P.B.J. Featured Articles

The Great Debates

From aftercare to jewellery preference, there will never be a time when two piercers will agree on absolutely everything. Is a piercer wrong or unprofessional because s/he prefers to use bent barbells instead of rings for navel piercings? Recommends Listerine instead of Oral-B? Uses 14 gauge barbells for tongue piercings? Not necessarily, as long as the piercer has thoroughly studied the alternatives, has intentionally chosen one method over the other's) based on experience and/or education, AND can explain to you, if asked, why s/he has chosen a particular method.

In this section, we introduce you to some of the more common topics of debate among professional body piercers, and provide unbiased information from all sides so that you have a better understanding of what the fuss is all about. Don't be afraid to ask your piercer to explain his/her reasoning for choosing one method over another.

This is an ongoing project, so if you have any information to add on the topics covered here, or if you have other topics that could be added, please let us know. So far, here's what we have (click on the heading to go there directly):

          REGARDING JEWELLERY

                    - Internal vs. External Thread

                    - Barbell or Ring?

                    - Orbital and Industrials - One or Two Pieces of Jewellery To Heal?

                    - 316L Stainless Steel, Titanium or Niobium?

                    - Gold For Fresh Piercings

          REGARDING AFTERCARE

                    - Use of Antibiotics

                    - Soap

                    - Salt

                    - Essential Oils

                    - Mouthwash

          MISCELLANEOUS

                    - Needle or Dermal Punch?

                    - Piercing Guns

With any body jewellery that has threaded ends (barbells of all shapes and labret studs), either the ball or the post needs to receive the thread. When a barbell is internally threaded, it means that the ball has the threaded rod attached and it screws into the post. Externally threaded barbells are the opposite: the post screws into the ball.

Pro External: 

(1) There is a possibility that the ball can become detached from the post if tightness is not checked regularly. For most piercings this is nothing more than an inconvenience, but with oral piercings, there is a chance that the detached ball could be swallowed. If the ball is smooth, as it is with external thread barbells, the ball will pass through the body with no damage or delay. With internally threaded barbells, the threaded rod is attached to the ball and if the ball is swallowed, the rod could cause internal damage during it's travels. (2) Externally threaded barbells are less expensive than internally threaded ones .

Pro Internal:  

For fresh piercings, not having the exposed thread on the post means that the post will enter (and exit) the piercing smoothly with no risk of exposed threads damaging the tissue as they pass through.

In general, rings allow for proper cleaning of a new piercing, and they accommodate swelling. Proper cleaning of a new piercing minimizes the chances of it becoming infected during the first few weeks. Proper cleaning involves using the jewellery to help get the soap all the way through the piercing and to ensure all the soap residue is completely rinsed out. By it's design, a ring accommodates this very nicely. By comparison, a barbell's movement within a piercing is limited by it's length, and the balls at either end stop the jewellery from moving any more. If a barbell is not long enough, there is more chance that the soap will either not get completely through the piercing, or will not be completely rinsed out after - both can increase the chances of the piercing becoming irritated.

For some piercings, such as the tongue, a ring is not practical. In these cases, a longer barbell is used so that it will not interfere with swelling, and will allow for proper cleaning. Once the initial healing stage is passed, the barbell is exchanged for a shorter, more snug fitting one.

Regarding The Navel: Although Captive Bead Rings have been the accepted jewellery for navel piercings, more and more body piercers are electing to use curved barbells instead of rings for navel piercings. For some people, curved barbells help to eliminate problems associated with big rings (most commonly, the ring is flipped to one side by clothing or sleeping on the stomach, or is snagged on clothing).

Regarding The Nipple:  For any piercing, the diameter of the ring is an important consideration. It must be large enough to ensure that the arc section that sits inside the piercing is not too curved - a tight curve puts pressure against the piercing and encourages migration or rejection. For some people, a ring that accommodates this necessity can be quite large, and the weight and/or swinging of the ring can cause discomfort especially for a fresh piercing. For this reason, many piercers are now using straight barbells with small balls for nipple piercings.

An Orbital is one ring going through two separate piercings; an Industrial (also called "Scaffold") is one barbell going through two separate piercings. The most common site for these projects is the ear, and the ear cartilage is the main issue (ear lobes are more giving, and adapt to pressure from the jewellery easier than cartilage does).

