The material covered in this review was obtained from in-depth research, extensive field-work, and personal knowledge. I searched Medline, PSYNDEX, PsychLit, and PubMed databases of English, German, and French articles published from 1966 until December, 2002, using the search term “piercing” (578 references), and then narrowing results to articles relevant to “body piercing” and “ear piercing”. I reviewed sources mentioned in the bibliographies of these references for additional citations, and
ReviewBody piercing: medical consequences and psychological motivations
Section snippets
Prevalence
Body piercing and other body modifications have increased tremendously in popularity in recent years, and have started to be practised across many social and age groups.7 However, no exact statistics for these practices are available, and estimates of incidence have been derived from studies with few participants. Estimates of the prevalence of the related body modification of tattooing in the USA lie between 7 million and 20 million people—the higher estimate is equivalent to around 13% of the
Effect on health-care systems
Reports of side-effects and complications associated with body piercing are increasing. These side-effects are thought to have an economic effect on health-care systems.12 In a 1999 UK survey, 95% of family practitioners in Bury and Rochdale stated they had seen patients with a complication resulting from a piercing.13 Among Pace University undergraduates in NY, USA, 17% reported a medical complication such as bleeding, tissue trauma, or bacterial infection relating to body piercing, especially
History, origins, and global significance
Body piercing confined to the ears, mouth, and nose has been a common practice in almost every society around the world as far back as can be traced.17 Furthermore, body piercing is practised by contemporary tribal societies on almost all continents (figure 2), but especially in Africa, Asia, and South America. Next to beauty and community affiliation, the main motivations for body piercing in tribal societies are ritual initiation, rites of passage, and sexuality. The ability to stand pain is
Regulations
Body piercing is done in regulated and unregulated shops, department stores, jewellery shops, homes, or physicians' offices. Generally no antibiotic is used, and sterilisation methods vary. Ear piercing is frequently done in beauty salons or jewellery stores, and body piercing often takes place in tattoo
establishments. In general, body piercing is in the hands of unlicensed personnel, who have learned techniques from magazines, videos, and other people who do piercings (piercers).30 Although
Sites and procedures
Earlobes and ear cartilage are the sites most frequently pierced. Other body parts that are often pierced include eyebrows, nose, cheeks, lips, frenulum, tongue, uvula, nipple, navel, and various genital sites (Table 1, Table 2, Table 3, Table 4, Table 5). Piercings in less frequently used sites, including flat surfaces such as the chest wall or the palm of the hand, have a high rate of rejection.23
Body piercing is usually done without anaesthesia. A hollow 12–18-gauge needle is passed through
General
The rate of acute complications resulting from body piercing is determined by piercing site, material, practitioner experience, hygiene, and aftercare (table 6). Local infection or bleeding is reported in 10–30% of piercings.42, 43, 44 In the UK, 95% of family practitioners reported treating medical complications arising from body piercing in various sites: navel (40%), ear (35%), nose (12%), nipple (5%), and 8% split between tongue, chin, eyebrows, and genitals.13 Infection was the most common
Psychological and sociological perspectives
Few data exist for the psychological and sociological aspects of body modifications in western societies. Most reports in this area have discriminative overtones, associating a certain psychopathological or antisocial behaviour with forms of body modification such as tattoos or piercings.93 Even forensic and psychiatric studies associate culturally-sanctioned practices such as tattooing and body piercing with self-mutilation—ie, deliberate, non-suicidal destruction of one's own body tissue.94
Conclusion
Depending on where on the body a piercing is located, body piercing makes both an introverted, private, and an extroverted, public statement towards society. In return, piercing is perceived with ambivalence and somewhat negatively by society. However, the collective prejudices against body piercing and the often severe side-effects seem to be incentives rather than disincentives for the practice. Thus, irrespective of personal judgment, this form of body modification should be accepted as a
Search strategy
References (109)
Body piercing in adolescents
J Pediatr Health Care
(1997)- et al.
Tattooing: another adolescent risk behavior warranting health education
Appl Nurs Res
(1997) - et al.
Prevalence of body art (body piercing and tattooing) in University undergraduates and incidence of medical complications
Mayo Clin Proc
(2002) Body piercing: issues for A&E nurses
Accid Emerg Nurs
(2001)- et al.
Sarcoid-like foreign body reaction in body piercing: a report of two cases
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1997) - et al.
Body piercing as a risk factor for viral hepatitis: an integrative research review
Am J Infect Control
(2001) Hepatitis C virus infection in the United States
J Hepatol
(1999)Lingual abscess secondary to body piercing
J Emerg Med
(2001)- et al.
Body piercing involving oral sites
J Am Dent Assoc
(1997) - et al.
Endocarditis due to Neisseria mucosa after tongue piercing
Clin Microbiol Infect
(2001)
Tongue piercing (oral body art)
Br J Oral Maxiofac Surg
Endocarditis after nipple piercing in a patient with a bicuspid aortic valve
Ann Thorac Surg
Body piercing: promoting informed decision making
J Sch Nurs
You pierced what?
Ped Nurs
The hole truth
Nursing Times
Non-mainstream body modification: genital piercing, branding, burning and cutting
J Contemp Ethnogr
Virginia code. Title 18.2: crimes and offenses generally, chapter 8, crimes involving morals and decency, article 4. Family offenses; crimes against children, etc. 18.2–371.3. Tattooing or body piercing of minors
Modifying the body: piercing and tattoos
Nurs Stand
Tattooing and body piercing: body art practices among college students
Clin Nurs Res
Prevalence of tattooing and body piercing in the Australian community
Commun Dis Intell
A trend and its complications: piercing
Kosmetische Medizin
Piercing problems for ‘one in five’
Body piercing in the accident and emergency department
J Accid Emerg Med
Attitudes of healthcare providers and students towards tattooed people
J Adv Nurs
Body piercing
BMJ
The penis inserts of Southeast Asia: an annotated bibliography with an overview and comparative perspectives
Body piercings
A fashion for ecstasy: ancient Maya body modifications
A trend and its complications: piercing
Kosmetische Medizin
The forgotten icon: on the decease of Sammy Streckenbach
Piercing
Punks—the colourful misery
Tattooing in adolescents: more common than you think
J Sch Nurs
Have you heard?
The Hartford Courant
Risks associated with tattooing and body piercing
J Public Health Policy
Safe, sane and attractive body piercings
Body art: regulatory issues and the NEHA body art model code
J Environ Health
Development of public health regulations for tattooing and piercing and their realisation
Gesundheitswesen
Guide des bonnes pratiques du piercing: guide technique á l'usage des professionnels du piercing, recommondations pour la prévention de la transmission des maladies infectieuses
Haemophilus aphrophilus endocarditis after tongue piercing
Emerg Infect Dis
Mother demands new law on body piercing
Daily Telegraph
Regulation of skin piercing: a consultation paper
Regulation of skin piercing businesses
Official newsletter of the European Communities no. L188/1. Brussels
Tattooing and body piercing— experiences from public health infection surveillance by a public health office
Gesundheitswesen
A clinical look at body piercing
Reg Nurse
Piercing and its infectious complications: a public health issue in France
Presse Med
Complications following piercing in the oral and facial region
Mund Kiefer Gesichtschir
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