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From: Anne Greenblatt <[e-mail]>
Newsgroups: rec.arts.bodyart,news.answers,rec.answers
Subject: rec.arts.bodyart: Piercing FAQ 3--Getting a New Piercing
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Archive-name: bodyart/piercing-faq/getting-new-pierce
Last-modified: May 01, 2000
Posting-frequency: Quarterly
URL: http://www.cs.uu.nl/wais/html/na-dir/bodyart/piercing-faq/.html

Summary: This posting contains information about body piercing. Anyone
    interested in the subject and/or who wishes to read/post to
    rec.arts.bodyart should read the Piercing FAQ first.

The rec.arts.bodyart Piercing FAQ is divided into 30 parts:

1--Introduction
2A--Jewelry Materials
2B--Jewelry Sizes & Designs
2C--Facial Piercings & Their Suggested Jewelry
2D--Body Piercings & Their Suggested Jewelry
2E--Genital Piercings & Their Suggested Jewelry
3--Getting A New Piercing
4A--Professional Organizations, Piercing Instruction
4B--Professional Piercers - United States - Alabama - California
4C--Professional Piercers - United States - Colorado - Iowa
4D--Professional Piercers - United States - Kansas - Nevada
4E--Professional Piercers - United States - New Hampshire - North Dakota
4F--Professional Piercers - United States - Ohio - Pennsylvania
4G--Professional Piercers - United States - Rhode Island - Wyoming
4H--Professional Piercers - Canada
4I--Professional Piercers - Beyond N. America
4J--Professional Piercers - Beyond N. America Cont'd
5--Care Of New Piercings
6--The Healing Process & Healing Problems
7--Healed Piercings
8--Historical Information
9A--Resource List
9B--Resource List Cont'd
10A--Personal Experiences - Facial & Unisex Piercings
10B--Personal Experiences - Genital Piercings
10C--Personal Experiences - Genital Piercings Cont'd
10D--Personal Experiences - Genital Piercings Cont'd
11A--Jewelry Manufacturers
11B--Jewelry Manufacturers Cont'd
11C--Jewelry Manufacturers Cont'd

This section includes:

3  Getting A New Piercing
   3.1  What to Look for in a Piercer
   3.2  Assessing Anatomy and Selecting Jewelry
   3.3  Piercing Needle or Gun?
   3.4  Basic Piercing Procedure
   3.5  Methods of Disinfection and Sterilization
   3.6  Anesthetics
   3.7  Are You Under 18?
   3.8  Does It Hurt?
   3.9  Making Your Experience More Comfortable
   3.10 Piercing Kits and Doing It Yourself

All texts written and (c) 2000 by Anne Greenblatt unless otherwise
noted.
Please see Part 1 of the FAQ for information regarding copyright and
dissemination of the FAQ.

DISCLAIMER!  The Piercing FAQ contains material of a sexually explicit
nature. The information contained in the Piercing FAQ should not be
construed as medical advice.


3 GETTING A NEW PIERCING

3.1  WHAT TO LOOK FOR IN A PIERCER

Consider first visiting the studio without intending to get pierced so
that
you are not under pressure or too nervous to be aware of the quality of
the
services.

The best way to judge a piercer is to look at his/her work. If
possible, talk
to customers about their experiences. Ask to see a portfolio,
specifically
photographs of the piercing you are interested in and preferably photos
of
successfully healed piercings.

While attendance of a piercer training seminar or class should be
considered
an advantage, it does not guarantee a piercer's level of skill or
experience.
Ideally, a training seminar serves as a well-rounded introduction to
safe and
responsible piercing.

The facility should be clean, orderly, and well-lit. All Instruments
utilized
during the procedure should be sterile. Disposable items such as gloves,
needle, cork, towels, cotton swabs, and gauze pads should all be new and
sterilized if possible.

The piercer should answer any questions before and after the piercing is
performed. You should feel comfortable and at ease, not rushed. The
piercer
should review the piercing procedure and give both oral and written
aftercare instructions. S/he should discuss the risks and possible
complications associated with the piercing, which may include infection,
migration or rejection, scarring, allergy or sensitivity to the jewelry,
allergy or sensitivity to the aftercare products, and suggest a course
of
action in case a problem does occur.

