Troubleshooting

Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

The content provided below is excerpted from The Piercing Bible. For more information, pick up your own autographed copy using the "Buy Now" button located below the book cover pictured on the right sidebar (pick your shipping method with the drop-down menu). The book also contains over 25 references citing the sources of the information contained in this chapter.

 

Occasionally things go awry with body piercings, even when they are performed by a qualified professional and cared for properly. Depending on what is wrong, the solution might be as simple as a change in your care regimen or jewelry. Sometimes minor complications improve spontaneously, while other times you will need to look after a piercing with an over-the-counter remedy. In more serious cases, doctor visits and medical treatments are called for; on occasion, removal of your jewelry is required. The good news is that grave situations are rare. In the event that you must abandon your piercing, it is uncommon that the site cannot be repierced.

A visit to a knowledgeable piercer is advisable at the first indication something is amiss with your piercing. If you have to see a doctor, your piercer may be able to direct you to a piercing-friendly practitioner. Never let embarrassment or fear of being judged by a medical professional get in the way of treatment you require. Speedy intervention can prevent more serious consequences, so it is crucial to address problems quickly. If you have a history of health problems or you experience any severe symptoms, seek immediate medical attention.

The following topics are posted:

Leave Jewelry In!
Localized Infection
Infection: Abscesses
Cellulitis
Hypergranulation Tissue
Localized Piercing Pimple
Discoloration
Scarring    Atrophic Scars    Hypertrophic Scars    Keloids
Scar Reduction Products
Dry Skin
Dermatitis
Embedded Jewelry
Traumatic Tear
Dealing with Migration and Rejection
Repiercing After Loss
Swallowed Jewelry

 
Leave Jewelry In!
Try to discover precisely what is wrong before taking out your jewelry. Chances are it can be cleared up, and there is no need to take such a drastic measure. In any case, simply removing your jewelry and giving up on your piercing may not resolve your problem. In fact, if you have an infection, this can cause a condition that is much more severe (see “Infection: Abscesses,” page 204). Even if you don’t have an infection, it is not easier or better to take out your jewelry now and try to get it reinserted or repierced later. Scar tissue, delayed healing, and other issues can occur from repiercing after unnecessarily abandoning a piercing.

When you seek medical care for an ailing piercing, many physicians will immediately ask (or order) you to remove your jewelry. If an infection is suspected or diagnosed, resist this command. If your health-care provider is unfamiliar with piercings, you may need to explain that jewelry or an appropriate substitute must remain in an infected piercing to keep the channel open and enable the wound to drain. Once this is explained, it usually makes sense to a doctor.

If metal jewelry will be left in a troubled piercing, it must be made of high-quality material and be in good condition. Wearing an appropriate style is crucial, as is a good fit. Problem piercings frequently swell and thus require a larger size. If you aren’t sure what is causing your complication, a jewelry swap is often a good idea. It is best to have a piercer help you with this when your piercing is distressed.

An inert plastic retainer is a good substitute for metal jewelry; you can obtain one from a piercer. Their flexibility makes them more comfortable to wear in a tender piercing, and a negative reaction to metal will obviously be ruled out or resolved. If a retainer is not readily available, the catheter tubing found in medical settings can suffice in an urgent situation. Details can be found in “Medical and Dental Emergencies and Appointments,” page 247, and “Retainers,” page 248. If you have recently abandoned an infected piercing, your piercer may still be able to insert an appropriate retainer or piece of jewelry. Even if it is thinner than your original gauge, this can help the wound to drain and prevent more serious problems.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

Localized Infection
When a piercing acts up, it is commonly assumed that it is infected. However, not everything that is wrong with a piercing is an infection. When piercings are performed and cared for according to accepted practice, an infection (invasion and multiplication of disease-causing microorganisms that have a detrimental effect) is not as prevalent as you might think. Other complications, such as irritation, are far more common; however, when a piercing is infected, it requires prompt care. Left untreated, an infection can worsen to become extremely dangerous and, in rare cases, life threatening.

