What is Body Piercing Infections?
Body piercings, or the practice of making openings in the body to insert jewelry, are becoming more popular and more socially accepted. Although the ear is still the most common place for a piercing, other areas like the mouth, nose, eyebrows, nipples, belly button, and genitals are also becoming increasingly popular.
However, piercings can sometimes lead to infections in the area surrounding the piercing, referred to as localized cellulitis. If not recognized and treated properly, these localized infections, though not common, can lead to more serious illnesses. Some of these include Ludwig angina (a severe infection of the neck and mouth), endocarditis (an infection of the heart’s inner lining), toxic shock syndrome (a severe disease often caused by a bacterial infection), and Fournier gangrene (a serious infection of the genital area). These are rare but serious complications that have been reported in medical case studies.
What Causes Body Piercing Infections?
Body piercing can sometimes lead to infections, often caused by the bacteria that are naturally found on your skin. These include bacteria known as staphylococcus and streptococcus. However, for ear and nose piercings that involve the cartilage, a type of bacteria called pseudomonas can cause infections more often.
People with genital piercings are at a higher risk of getting sexually transmitted infections, like gonorrhea and chlamydia. If you have a type of bacteria called Staphylococcus aureus on your skin, you’re also at an increased risk of nose piercing infections.
Surprisingly, infections from lip and tongue piercings are low, even though the mouth contains a lot of bacteria.
Risk Factors and Frequency for Body Piercing Infections
A recent national survey indicates that about 35% of people have at least one body piercing. Interestingly, 14% of those with piercings have them in places other than their earlobes. As per the survey, women tend to have more body piercings than men. They are also more likely to have piercings in places other than their earlobes. The age group with the most number of body piercings is 24 to 34.
- About 23% of people who have piercings in areas other than the earlobes have reported medical complications.
- One-third of people with body piercings did not get their piercings in a professional body art studio, which could increase the risk of infections.
Signs and Symptoms of Body Piercing Infections
Complications from skin and soft tissue, such as those from a body piercing, can appear like a localized skin infection or abscess. The signs include areas of redness, swelling, warmth, tenderness, fluid-filled bumps, and possibly pus discharge. Some general symptoms like fever, fast heart rate, feeling unwell, or changes in consciousness can vary based on the location of the piercing and if the infection has spread through the body. Important questions to ask include who did the piercing, when it happened, and what equipment was used. This can help in assessing any possible infection resulting from the body piercing.
Testing for Body Piercing Infections
In simple terms, when you have a small infection that only affects one area of your body, your doctor is usually able to diagnose it just from your reported symptoms and a basic physical exam–no tests needed. However, sometimes, your doctor might need to do more checks. This is especially true if you have general symptoms like a fever, fast heartbeat, low blood pressure, or if you’re not thinking clearly.
Your doctor might decide to do some common lab tests or imaging. This could include a blood test to count the different types of cells (complete blood count), tests to check the levels of salts and minerals in your blood (electrolytes), kidney function tests, and a test to measure the amount of lactic acid (a substance the body produces when it’s not getting enough oxygen). The doctor could also decide to take pictures of the inside of your body using an x-ray or ultrasound. All of these tests will help the doctor understand what’s causing your symptoms.
Treatment Options for Body Piercing Infections
Minor skin infections can often be treated at home with warm compresses and over-the-counter or prescribed creams containing antibiotics like bacitracin or mupirocin. If necessary, your doctor might prescribe oral antibiotics such as cephalexin or clindamycin, which are effective against common bacterial infections caused by streptococcus and staphylococcus. Infections resistant to common antibiotics, often caused by a type of bacteria known as MRSA (methicillin-resistant Staphylococcus aureus), typically require a different antibiotic, such as oral trimethoprim/sulfamethoxazole.
Certain infections, for example, in the cartilage of the upper ear often caused by a bacteria called Pseudomonas, may require different antibiotics known as fluoroquinolones, an example being ciprofloxacin.
If a piercing is the source of an infection, it’s often necessary to remove the jewelry. To keep the piercing open while treating the infection, a doctor or piercer may put in a special loose loop of surgical thread known as a suture through the piercing hole
Oral piercings generally have lower risk for infections, but if an infection does occur, it can typically be treated with an antibiotic called amoxicillin/clavulanate. The standard treatment for skin infections, termed cellulitis, is typically 5 days, but can be extended if there’s no sign of improvement. In addition to antibiotics, using mouth rinses containing alcohol or skin cleansers containing a substance called carbamide peroxide can aid in healing the infection.
Infections in genital piercings may require special consideration. Besides the standard antibiotic treatment for skin infections, it may be important to screen and treat other sexually transmitted infections like Neisseria gonorrhea and Chlamydia trachomatis. This is often done with an injection of ceftriaxone and an oral pill of azithromycin.
If you’ve not had a tetanus vaccine within the last five years and have just had a recent body piercing that’s now infected, your doctor will probably recommend a tetanus booster shot. After all, tetanus is a serious bacterial infection that can be transmitted through puncture wounds or cuts, such as those made when getting a piercing.
What else can Body Piercing Infections be?
When someone complains about a problem at the site of a body piercing, the diagnosis should be quite clear. However, there are several other conditions that could be causing the issue. These may include:
- A leftover foreign object at the site of the piercing
- An allergic reaction
- Deep vein thrombosis, a condition in which a blood clot forms in a deep vein
- Sepsis, which is a life-threatening reaction to an infection that could spread from the local piercing site
- Signs of a bleeding disorder, which could have been noticed after the initial piercing
What to expect with Body Piercing Infections
It is rare for body piercings to lead to serious complications. However, if there is an infection, it’s important to see a doctor. Treatments usually include antibiotics, and sometimes the doctor needs to make a small opening to drain a pocket of pus (abscess). These are the key components of treating these types of infections.
Possible Complications When Diagnosed with Body Piercing Infections
Infections from piercings can lead to minor problems if they are noticed early and treated with the right antibiotics. However, if these infections are not promptly spotted or dealt with, they can become much worse, causing issues with the skin and soft tissues around them. They may also lead to more severe complications such as the formation of abscesses, a hole in the nasal septum, or even compromise the airway, a situation similar to Ludwig’s angina. In some cases, the infection may even spread to distant parts of the body leading to a condition called endocarditis. Additionally, using antibiotics to treat these infections can lead to a known risk of Clostridium difficile colitis, a type of colon inflammation.
Possible Complications:
- Skin and soft tissue infections
- Formation of abscesses
- Nasal septal perforation (a hole in the nasal septum)
- Airway compromise similar to Ludwig’s angina
- Distant dissemination leading to endocarditis
- Clostridium difficile colitis due to antibiotic use
Preventing Body Piercing Infections
It’s crucial for patients to understand the risk of infection that comes with body piercings. Emphasizing the importance of preventing infections is key. It’s worth remembering that using a reputable and certified piercing parlor is a good measure to take since these establishments must adhere to proper cleanliness and sterilization standards.
