding the length of the jewelry, see your piercer immediately to change the jewelry to a longer post.

If the signs of infection do not begin to improve or worsen after a few days, seek professional medical help.

​Affected:

There is a significant number of signs and reactions that can be called affected. Sometimes, the piercing may show signs of infection, or something completely different may happen. I would have to say that the number one cause would be jewelry that is of the wrong shape or size. However, sometimes it is purely genetic, or a foreign object has worked its way into the piercing. Often, an affected piercing is significantly more complicated to resolve than an infection. However, the key is to find the root cause of the problem and correct it. I want to emphasize that it is essential to consult your piercer or medical professional in person. 

If you get one of these bumps, the most common causes are:

• Trauma, overhandling, and movement - Piercings can be sensitive to movement, pressure, and abuse. Often, isolating the piercing, avoiding sleeping on it, refraining from playing with it, and giving the piercing a little TLC and time will help the bump go away.
• Harsh disinfectants and cleaners - Improper aftercare methods and products can lead to skin irritation and bumps. Clean your piercing only with sterile, medical-grade saline sprays, such as Neilmed Piercing Aftercare. Do not rotate or move the jewelry. Additionally, do not use Q-tips and cotton balls to apply or clean the piercing.
• Improper jewelry style or size. If the jewelry is too tight, too heavy, or curved in a way that creates pressure on the piercing, it can cause bumps to form on the skin. This is why a piercing that healed perfectly with straight post jewelry may suddenly develop a bump when a small ring is inserted into the piercing. Putting the correct jewelry in the piercing will cause the bump to fade over time. This is one of the reasons that downsizing during the healing process can be significant.  It will reduce the movement, the weight, and the amount of contact the jewelry has.
• The angle or placement of the piercing is not correct for your anatomy. In this case, there is no alternative solution other than to remove the jewelry or wait it out.

The most common are bumps that form on the edge of the piercing. They can be several things, but often have some root cause that, when corrected, the bump will reduce in size or go away. Firstly, I must stress that these bumps are usually your body's way of resolving a problem, and popping them will usually exacerbate the issue. Bumps come in several forms, and usually, it will take time and additional care to fix the issue. However, sometimes with time, they go away. Here are some of the more common ones:

• Hypergranulation Tissue - This will usually form on the side, but more often on the top edge of a piercing. They are a type of benign growth that forms on the edge of wounds caused by excessive trauma, moisture, or infection. They form during routine healing, but then the body begins to overproduce tissue. Often this will cause the piercing to grow outward instead of the /normal inward course.  These will protrude from the surface of the skin, are frequently not painful or tender, red in color, often produce clear and sticky drainage, and are prone to bleeding easily. Successful treatment varies significantly from person to person, but the one that I've noticed works best is Soaks and Compresses, applied twice daily. However, if that doesn't resolve it, you may want to try one of the other forms of treatment:
  • Isolate the piercing and allow it time to reabsorb the tissue. Often, a little TLC and time are the best options.
  • Over-the-counter cortisone cream as the instructions direct
• A Piercing Pimple - There seems to be no reliable cause for this, but they will often form on or around piercing holes. They are pus-filled, inflamed tissue and can be frustrating because usually they will go away, only to return a few months later.  The best course of action is to help your body absorb the tissue and fight the need that we all have to pop it. Your best bet, once again, is to use soaks or compresses twice daily. Also, lightly massaging the area, once again not popping but lightly rubbing the area, and some have had success taking antihistamines. If the problem does resolve, see your doctor and have them check for the possibility of an infection.
• Scarring - Time and time again, I have had fair-skinned clients come in and state that they think they have a Keloid. Though hypertrophic scarring is possible in fair-skinned people, it is scarce. The fact is that some people are more prone to scarring than others, and if you are prone to Keloids and scarring, then there is always a chance that getting a piercing will result in scarring. However, the chances of extreme scarring can be reduced with correct placement and jewelry. Often, suppose a piercing begins to produce excessive or raised scarring. In that case, it is caused by the abuse it is receiving from the jewelry and can be stopped or reduced by putting looser-fitting or differently shaped jewelry into the piercing. Often, there is no alternative to resolving the problem through medical procedures. Some have had success with compression therapy to flatten out the scar tissue. Additionally, saline soaks with rubbing alcohol, combined with applying 3 percent hydrogen peroxide, tea tree oil, or Camphor-Phenique twice daily for two to three weeks, can be effective. More severe treatments may also be considered, but often it comes down to consulting your doctor.
• Abscess or cyst - this occurs when a minor infection has developed, and your body isolates the infection, pushing it to the surface. If this is the case, you may need to consult a medical professional and have the abscess lanced and drained. However, often they will rupture on their own. Make sure to clean the area with a gauze sponge that has been dampened with sterile saline if they do.
• Rejection Bump - These form in the middle of the piercing between the two piercing holes. It is often the first sign that the piercing is rejecting. The only real solution is to remove the jewelry.

Other problems that are not a bump or an infection may include the following:

• Rejection and Migration - This occurs when the body begins to force the jewelry out. Often, the first sign of this will be redness or a scar in the shape of a line leading from the original piercing hole to the current hole. As the jewelry migrates, you will begin to be able to see the jewelry through the skin. All piercings will shift or move slightly during the healing process until the body accepts the jewelry or has pushed it to a more comfortable spot. However, if the jewelry is too tight, heavy, or the piercing is improperly placed, it can lead to migration. Additionally, improper use of the piercing during and after healing can cause it to migrate. Usually, when it starts, there is very little that can be done to stop it; however, changing the jewelry that is of poor quality, damaged, or improperly made can reduce or prevent migration. The point of no return is often reached when the jewelry is visible through the skin or prolonged redness has developed around the piercing holes. Not removing the jewelry may result in scarring or splitting of the piercing area. Often, once the area is completely healed, the piercing can be redone. Usually, with better placement and correct jewelry, the piercing will heal fine. However, understand that if the piercing migrated, there is an increased chance that it will again. This is especially true of piercings that are prone to migration, surface-to-surface piercings, and microdermal.
• Embedded Jewelry - This occurs when tissue grows around the end of the jewelry, typically barbells or stud-style jewelry. It is usually a sign that the jewelry is not long enough for the piercing, and as the piercing swells, heals, and experiences trauma, the jewelry has been pulled out. If you see signs of this, the jewelry should be removed and replaced with a longer piece immediately, especially if more than half of the end of the jewelry is inside the piercing. If left in place, the tissue may encase the jewelry end and will have to be cut out.

I must point out that everybody is different, with their unique combination of factors that may cause a healing piercing to go bad suddenly, and this is by no means a comprehensive list of all potential problems, but rather a standard list. I cannot stress enough that if you are having a problem, you should address it immediately and see your piercer or doctor. Ask a question like How soon should I see improvement or get worried? What do they think is causing the problem? And if you feel like you are getting the brush, go elsewhere. Often, someone with limited or no knowledge will give short defensive answers and seem more interested in getting rid of you than addressing the problem.  A well-trained and experienced piercer will take the time to address the root cause of the problem and attempt to find a solution. Also, don't panic and jump from solution to solution; often, it will take time for the problem to go away. If the solution worked or didn't work, please let your piercer know. Your experience could help someone else in the future by providing your piercer with insight they wouldn't have otherwise.