Many minor (or self-limiting) infections are successfully self-treated. If your condition is recent, mild, and you do not take steroids or have a chronic illness or other health condition, you can try the suggestions listed below for a few days. Numerous products for this purpose are readily available in drugstores. If your piercing is visible to the public, show it to a pharmacist and ask for his suggestion on the best over-the-counter product  or whether he thinks you need to see a doctor right away. Mild localized infection

Identifying Minor Localized Infection
• Skin is pinkish or reddish, swollen, and warm to the touch
• Localized tenderness
• A small amount of pus
• Swollen lymph nodes

You can have an infection even if you don’t have all of the symptoms above. Conversely, having several of them doesn’t guarantee that your piercing is infected. Some redness, swelling, and tenderness are normal in fresh piercings, especially during the first two weeks.

What to Do for a Minor Localized Infection
The following suggestions are for minor infections only:
•    Take ibuprofen or acetaminophen to diminish swelling and tenderness.
•    In the shower, rinse well with running water, and dry with clean, disposable paper products. Spray it 4-6 times daily with Briotech.
•    Perform mild saline soaks and/or apply warm, moist compresses to encourage drainage and relieve discomfort (see the information on warm compresses under “Running Cold and Hot,” page 199).
•    Apply topical over-the-counter antibiotic cream or gel (not ointment) according to package instructions. While this type of product is not suggested for routine aftercare, this is the time to put it to use. The topical antibiotic products usually contain bacitracin, neomycin, or polymyxin B, alone or in combination, to fight different types of microorganisms. Combinations of the three ingredients work against a broader spectrum of bacteria, but allergic reactions to neomycin are common.  Stop using the antibiotic if you notice redness, itching, or skin eruptions surrounding the area, and consult your physician.

See a doctor right away if you experience the following:
•    Your symptoms last for a week or markedly worsen.
•    You experience a fever, chills, nausea, vomiting, dizziness, or disorientation.
•    The piercing is very painful, swollen, has red streaks emanating from it, or there is a loss of function in the region.
•    You have copious pus discharge that is greenish, yellowish, or grayish.

For topical treatment of localized piercing infections, a cream or gel called Bactroban (mupirocin antibiotic, available only by prescription) is recognized as an effective medication.  A doctor who is unfamiliar with piercings may be unsure what to recommend, so you can inform him this product is commonly prescribed for bacterial infections in piercings. Never try to self-treat an infection with leftover antibiotic medication or someone else’s prescription.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


Infection: Abscesses
An abscess is a pocket of infection containing pus, trapped under the skin, surrounded by inflamed tissue. Medical research shows that abscesses usually occur long after the initial piercing—on average from four to twelve months later. 

An abscess can be created when jewelry is removed from an infected piercing, thus eliminating the pathway for pus and matter to leave the body, trapping the infection inside. Occasionally an infection will occur and an abscess will form adjacent to a piercing when jewelry is in place. This is more apt to happen if your jewelry constricts the tissue because the initial size was too small, or because of an unexpected amount of post-piercing swelling.

Identifying an Abscess
•    Tenderness, pain, inflammation, heat, and swelling at the site of a hard localized mass (feels like a marble under the skin). In the case of nipples, the duct system can result in an abscess forming inches away from your piercing.
•    Redness or darkening of skin (if the abscess is closer to the surface, rather than very deep underneath).
•    Worsens over time and may cause nausea, fever, and chills if severe.
•    Infections caused by the bacterium Mycobacterium abscessus have been described as cold abscesses because of the absence of tenderness and inflammation. This means you could have an abscess when a hard mass is present, even if you don’t have any of the other symptoms.

What to Do for an Abscess
•    For milder cases (a localized abscess without systemic symptoms such as fever or nausea), saline soaks or application of warm-to-hot moist compresses might cause spontaneous drainage.
•    Switching to jewelry of a thinner gauge may also help to encourage drainage if the mass is close to an opening of the piercing.
•    Elevating the area and taking over-the-counter analgesics according to package instructions may help to make you more comfortable.

If the abscess does not drain within forty-eight hours as a result of these steps, or if symptoms worsen, a visit to the doctor is urgent. Infection can spread to deeper tissue or the bloodstream if untreated. This is serious!