A responsible piercing studio will require that you complete a waiver
form
which describes the limits of piercer liability as well as what you
should
expect before, during and after the piercing procedure. The waiver
serves to
protect both the piercer and customer. It is your responsibility to
inform the
piercer of any medical conditions which may be exacerbated by the
piercing
procedure or of conditions which may interfere with the healing process.

The piercer should practice aseptic technique which includes appropriate
sterilization of instruments and jewelry, disinfection of surfaces, and
avoiding cross-contamination. Every instrument which comes into contact
with
your body or with the jewelry should come from sealed sterilization
packets
with sterilization indicators. The needle and jewelry should remain in
sterilization packets until they are used.

Jewelry, as it is received from the manufacturer, should be assumed to
be
non-sterile. Ideally, the jewelry should be sterilized in individual
autoclave packages which are opened in front of the customer so that
there
is no question that the jewelry has been sterilized. Jewelry which has
been
bulk sterilized must be stored and handled responsibly. Jewelry which
has
been stored in a display case or handled with bare hands should be
re-sterilized. Jewelry which has previously been worn should be
sterilized.

The piercer should wear new, disposable gloves throughout the procedure
and
should change gloves when appropriate to avoid cross contamination.
Cross
contamination occurs when a clean or sterile item comes into contact
with a contaminated item. Cross contamination also occurs when a clean
or
sterile item is handled with contaminated gloves or gloves that have
been
worn to handle contaminated items. To prevent cross contamination of
sterile
instruments during the piercing procedure, the piercer should change
gloves
if s/he touches anything that is non-sterile or unsuitably contaminated
(ie.
handled with bare hands or used instruments that have not been
sterilized).
After the piercer completes the piercing procedure, s/he should change
gloves before handling items that will not be disposed of or autoclaved.


3.2 ASSESSING ANATOMY AND SELECTING JEWELRY

Because everyone is built differently, not everyone is anatomically
suited
for every piercing. Certain daily activities and sports can prolong
healing or prohibit certain piercings. An experienced piercer will be
able
to ascertain if the piercing is likely to be successful.

A piercing should not be attempted if there is not enough tissue to
support
the piercing. Piercings made in flat areas often migrate or reject
(grow-out). The optimum area to be pierced is one in which the piercing
will
be perpendicular to the tissue, like an earlobe piercing.

Wearing jewelry of an appropriate metal, design, and dimensions (gauge
and
diameter) is important for a successful piercing. Jewelry that is too
thin
in gauge is more easily rejected by the body. Wearing jewelry that is
too
thin increases the risk of the piercing being torn if the jewelry gets
caught or pulled. Wearing jewelry that is too thick and heavy may cause
the
piercing to migrate or reject. The jewelry must not be so thick that the
strength of the tissue is compromised.

The diameter or length of the jewelry must be chosen carefully. The
jewelry
should be chosen after the piercing is measured. Some piercings tend to
swell during the healing period. Wearing jewelry that is too small in
diameter or length will constrict the piercing and cause the piercing to
migrate and scar.

The jewelry should be new and should be polished to a mirror-like shine,
regardless of the type of metal. Used jewelry has minute scratches
which can
irritate a new piercing and trap bacteria. Oral jewelry is often
scratched
even after only a short time of wear. Oral jewelry collects plaque
which is
very difficult to thoroughly remove.


3.3   PIERCING NEEDLE OR GUN?

Ear Piercing Gun

The piercing gun or piercing implement was originally intended to be
used
on earlobes only. Even so, ear piercing studs are usually of one length
and too short to accommodate swelling or earlobes which are thicker than
average.

Ear piercing studs are very difficult to clean thoroughly. The butterfly
clip backing can become clogged with hair, discharge, dirt, and
bacteria.
Studs also have a tendency to become wrapped with hair, embedding the
hair
in the piercing.