Two Pieces - Pro:  

Two separate pieces of jewellery (most commonly, Captive Bead Rings) allow the piercings to be cleaned separately, and during healing, the movement of one ring will not irritate the other piercing. Also, by waiting for the piercings to heal before inserting the final jewellery, your piercer can accurately measure the distance between the two piercings to ensure a proper-fitting barbell or ring.

Two Pieces - Con:  

Piercers opposed to this approach claim that two separate rings will affect the alignment of the two piercings so that when the barbell is inserted after the piercings have healed, it will put pressure on the piercings.

One Piece - Pro:  

The barbell will keep the piercings aligned so there is no pressure on the piercings

One Piece - Con:  

The movement of the barbell affects both piercings whether sleeping, wearing headphones, or cleaning the piercings - the piercings can not be dealt with separately. Also, there is usually a certain amount of swelling with any new piercing. By their design, rings accommodate this swelling without restricting it. If you have a barbell in,  especially one that is measured so the balls touch the edges of the ear, there is no allowance for swelling, and the barbell will restrict the swelling. Another problem with a snug-fitting initial barbell is that it can not be moved to accommodate cleaning without bending your ear. 

NOTE: 

Regardless of the method used by your piercer, it is important that the needle is angled to align with the second piercing site during the piercing. If each piercing is done horizontally, there will always be pressure against both piercings when the end jewellery is inserted. Piercers who prefer using two rings for the initial healing emphasize that the rings are the smallest diameter that can safely be used (to avoid pressure against the piercings), and that the weight does not affect the piercing angle: An angled piercing will not turn into a horizontal piercing by the weight of the jewellery.

If you are planning a project such as this, be sure to discuss it with your piercer first, before the piercing starts.

The Facts:

STAINLESS STEEL: Stainless steel is a generic term for a group of corrosion resistant steels containing a minimum of 12% chromium. The specific classification 316 refers to the specific alloys. The "L" refers to "low" carbon content (there is also a "316H" alloy). The major alloys in 316L steel are Chromium (16-18%), Nickel (10-14%), Molybdenum (2-3%) and Manganese (0.5 - 2.0%).

Although 316L stainless steel contains nickel, the alloys bind the nickel so firmly that sweat can not liberate the nickel salts. For "most" people, even those with a nickel sensitivity, 316L stainless steel will not induce nickel dermatitis because there is no nickel release.

However, there are some people who are "hypersensitive" to nickel, and react to the nickel content in 316L stainless steel. If you know you are among this group, or you just don't want to take a chance, you can ask your piercer to use niobium or titanium instead.

COMMERCIALLY PURE TITANIUM (Grades 1,2,3,4) is used by some jewellery manufacturers, but it is important to note that these grades are NOT recognized by the American Society for Testing of Materials (ASTM) as being suitable for medical implantation application. Titanium is an elemental metal, and in it's 100% pure, unalloyed form as these grades are, it will not cause an allergic reaction.

GRADE 23 TITANIUM (specifically: Ti 6Al 4V Eli) is one of only three titanium alloys recognized by the ASTM as suitable for implantation applications. In addition, an "F" prefix granted by the ASTM (F-136) indicates FDA consent for use in medical devices. NO HIGHER QUALIFICATION CURRENTLY EXISTS. Unlike Commercially Pure Titanium grades, Grade 23 Titanium IS alloyed with (most prominently) Aluminum (6%) and Vanadium (4%). However, this alloy is completely biocompatible (or it wouldn't be approved for medical implant devices). Basically, Grade 23 Titanium is a better quality grade for body jewellery because of it's recognition by the ASTM and FDA for medical implant applications.

DENTAL GRADE TITANIUM is not suitable for body jewellery application because it has a rough surface designed to encourage bonding to bone and tissue.

NIOBIUM:  The simple one - Niobium is also an elemental metal, and the niobium used for body jewellery does not contain any alloys.

 NOTE:

Your piercer should have a good selection of at least titanium jewellery, if not titanium and niobium, to allow you the option of selecting which metal you would prefer to use. If your piercer sells titanium jewellery, s/he must be able to tell you what grade the titanium is. As with stainless steel, there are many different titanium alloys available, and not all are suitable for body piercing application.