•    If red streaks emanate from the site, the lump is larger than 1/2 inch across, or a fever is present, you must visit the emergency room right away, as the infection may have spread and become cellulitis (discussed next).
•    An incision and drainage procedure to empty the pus-filled cavity is commonly needed. If the abscess is in close proximity to the piercing, the channel may be lost (cut) in the process.
• Antibiotics alone will not necessarily resolve an abscess. It usually must be cleared out as well. In fact, doctors sometimes drain an abscess without prescribing antibiotics.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional. 

Cellulitis
Cellulitis refers to an inflammation of the cells. When it spreads beyond a localized area throughout the deeper layers of the skin and surrounding tissue, immediate medical attention is required. Without proper care, this can enter the bloodstream and lymph nodes and become septicemia (a severe total body infection), which is potentially deadly.

Identifying Cellulitis
•    Inflammation and redness of the skin further than 1/2 inch from the wound, possibly including broad areas of redness, or red streaking
•    Tight, glossy, stretched appearance of the skin, or dimpling like an orange peel
•    Warmth, tenderness, and swelling

Emergency medical care is required immediately if:
•    The rash is changing rapidly, or a large area is already involved.
•    Fever, pain, chills, weakness, vomiting, joint or body aches, swollen lymph nodes, or mental confusion accompany the other symptoms.
•    The infection is on your face, especially in the area of the eye.
•    You are immunocompromised (have AIDS, diabetes, or lupus) or have other medical history of concern, including a heart condition.

What to Do for Cellulitis
You must visit a doctor for treatment; do not delay. Cellulitis is not a condition that can be handled with home care. If the infection is deemed severe, you may need to be hospitalized for intravenous antibiotics or surgical intervention.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


Hypergranulation Tissue

The terms hypergranulation tissue, granuloma, and pyogenic granuloma are all fancy words for benign (noncancerous) types of growths that form on wounds, including piercings. These can simply be a consequence of injuring the body, or they can be caused by excessive trauma, moisture, or infection. If you are taking Accutane or certain other medications, you are at increased risk for this complication, though you may see improvement if you lower the dosage or discontinue taking the medicine. Always take prescription medications according to your doctor’s instructions.

These bumps are comprised of cells that are normally formed during wound healing but that have overgrown, often quite rapidly. These unsightly lumps are most common on piercings of the navel, outer labium, nostril, and the inside of the lip, though they may also occur elsewhere. In some cases, they can successfully be treated and the piercing may be maintained, though healing of the piercing is suspended while excess granulation tissue is present. You may need to be patient and to try different treatments or combinations of remedies to achieve a satisfactory resolution. Hypergranulation tissue

Identifying Hypergranulation Tissue
•    Bump of tissue protrudes above the surface of your skin
•    Looks like raw hamburger, or like the inside of the piercing is on the outside of your body
•    Oozing clear or yellow sticky drainage
•    Bleeds easily
•    Usually looks worse than it feels, though it can be tender

What to Do for Hypergranulation Tissue
Keep the area as dry and free from friction and irritation as possible. Do not try all the listed products at once, and keep careful watch on the area to gauge your response to treatments.

•    Frequent 
saline soaks, or more aggressive sodium chloride treatment: use a hypertonic product (one that contains more salt than the body’s fluids do) such as Curasalt (20 percent sodium chloride–impregnated gauze), or Hypergel Hypertonic Gel (20 percent hypertonic saline gel). Use according to the package directions, but be careful to cover only the hypergranulation tissue, or you will cause drying and irritation to the healthy skin surrounding the problem. Or apply witch hazel or other skin drying agent several times daily. 
•    Topical application of over-the-counter cortisone cream according to package instructions.
•    Use a styptic pencil to stop bleeding and dry out the tissue.
•    Topical application of rubbing alcohol, 3 percent hydrogen peroxide, iodine, Campho-Phenique, or undiluted tea tree oil, twice daily for one to two weeks. Seek medical care if you don’t see improvement or your symptoms worsen.
•    Topical application of a paste made from bottled or distilled water and aspirin tablets or powder. Apply only to the hypergranulation tissue for ten minutes and then rinse well, two to three times a day for two to three weeks. This can burn your skin. Discontinue if irritation results.