The piercing gun procedure causes more tissue trauma than the piercing
needle procedure. The studs are considerably duller than a piercing
needle
and literally tear a hole through the tissue, whereas the needle slices
a
clean hole the gauge of the jewelry to be installed. A cleanly made hole
is especially important in cartilage piercings.

Most importantly, the cleanliness of the piercing gun method is
questioned. Ear piercing guns are often made of plastic which cannot be
properly sterilized in an autoclave. Simply wiping the gun with a
surface
disinfectant between clients is not adequate when the piercing gun could
have possibly been exposed to bloodborne pathogens. Although the
piercing
studs themselves may be sterile, piercing guns which touch the earlobe
before and after the procedure can be easily contaminated with blood.
The
gun may also be indirectly contaminated if the piercer touches the studs
after they are installed and then touches the piercing gun without
changing gloves.

While some newer piercing guns are designed with sterilized,
encapsulated
stud cartridges to reduce the risk of contamination of the gun, older
models without this safeguard are still used and are readily available
for
sale.

From The Centers for Disease Control and Prevention
  http://www.cdc.gov/nchstp/hiv_aids/hivinfo/transmit.htm

  "In 1985, CDC issued routine precautions that all personal service
  workers, such as hairdressers, barbers, cosmetologists, and massage
  therapists should follow, even though there is no evidence of
transmission
  from a personal service worker to a client or vice versa. Instruments
that
  are intended to go through or penetrate the skin, such as tattooing
and
  acupuncture needles or ear piercing devices, should be used once and
  thrown away or thoroughly cleaned and then sterilized. Instruments
such as
  razors, which are not intended to penetrate the skin but which may
become
  contaminated with blood should be used for only one client and thrown
away
  or thoroughly cleaned and disinfected after each use."

Single-Use Disposable Needles

Piercing needles are hollow, lancet-point needles, beveled and sharpened
similarly to the hypodermic needles used by medical professionals. Most
are
about 2 inches in length. Piercing needles slice a crescent-shaped hole
and
do not remove tissue. The larger the needle, the more exaggerated the
crescent shape of the hole. Most piercers do not perform piercings
larger
than 10 or 8ga. Many piercers in Europe use cannula needles designed for
intravenous drips, which are fitted with a plastic sheath that is used
to
thread the jewelry into the piercing.

The needle should remain in its sterile autoclave package until the
piercer
is ready to proceed with the piercing. Needles should be used only once
and
placed in a medical sharps container which is disposed of through a
medical
waste disposal service. Aside from cleanliness concerns, needles are
noticibly dulled from a single use.

References:

"Complications of Ear Piercing: Treatment and Prevention," W.M.
Hendricks,
Asheboro Dermatology Clinic, North Carolina. Cutis, 48:5, 1991 Nov,
384-94,
ISSN 0011-4162.

"Embedded Earrings," H.A. Cohen et.al., Pediatric Community Clinic,
Petach
Tikvah, Israel. Cutis, 53:2, 1994 Feb, 82, ISSN 0011-4162.

"Embedded Earrings: a Complication of the Ear Piercing Gun," H.R. Muntz
et.
al., Department of Pediatric Otolaryngology, St. Louis Children's
Hospital,
Washington University Medical Center, Missouri 63110. In J Pediatr
Otorhinolaryngol, 19:1, 1990 Mar, 73-6, ISSN 0615-5876.

"Experts Discourage Use of Home Piercing Kits," WRAL-5, Oct 20 97,
http://www.wraltv.com/features/healthteam/1997/1020-ear-piercing/

"Hazards of Ear Piercing Procedures which Traverse Cartilage: A Report
of
Pseudomonas perichondritis and Review of Other Complications," V.L.
Cumberworth and T.B. Hogarth, Department of Otolaryngology, Queen's
Medical
Centre, University Hospital, Nottingham, England. Br J Clin Pract,
44:11,
1990 Nov, 512-3, ISSN 0007-0947.