The majority of professional body piercers agree that hollow gold jewellery, gold plated jewellery, and solid gold jewellery 10k or lower are inappropriate for fresh piercings. At the other end of the scale, it is also accepted that pure 24k gold will not produce allergic reactions, but the softness and cost of pure gold make it impractical for body jewellery application. The debate centers around whether 14k or 18k gold should be used for fresh piercings.

The Facts:

The karat number for gold gives you the percentage of pure gold and percentage of alloy material it contains. Depending on the manufacturer, these alloys involve differing amounts of nickel, silver, zinc and copper. To find out how much pure gold there actually is, you simply divide the karat number by 24 (pure gold). Doing this, you will find that 10k gold contains 0.417 (41.7%) pure gold, which means it contains 58.3% alloy material. 14k gold contains 58.3% pure gold / 41.7% alloy material. 18k gold contains 75% pure gold / 25% alloy material.

The main concern with piercing is infection, and during the first few weeks, your body is at it's most vulnerable stage, unable to defend itself from bacteria. This is the time when you need to help your body protect itself by cleaning the piercing, ensuring that nothing enters the piercing and interferes with your body's efforts in building the protective "new skin" barrier.

While reading all the options listed below, keep in mind two important things:  (1) Only soap will "clean" a piercing. (2) Piercings are easily irritated by any number of additives in the products you choose to use, and the only way to deal with the symptoms permanently is to remove the source of irritation. An ointment or lotion may give temporary relief of the symptoms, but if the source of irritation is not removed, the symptoms will return. In addition, the product you use to mask the symptoms may contain additives that add to the irritation.

Main Entry: 1pro.phy.lac.tic Pronunciation: "prO-f&-'lak-tik also "präf-&-'lak-tik Function: adjective

1 : guarding from or preventing the spread or occurrence of disease or infection <pro·phy·lac·tic therapy>

2 : tending to prevent or ward off: Preventive.  Copyright 1997 by Merriam-Webster, Incorporated.

Some piercers recommend using a product that is designed to protect the fresh piercing from invasion by potentially harmful organisms. Often, these products are OTC (over-the-counter) antibiotics such as Bacitracin, Polysporin, or Neosporin.

In Favour: 

If properly understood and explained by the piercer, prophylactics should perform as they are intended, and provide added protection against infection during the initial 10-14 day healing process.

Opposed: 

Basically, if not understood by the piercer, and not properly explained to the client (therefore, not properly used), there will be no benefit. Even when used properly, prophylactics are only beneficial during the very early stages of the healing process when the body can't protect the "raw" tissue. They also have a very focused, specific purpose - preventing infection caused by micro-organisms - for a very specific time (usually no less than 7 days; no more than 14). They will not be of any benefit to piercings that are irritated by other ointments, lotions or potions, they will not be effective if they are not applied as instructed, when instructed (by the manufacturer), they will not clean a piercing, and they will not heal lumps and bumps or cure existing infections.

NOTE: 

Many body piercers are recommending the use of OTC antibiotic ointments without giving clients any information other than a product name. As the owner of your body, you need to decide for yourself whether you should use these products. You need to know (a) how to use them, (b) how long to use them, and (c) when to stop using them. You also need to understand what they will and will not do. If your piercer tells you to use an antibiotic ointment but does not provide any other information, assume, for your own safety, that the piercer does not understand why s/he is recommending them.

The Facts:

Antibacterial soaps most commonly contain the antibacterial ingredient Triclosan. As the name indicates, these soaps are effective against bacteria. Antimicrobial soaps most commonly contain Chloroxylenol (PCMX). These soaps are effective against a broader range of microorganisms (viruses, fungi, algae, protozoa) in addition to gram-positive and gram-negative bacteria.

Liquid antibacterial soaps were not created for body piercing aftercare - they were created for a much more general public. Because of this, many soaps contain dyes that make them look good in the bathroom, fragrances that make you smell nice after you have washed, and/or moisturizers so that you can wash your hands as much as you want without drying out the skin. Every additive has the potential for irritating a fresh piercing.

There are cleaners specifically designed for wound care, but they are traditionally difficult to find, and quite expensive. If you are interested, ask your physician.