If none of these help your condition, visit a doctor for treatment. These often recur, especially when a problem with moisture, jewelry fit, or friction is not resolved. If the condition proves intractable, the piercing will need to be abandoned. Frequently the bumps diminish significantly or disappear completely when you remove your jewelry.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


“Localized Piercing Pimple”
This complication is somewhat common, but, unfortunately, the piercing-friendly medical professionals I polled failed to come to a consensus on a diagnosis or suggested treatment. Therefore, I’ve named this complication based on its appearance and address it below using my professional piercing experience in conjunction with accepted health-care principles. Overall, the symptoms are similar to those of folliculitis, which is an inflammation and infection in or near a hair follicle. This type of complication routinely occurs near nipple piercings, where hair follicles are not plentiful. Piercers sometimes mislabel this as a “follicular cyst,” but that is a condition of the ovary.

Sometimes a pustule (a small round area of inflamed skin filled with pus) will appear under the skin near the opening of a piercing. It may be caused by trauma or a mild infection that remains contained locally. A small pocket forms close to the surface and repeatedly fills, and drains. Sometimes it seems to be gone for good, and then the cycle begins again weeks or months later. The best way to resolve the problem appears to be by helping your body to break down and absorb the sack or pocket that has formed. You may be tempted to pop this pimple-like eruption yourself, but never lance your skin with nonsterile implements; use soaks and compresses to encourage drainage. If you have a localized pustule that won’t open or drain and needs to be lanced, seek medical assistance. Localized Piercing Pimple

Identifying a Piercing Pimple
•    Small, slightly elevated pus-filled bump or pimple adjacent to the piercing
•    Red and inflamed, but contained locally
•    May be tender, itch, or burn, though some are painless
•    Usually secretes pus and/or blood when drained (or popped)

What to Do for a Piercing Pimple
• NEW! Some piercees have had excellent results for this problem using Briotech. It is certainly worth a try.

 •    Follow the suggestions under “What to Do for a Minor Localized Infection,” page 204.
•    Over-the-counter antihistamines taken according to package instructions can diminish itching and inflammation.
•    Do plenty of warm saline soaks or hot compresses. Continue them for two weeks after the problem seems to have been resolved.
•      Light massage of the area may help break up the pocket and prevent it from refilling. (In combination with saline or other remedies, this is the one thing that seems to really help prevent recurrence.)
•    If you do not respond to treatment, lab analysis for an invading microorganism may be needed to determine if the cause is fungal or bacterial so your doctor can prescribe appropriate medication to target the problem.
•    You must see a doctor if you have increased pain, a fever over 100 ̊F (37.8 ̊C), or the infection obviously worsens or spreads.
•    If you have a verified diagnosis of folliculitis, laser hair removal can destroy the hair follicle, prevent future episodes, and reduce the scarring of repeated eruptions.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


Discoloration
Some discoloration extending from your piercing in an area the size of a pea is a stan- dard part of the healing process. It can remain for many months. Shades described as purplish, pinkish, reddish, or brownish are normal, depending on individual complexion. This discoloration is apt to diminish over time; still, a mark beyond the borders of your piercing could be permanent, depending on your skin type, healing course, and piercing placement. Hyperpigmentation (discoloration)

Certain piercings, including the ever-popular navel, have a tendency toward discoloration around the openings, especially if you experience problems or trauma during healing. After your piercing is no longer an open wound, try one of the options described in “Scar-Reduction Products,” page 211, to minimize any residual discoloration. Sometimes the best resolution is to wear jewelry that has a ball, gemstone, or other ornament that obscures the discolored area.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

Scarring

A scar is simply defined as “a mark left on the skin after the healing of a cut, burn, or other area of wounded tissue,” so scar formation is a normal process following any type of breach in the tissue, including piercing. Unfortunately, however, the body sometimes fails to perform this job properly and complications occur. Below are some of the most common scarring problems with suggestions on how to handle them.