"The Piercing Gun," Association of Professional Piercers Procedural
Standards, 1998 edition, pp 31-38, http://www.safepiercing.org


3.4  BASIC PIERCING PROCEDURE

Prep

The area to be pierced should be cleansed using a surgical scrub.
Povidone
iodine is most often used for prep. To prevent contamination and
preserve
efficacy, individually packaged single use disposable swabs and wipes
should
be used instead of a bottle. Some people are allergic to povidone
iodine; an
allergy to shellfish is a predictor. Povidone iodine can cause chemical
irritation to mucous membranes in areas such as the inside of the nose
and
genitals.

Surgical scrubs containing Chloroxylenol (PCMX) are a more appropriate
alternative to povidone iodine. PCMX is non-toxic, more effective
against a
broader range of microorganisms than povidone iodine, safe for use on
mucous
membranes, and is unlikely to cause an allergic reaction. (1)

Chlorhexidine gluconate solutions (name brand Hibiclens) are
impractical for
use as prep because they require thorough rinsing and should not be used
near the eyes or ears.

Prior to oral piercings the mouth should be prepped by rinsing with an
antibacterial mouthwash.

After the area has been thoroughly disinfected, placement should be
marked
with a non-toxic permanent marker, such as a surgical marker or Sharpie
brand marker, or a sterilized toothpick dipped in Gentian Violet.
Preferably, markers are not used on more than one client; if reused, the
entire marker including the nib should be disinfected using an
appropriate,
non-toxic disinfectant. Markers should never be reused after marking
placement for genital or oral piercings or in areas of broken skin.

Tools

Most piercers use forceps to hold the area to be pierced. Forceps
provide a
guide for accurate placement and reduce the risk of an accidental needle
stick to the piercer. The forceps most frequently used are the
Pennington
(triangular head) and the Foerster (oval head) forceps. The serrations
on
forceps are sharp and should be filed down to prevent irritating the
skin.
The forceps should be secured using a rubberband wrapped around the
handles
and not by the teeth of the handles. Securing the forceps by the teeth
on
the handles is extremely uncomfortable and can result in bruising. Most
piercers use sterilized, disposable cork to support the side opposite
the
needle and to prevent an accidental needle stick.

Vertical clitoral hood, Prince Albert, nostril, septum, and some ear
cartilage piercings are performed with the aid of a needle receiving
tube.

The jaws of pliers used to open and close rings should be wrapped in
surgical tape or padded with gauze to prevent scratching the jewelry.
Brass-jaw pliers are less likely to scratch the jewelry than steel
pliers.

References:

(1) Literature provided by Care-Tech Laboratories,
  http://www.caretechlabs.com, 1-800-325-9681


3.5   METHODS OF DISINFECTION AND STERILIZATION

Disinfectants

Disinfectants and "cold-sterilization" solutions destroy many
microorganisms
(bacteria, viruses, fungi) but do not destroy bacterial spores.
Disinfection
does not replace autoclave sterilization.

Disinfectants should be used on hard surfaces (ie. trays, countertop,
chair)
and reusable, non-autoclaveable tools, such as plastic calipers, before
and
after each procedure. Product usage instructions vary and some may not
be
suitable for all surfaces or applications. Some disinfectants are toxic
and
require special disposal, making them inappropriate for soaking jewelry
prior to insertion.

Ultrasonic Cleaner

Prior to sterilization, instruments contaminated with blood and other
debris should be cleaned in an ultrasonic cleaner. The ultrasonic
cleaner uses cavitation (implosion of microscopic air bubbles produced
by ultrasonic vibration) to remove debris.

The ultrasonic cleaner is usually filled with a disinfectant or
ultrasonic-specific solution.

Jewelry should not be placed directly in the ultrasonic cleaner or with
tools or other jewelry because it will be scratched.

Sterilization

Sterilization is the process of killing all microorganisms including
bacteria, bacterial spores, fungi, and viruses. Improper sterilization
can
result in the spread of infectious bacteria and bloodborne viruses such
as
Hepatitis and HIV.

Boiling is not an appropriate method of sterilization.