NOTE: 

Most professional body piercers will recommend a specific brand of liquid antibacterial soap, based on what has proven to be successful with the majority of their clients. Avoid bar soap because flakes can stay inside a piercing and irritate it, and always lather the soap in your hands first then apply the lather to the piercing. If your piercing shows signs of irritation after the first week, consider switching to a different brand.

The Facts:

• TABLE SALT (sodium chloride) contains iodine which may irritate a piercing.

• SEA SALT (sodium chloride) does not contain iodine.

• SALINE SOLUTION often contains enzymes, disinfectants, or cleansers which may irritate a piercing.

• EPSOM SALT (hydrated magnesium sulfate, aka: sulfuric acid) will irritate a piercing. According to the Material Safety Data Sheet for Magnesium sulfate, it could cause irritation on (intact) skin, and if it comes in contact with the skin, it is recommended that the area contacted be washed with soap for 15 minutes.

In Favour: 

Piercers who recommend using salt claim that it helps to remove dried discharge ("crusties"), relieves itching, increases air and blood circulation, and draws out infection. We have read recommended dilutions ranging from ¼ tsp per 8 oz distilled water all the way up to 2 tablespoons in a shot glass of water. According to the Association of Professional Piercers, the recommended mix is the first one - ¼ tsp salt to 8oz water.

Opposed: 

Piercers opposed to the use of salt argue that soap is the only way to "clean" a piercing, and that the antibacterial (or antimicrobial) ingredients effectively reduce the risk of bacterial infection (as opposed to salt which "draws out an infection" after infection has started). If mixed too strong, it will irritate the piercing and discourage healing, and if not heated to at least body temperature, it will be ineffective.

As with the salt issue, the use of essential oils is a highly individual choice among body piercers, and there doesn't seem to be much agreement on the specific oils to use, or the most beneficial strength. With tea tree oil, for example, many piercers recommend using it diluted. Dr. Weil, "America's best-known advocate for the integration of traditional and alternative medicines", insists that it can be used full-strength on piercings (www.pathfinder.com/drweil/qa_answer/0,3189,1718,00.html)

NOTE: 

If you choose to use tea tree oil or any other essential oil, discuss it with your piercer, and follow your piercer's directions. If you notice signs that the piercing is being irritated (red and/or itchy skin), advise your piercer.

The most common argument given against Listerine is that it contains alcohol, which causes the tongue to swell, and encourages the growth of Candida albicans (aka: Thrush). To clarify:

1. Alcohol in mouthwash does not cause swelling. You do not swallow it, so it does not have a systemic effect the same way that drinking  a shot of whiskey does.

2. Listerine contains Eucalyptol (a topical antiseptic) and thymol (a fungicide). This combination delays the potential onset of fungal infection (thrush), allowing for the extended use without the threat of overpopulation of the microorganism.

Piercers who recommend the use of Listerine emphasize that it:

(a) Must be Yellow Listerine. Green and Blue Listerine contain sorbitol, a sugar substitute, which supports microbial growth.

(b) Should only be used for ten days maximum. At the end of the ten day period, you should stop using yellow Listerine and switch to a gentler mouthwash to re-establish the natural ecology in the mouth.

(c) Must be used frequently (every hour and a half) during the first ten days after the piercing because fungicides only "inhibit" (do not eliminate) the growth of the microorganism.

(d) Must be used full strength.

There is absolutely no benefit to using Listerine only a couple of times a day, or watering it down. If you are not prepared to use it as frequently as required, or if you intend to water it down so it tastes better, don't use it at all.

No mouthwash "heals" a piercing - all they do is provide some control over the bacterial population in your mouth. Unfortunately, this will usually cause an imbalance in the "normal" population of "good" and "bad" bacteria:

Scope, Green Listerine and Blue Listerine contain sorbitol, a sugar substitute, which actually supports microbial growth.

Oral-B contains glycerine which also supports microbial growth. In one study done to determine the effects of different mouthwashes on gram-positive and gram-negative bacteria, "The Oral-B research agent did agree that gram-negative bacteria could have found a food source in the form of glycerine". This product contains an antibacterial ingredient (cetylpyridinium HCl), but it has no anti-fungal ingredients to control Candida albicans.