Atrophic Scarring
Atrophic scarring, a depression or pitting below the normal skin level, sometimes Atrophic Scarringoccurs when a piercing migrates. Unfortunately, this type of scarring is usually permanent. Navel and facial piercings are the most common sites to find this type of pockmark. There are no easy fixes, but a dermatologist can explain treatments such as dermabrasion or laser resurfacing that might be effective. If the piercing can be maintained, generally the best way to deal with this problem is to leave jewelry in place. This will usually mask the scar or at least part of it.

Excessive Scarring
The presence of jewelry causes prolonged healing and predisposes the wound to chronic inflammation. Both of these conditions increase the likelihood of excessive scar formation. Keloids and hypertrophic scars are the types of bumps and lumps commonly found on ear cartilage piercings, though other pierced sites also fall victim to these conditions. Keloid on ear lobe piercing

A keloid is a very large, dense mound of scar tissue that becomes significantly bigger than your original wound. They can be extremely unsightly, and some grow to shocking dimensions. Unfortunately, once you have formed a keloid, you can seldom fully recover from it and will always have some amount of scar tissue.

A hypertrophic scar is a lumpy scar that sits above the surface of the skin. This is the smaller and far more common growth that forms around a piercing. They are not as big or severe as keloids, respond better to treatment, and are more easily resolved. Hypertrophic scarring sometimes goes away spontaneously, or it may recur and recede in cycles for an extended period of time before improving substantially or disappearing.
Hypertrophic scars are frequently mislabeled as keloids—even by doctors—possibly because both are types of excessive scarring. These problems tend to run in families and occur in about 5 to 15 percent of wounds. Hypertrophic scarring

Identifying Hypertrophic Scarring
•    Raised fleshy bump surrounding a piercing that stays within the bounds of the injury
•    Usually somewhat pink or red in color, at least initially
•    Not tender; may itch
•    Tends to form during the healing period
•    No pus or other drainage

What to Do for Hypertrophic Scarring
Try one of the following methods at a time:

 
•    NEW! If your piercing is on your helix (ear cartilage) or other area where a disc might sit flush against the scar tissue, check out the No-Pull Piercing Disc.

 •    NEW! Some piercees have had good results with bump/scar reduction using Briotech. It is certainly worth a try.

•    A simple and inexpensive form of compression therapy (continuous mechanical pressure on a scar to flatten it) using Micropore breathable paper tape. It comes in “flesh tone,” which will not be visible on certain shades of skin. I personally found this to be effective in diminishing a hypertrophic scar that had formed on the back of one of my ear cartilage piercings. This is best used on healed piercings.
  –    Use scissors to cut a piece of paper tape that will fully cover the entire bump plus a millimeter or so of unaffected tissue. Use a clean hole punch to create a tiny dressing for the smallest of bumps.
  –    Cut a slit to the center of the bandage so you can place it around your ring or bar; you should be able to completely seal the piercing without covering the jewelry, as a Band-Aid would.
  –    Wear the tape continuously and change it when necessary. It can be left on during normal bathing.
  –    Discontinue if you do not see improvement in two to three months.
•    Frequent mild 
saline soaks plus topical application of alcohol, 3 percent hydrogen peroxide, tea tree oil, or Campho-Phenique twice daily for two to three weeks. If you don’t see any improvement, try one of the other options. (The phenol in Campho-Phenique is a caustic substance that destroys tissue, so use it carefully.)
•    Over-the-counter alpha hydroxy acid (AHA) cream used according to package instructions. This exfoliates skin and may diminish scar tissue over time. Use only over-the-counter strength (containing less than 10 percent AHAs). This concentration promotes exfoliation but is not potent enough to generate collagen production, which can increase the size of your hypertrophic scar. This product can cause sun sensitivity.
•    Daily massage with emu oil or other nonirritating oil or lotion to soften the tissue can be added to the following methods:
  –    Topical treatment with an over-the-counter corticosteroid cream according to the package instructions.
  – Topical application of a chamomile tea bag compress for fifteen minutes, three times a day, for two weeks.
•    Some piercees find laser or other medical treatments are effective for hypertrophic scars. See a dermatologist for other treatment options.


Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

Identifying Keloids
•    Bulbous and large, extending well beyond the boundaries of the original wound
•    Sometimes tender, painful, or itchy
•    Usually red or hyperpigmented and vascular, containing broad bundles of collagen, which are absent in hypertrophic scars
•    Can develop over many months, or even up to a year following the piercing Keloid on ear cartilage

What to Do for Keloids
Prevention is best: avoid piercings if you or a member of your immediate family has had keloids. Treatments are often ineffective and there is a high rate of recurrence, especially for those with a family history of keloid formation. There is a greater incidence of keloids in black and Asian populations, though anyone can get them. Combination approaches are common using multiple modalities as suggested by a doctor.

Scar-Reduction Products
There are many scar-reduction products on the market. You may try to use them for any type of scarring, but they are less likely to be effective on atrophic or keloid scars. Unfortunately, even when you consistently comply with instructions, these treatments are effective for only some piercees. Certain products do have guarantees, however, so check before buying them. Listed below are some of the scar-reduction products available. Silicone strips may be the most economical treatment because they are washable and reusable.
•    Scargo, Scar Freee, and other oils and lotions with natural ingredients such as cocoa butter, shea butter, aloe, arnica, calendula, or camphor (available at health food stores).
•    ScarEase, ReJuveness, and other silicone sheets, and Biodermis, Kelo-cote, and other silicone gel systems. It isn’t understood exactly how silicone helps scars heal. Some researchers believe that static electricity from the silicone helps align collagen fibers in the scar, while others believe it might help to trap moisture, which can help scars to fade.
•    Mederma, Derma E Scar Gel, and other products containing allicin (onion or garlic extract). This is intended to act as an anti-inflammatory and may inhibit the overproduction of collagen in a scar. These need to be rubbed in several times daily over an extended period of time.
 

•    NEW! If your piercing is on your helix (ear cartilage) or other area where a disc might sit flush against the scar tissue, check out the No-Pull Piercing Disc.

•    NEW! Some piercees have had good results in scar reduction using Briotech. It is certainly worth a try.


Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

Dry Skin
If the area surrounding your piercing is excessively dry, chapped, or cracked, this can cause discomfort, delay your healing, and increase your risk of infection. To keep your skin moisturized and in good condition, follow the instructions under “Lubrication,” page 197 [including the use of emu oil]; or apply a low-fragrance, water-based, nonirritating moisturizing cream (with clean hands, of course) on the exterior of the piercing, two to three times daily.

Here are some ways to troubleshoot dryness:
•    Don’t overclean; washing once a day could be sufficient, depending on your environment and activities.
•    Bathe in a shower rather than a tub and use cooler water.
•    Avoid harsh products; switch to a milder soap and thoroughly rinse at the end of your shower.
•    Use no more than 1/8 teaspoon of salt per cup of water for
saline soaks, and carefully rinse off saline residue. Limit soaks to once or twice daily.
•    Use fragrance-free, dye-free laundry detergent.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


Dermatitis
Contact dermatitis is a skin rash caused by an allergen or irritant. When it appears near your healing piercing, it is usually from a care product or poor-quality jewelry containing unsuitable materials. Harsh soaps and cleansers are apt to cause irritation, inflammation, and sometimes dermatitis in the adjacent tissue (in addition to killing off some of the delicate new skin cells that are formed during healing). When you have sensitive skin, problems can develop even if you use a mild soap.

A red rash that surrounds your piercing or one that covers a large area (without pain and swelling) usually indicates contact dermatitis from your cleaning product or jewelry. Skin eruptions below your piercing (where soap suds run during bathing) obviously demonstrate contact dermatitis caused by the product you are using to clean your piercing.