Autoclave

The most complete and reliable method of sterilization is the steam
autoclave or chemical autoclave. The steam autoclave uses pressurized
steam;
the chemical autoclave often uses Ethylene oxide. Steam autoclaves are
used
by piercers more frequently than chemical autoclaves because of the
hazards
associated with Ethylene oxide.

Pressure Cookers

Pressure cookers may also be used for sterilization but with many
disadvantages. Pressure cookers are not as reliable as autoclaves in
maintaining temperature and pressure and do not display time,
temperature or
pressure (PSI). Pressure cookers will not dry the sterilized items; wet
sterilization bags are susceptible to contamination.

If a pressure cooker is used, items should be processed for at least 30
minutes at 15-20 pounds pressure. Internal indicators which indicate
that
heat and steam have penetrated the packaging and reached the instruments
should be used inside every sterilization bag.

Dry Heat

While Occupational Safety and Health Administration Standards (December
6,
1991; 29 CFR 1910.1030) recognizes dry heat sterilizers, they have
several
disadvantages. Sterilizing items in a dry heat sterilizer is extremely
time
and energy consuming. Some jewelry and piercing equipment cannot
tolerate
the high temperature required for sterilization.

Sterilization Packaging

Instruments to be sterilized are placed in self-sealing sterilization
bags
or sterilization tubing sealed with indicator tape. The tape and the
outside
of the bag or tubing are marked with external indicators which change
color
when exposed to heat and steam. Internal indicators which indicate that
heat
and steam have penetrated the packaging and reached the instruments can
be
used as an added precaution.

Sterilization bags should be allowed to dry thoroughly before being
removed
from the autoclave. Wet bags are susceptible to contamination.

Sterilizer Monitoring and Testing

Sterilizers should be spore tested at least monthly. Spore testing kits
contain two bacteria spore samples, one of which is cycled in the
autoclave
and the other used as a control. Spore testing systems are available for
in-studio testing or testing by an independent laboratory.

References:

Association of Professional Piercers
  http://www.safepiercing.org/

Centers for Disease Control and Prevention - Hospital Infections Program
  "Sterilization or Disinfection of Patient-Care Equipment: General
  Principles" http://www.cdc.gov/ncidod/diseases/hip/sterilgp.htm

Occupational Safety and Health Administration (OSHA)
  "Occupational Exposure To Bloodborne Pathogens Standards"
  http://www.osha-slc.gov/OshStd_data/1910.1030.html


3.6  ANESTHETICS

In the United States topical anesthetics are only available by
physician's
prescription. Injectable anesthetics are only available to licensed
physicians.

Topical anesthetics have little effect on areas other than mucous
membranes
and require a few minutes to be absorbed. Ethyl Chloride spray is used
by
many piercers in Europe. Frostbite and chemical irritation can result if
Ethyl Chloride is misused.

Most piercers agree that injectable anesthetics are not advantageous.
When
performed by an experienced piercer the piercing should require only a
second to perform. Injectable anesthetics may interfere with placement
of
the piercing because the anesthetized tissue will swell.

Some people are allergic to anesthetics. A severe allergic reaction,
called
anaphylaxis, can be deadly. Physicians are trained to look for signs of
a
severe allergic reaction and are able to treat severe reactions. A
piercer
may not have these resources available.

Some piercers feel numbing the area masks poor piercing technique.
Those in
favor of using anesthetics feel that piercers should use every tool
available towards making the piercee more comfortable. You as a piercee
should weigh supporting arguments and make your own decision as to
whether
or not to allow the use of anesthetics during your piercing.


3.7  ARE YOU UNDER 18?

Many states now have laws restricting or prohibiting piercing minors.

In the United States, most piercers require that you be 18 or over. If
you
are under 18 some piercers may perform certain piercings with parental
consent and/or presence during the piercing.

Most teenagers are still growing and developing. A reputable piercer
will
refuse to perform piercings in areas that are still developing. For
example,
navel piercings would not be suitable for a growing body. Most facial
piercings are suitable for most teens over the age of 16. Some state
regulations explicitly prohibit performing nipple and genital piercings
on
minors due to the sexual nature of the piercings.

