THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 529.5 Guest: Dr. Eva Simmons-O'Brien, Prof. Dermatology, Johns Hopkins Hospital Topic: Cautions and precautions on body piercing Host: Steve Girard

NEMA: Body piercing....cool for some, puzzling to others..but is it safe? And what are the repercussions of having something...ouch, pierced? We're with Dr. Eva Simmons-O'Brien, Professor of Dermatology at Johns Hopkins Hospital....

Simmons- O'Brien: The first thing people need to find out prior to getting the body part pierced is to make sure they're going to someone who has a very good reputation in terms of a clean environment and appropriate sterilization of the objects that are going to be used as part of the piercing...and that the individual has been doing the procedure for a number of years, and then the next thing to be concerned about is making sure that area of the body that's going to be pierced is free of any other type of infection or skin process that might be going on... you don't want to pierce into an area of the skin that has lost its integrity, meaning its been injured in some way, because then you're just setting yourself up for a potential infection. The minute you basically disrupt the skin in terms of puncturing it or scratching it, you set up an entry way, or an area of focus for those organisms to actually go inside of your skin and set up shop if you will.

And after that, you have to know, or have a pretty good idea of how you heal when you've been cut or scratched or scarred before, because certain people are set up for what we call keloids, which are very thick scars that can grow in size way beyond the area that was pierced, and can be very painful and very disfiguring.

30% of the population are affected by what we call nickel allergies, the metal nickel, and nickel is contained in stainless steel, and its contained in silver, and its even contained in some gold. So, its very possible that you might have the piercing done, and then all of the sudden, a few weeks later, start itching terribly around the area that's been pierced, and you very well could have a nickel allergy.

NEMA: Are there special problems associated with piercing the nose...

Simmons- O'Brien: We all have organisms in our nose, and some of the organisms can be very destructive, and I believe that would be the concern about piercing in the nose....that you're introducing an area of the skin, you're opening an area of the skin...you're actually puncturing it and then you're potentially introducing into it bacteria that could really end up damaging the tissue in the nose, the cartilage in the nose...and might set someone up for a terrible infection in the nose.... then that would be a potentially serious condition.

NEMA: Dr. Simmons-O'Brien says someone with bleeding problems because of medication or condition should not get a piercing...and that taking non-steroid pain medications like aspirin, or ibuprofen can make you bleed or bruise more easily after a piercing. The doctor says most people go through piercing without problems, but they should be made aware there are potential problems, and they should be fully explained. Oh...and when someone wants to take the ear or nose, or whatever ring out down the road...there's a pretty good chance they've got a hole... or a scar for life. I'm Steve Girard.