Biotene was created to help people who suffer from xerostomia (dry mouth). It promotes the growth of bacteria, and was never intended for use in healing oral wounds.

NOTE:

Most mouthwashes (and toothpastes for that matter) will in some way affect the ecology or natural balance of good and bad bacteria in a healthy mouth. It is not a simple case of a mouthwash being good or bad. There are over 400 different microorganisms that inhabit a healthy mouth, and only 20 of those have been associated with caries (tooth decay) or periodontal disease. Remember, mouthwashes were created to deal in some way with these microorganisms; they were not created to heal oral piercings.

We asked some dentists to comment on appropriate aftercare procedures for oral piercings, and the overwhelming response was "nothing", as in, do nothing except rinse the mouth with water to remove food particles. The dentists reminded us that this is the most common regimen recommended after much more invasive surgical procedures than piercing. When asked if there was a difference because of the fact that with piercing, one is attempting to heal an open wound, one dentist responded, "Do you really think those flimsy sutures will close a surgical incision tightly enough to prevent saliva and bacteria from penetrating? Besides, no attempt is made for most routine extractions to close the socket; it remains open to the oral environment."

A needle cuts through tissue, using scalpel-sharp edges to make a curved slit which the jewellery will pass through. A dermal punch removes tissue, creating a round hole for the jewellery to be inserted. A coring needle does the same thing - it removes a core of tissue.

Because a needle does not remove tissue, piercings are more likely to close over fully if and when the jewellery is removed.

Most piercers who use dermal punches use them to either (a) create an instant large-gauge hole, most commonly in earlobes, or (b) for cartilage piercings*.

*With most piercings, the tissue moves out of the way of the needle and jewellery, and settles around it. With cartilage piercings, the cartilage is not flexible, so instead of moving, it remains and pushes against the jewellery. This can cause pain and discomfort that may not stop until the jewellery is removed. To avoid this, piercers who use needles will use a needle that is one gauge thicker than the jewellery to be used. Dermal punches remove the cartilage, thus avoiding the problem.

NOTE:

Keep in mind that the removal of tissue by dermal punch or coring needle is a more permanent form of body modification. If you remove jewellery from a needle-pierced hole, the tissue will close in around the piercing. If you remove jewellery from a dermal punched hole, the hole will remain because the tissue has been removed.

It has taken us a while to include piercing guns in this section, because we pride ourselves in providing unbiased information. We tried very hard to find some positive things about piercing guns, but even the manufacturers of these guns wouldn't talk to us.

While we work on this section, please check out our petition. By signing this petition, piercers and/or studios listed are simply declaring their concern for the health risks that piercing guns pose, and letting you know that there is a better, safer way to be pierced. This petition is simply our effort to help these piercers get their message out, without the need to conform to Association policies or pay membership dues. If you are a piercer and would like to be added to the petition, simply email us with your name, address and phone number.

Although it is important that you follow your piercer's aftercare instructions, you must always be alert to changes in your piercing, and signs of irritation (and of course, infection). If something is "not right" with your piercing, visit your piercer so that he/she can see the problem. A professional body piercer will readily acknowledge that bodies heal differently and react to different things, and will start eliminating potential sources of irritation. This may take some time, especially if the piercer has recommended using several products.

Unfortunately, there are piercers out there who allow their egos to override everything. These people often use such catch-phrases as, "Don't worry, it can stay red and dry like that for a year" or "Try using XYZ ointment". If you suspect that your piercing is irritated, the piercer should be guiding you in the removal of potential sources of irritation, not adding more products to the list. Many products will give temporary relief of symptoms including lumps and bumps, but if they were caused by irritation and the source is not removed, they will return.

During the first 7-10 days, a piercing can be expected to show signs of irritation in response to the procedure. However, the changes should gradually decrease over the course of those first 7-10 days. If redness persists more than ten days, or worsens, chances are that your piercing is being irritated and if this is the case, the healing process is hindered or stopped completely as the body deals with the irritation.

If you don't like your piercer's response to your concern, go to another piercer. If there are no other piercers around, find a few body piercers on the internet and pose your concerns to them. Don't be afraid to get several opinions - people do it all the time with doctors; why shouldn't you do it with piercers?