Please think twice before getting pierced by a piercer who does not
care how
old you are. A piercer who is not concerned about your physical
development
and the appropriateness of the piercing may not care about hygiene and
safety either.

Parents: If your teen is interested in getting pierced, realize that
he/she is probably interested in getting pierced safely. If not allowed
to
get pierced ptofessionally, some teens will resort to piercing
themselves
with whatever is available which can result in infection, scarring,
excessive bleeding and swelling, or possibly more severe adverse
reactions. This publication is designed to help you and your teen make
an
informed decision.


3.8  DOES IT HURT?

Most people experience some level of discomfort or pain during the
piercing
procedure. The amount of discomfort or pain you feel is influenced not
only
by the location of the piercing but by your state of mind. When
performed by
an experienced piercer, most piercings require only a second to be
performed
and pain is minimized.

Many people find breathing exercises helpful towards relaxation,
concentrating on breathing slowly and deeply during the entire
procedure,
even while the piercer is preparing for the piercing. Many piercers will
work with your breathing pattern, either by piercing on your exhale or
on
your signal. Holding your breath will cause you to tense.

A feeling of light headedness or slight dizziness during the first 10
to 20
minutes after the piercing is not unusual. Some people feel a rush of
adrenaline and endorphins. Both sensations are the part of body's
natural
chemical response to what it perceives as a sudden injury.

Some people do react strongly enough to faint. If you feel faint recline
with your legs elevated. People who have not eaten within 6 hours of
getting
pierced are more likely to feel faint.

Most importantly do not feel embarrassed if you do feel lightheaded,
faint,
or become nauseous. You cannot control how your body reacts and your
piercer
is already familiar with and prepared to handle these responses.


3.9  MAKING YOUR EXPERIENCE MORE COMFORTABLE

Get plenty of rest the night before. Eat a good meal and drink plenty of
fluids within 6 hours of getting pierced.

Do not consume alcohol, large amounts of caffeinated beverages, or
blood-thinning medications within 12 hours prior to or 24 hours after
getting pierced (or 24 hours after the piercing stops bleeding). If you
must
take blood-thinning medication discuss this with your piercer and your
doctor prior to your appointment.

Wear clean clothes. Depending on the location of your piercing, do not
wear
restrictive clothing.

If you are getting a facial piercing, do not wear makeup around the
piercing
site. If you are getting an ear piercing, wear your hair away from your
ear.

If you are considering getting more than one piercing in a single
session,
consider factors such as your body's ability to heal multiple piercings
and
comfort during the healing period.


3.10  PIERCING KITS AND DOING IT YOURSELF

Piercing kits have many disadvantages. Most kits do not include
everything
considered essential to performing a safe, hygienic piercing. The
jewelry
and tools are usually non-sterile and have probably been handled with
unwashed hands. The jewelry and all tools that come in contact with
piercing
and jewelry must be sterilized in an autoclave. Piercing kits usually
do not
contain gloves and skin disinfectants necessary for disinfecting the
skin
prior to piercing.

Piercing kits come with "one size fits all" jewelry which may not be
appropriate in gauge or dimensions for your piercing. The instructions,
when
included, will not explain the anatomical considerations for placement.
Nor
will the instructions replace the knowledge and practiced technique of
an
experienced piercer.

Some piercings are more easily performed using forceps or a needle
receiving
tube. Some sizes of rings require pliers to open and close the ring or
to
remove and replace the bead. If you do not have the appropriate tools,
the
piercing may be difficult to perform and the results may be poor.

When the expense of everything that is required to perform a piercing
safely
and hygienically is calculated, the cost is often greater than getting
pierced at a reputable studio. If you are unable to properly sterilize
the
jewelry, needle and tools in an autoclave, the cost may be greater if an
infection results.


--
--

                              Anne Greenblatt
                Manager of the rec.arts.bodyart Piercing FAQ
                             Piercing Exquisite
                      http://www.piercingexquisite.com