Many people are sensitive to nickel (it is one of the ten most common causes of allergic contact dermatitis). Unfortunately, it is used in cheap jewelry of all sorts, including body jewelry. A nickel allergy may develop after your initial exposure to an item containing nickel or after repeated or prolonged exposure to it. So even a piece that seems fine initially can cause trouble over time if the nickel content is too high. A lasting allergy can form that has ramifications on many aspects of daily life. If you become highly sensitized to nickel, you should not eat foods that contain traces of nickel, including nuts, chocolate, beer, tea, coffee, and apricots. Skin contact with metal, including watches and other jewelry and clothing with metal snaps, buttons, rivets, or zippers can all cause localized itchy rashes that can spread to other areas of your body. Treatments, whether prescribed by a doctor or over-the-counter, are temporary solutions to deal with an outbreak, but they cannot desensitize you or cure an allergy. It is not advisable to use clear nail polish to coat offending jewelry because it contains chemicals including toluene, formaldehyde, or dibutyl phthalate, which can actually cause dermatitis in nickel-sensitive individuals.

Identifying Dermatitis
•    Redness, rash (blisters, multiple pimple-like eruptions, or hives), and inflammation; sometimes cracking, flaking, or peeling skin follow the initial outbreak
•    Localized swelling, tenderness, and possible warmth
•    Oozing clear fluid
•    Itching and possibly burning (not present in local infection or cellulitis, which share some of the same symptoms)
•    The hole of your healing piercing becomes visibly larger than the jewelry in it (the skin appears to be receding from the ornament)

What to Do for Dermatitis
•    Replace your jewelry with a more inert material or stop using an offending care product. This usually results in rapid improvement; no other action may be required.
• Apply over-the-counter topical hydrocortisone, allergy-relief medications such as Benadryl (diphenhydramine), and/or topical anti-itch products can ease symptoms.
•    If your allergy is severe, visit a doctor for prescription medication.
•    Do not scratch an itchy rash with dirty fingers, as you can cause yourself a sec- ondary infection.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.


Embedded Jewelry
When you fail to change out jewelry that is too short, it can become embedded. It is much easer to prevent this from happening than to treat it after it does. If your jewelry is starting to sink into your tissue, see your piercer for a longer piece right away. Embedding Jewelry

Tongue and lip jewelry normally nest (sink a millimeter or two) into the soft oral tissues, but if more than half of the ball has disappeared into your piercing or the skin appears to be growing over your jewelry, visit your piercer as soon as possible. Oral tissue regenerates extremely quickly, and jewelry can end up embedded overnight. If you cannot immediately get to your piercer for help, use elevation, rest, ice, and over-the-counter anti-inflammatory medication to minimize the symptoms until you are able to get your jewelry changed.

In the unfortunate event that the tissue completely grows over the jewelry and you or your piercer cannot push it back through the surface, you must seek medical care. A small incision will be made (generally under local anesthesia) to allow for removal of your unintentional implant. If you want to preserve the hole, obtain jewelry of the proper size beforehand, as it might be possible to insert it after the embedded piece has been liberated.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional. 


Traumatic Tear
Skin is pretty tough, so a serious snag is needed to cause real damage. When you wear jewelry of the suggested minimum thickness and exercise some awareness of your piercing, this type of unfortunate event seldom occurs, but accidents do happen. Piercings occasionally catch and tear. If your jewelry is ripped through your piercing, control the bleeding and clean the gash. Visit a medical facility if you cannot join the edges of the split tissue together properly or if direct pressure does not stop the bleed- ing, which is rare.

If the jewelry is not completely torn out, it might be possible to preserve your pierc- ing using a plastic retainer, depending on the original placement and the amount of damage. Place the plastic piece in the original location as close to the body as possible and use medical tape such as Micropore to secure it. Resume the care regimen as if you had a new piercing and replace the tape as needed. If the tissue heals satisfacto- rily, you may be able to reinsert regular jewelry in a few months. Your piercing may permanently require gentle handling following a tear because scar tissue is only about 80 percent as strong as normal skin.
Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

Dealing with Rejection and Migration
When your jewelry moves closer to the surface or your tissue gets narrower between the openings of a piercing, you are experiencing migration. The piercing may move only a little and then settle and stay in a different position. For safety and longevity, a piercing should have at least 5/16 inch (almost 8 mm) of tissue between the entrance and exit holes. If your piercing is narrower than that, there is a strong possibility you will lose it.

Don’t allow jewelry to come all the way through to the surface or an unsightly split scar will often remain (unless you undergo plastic surgery). Also, future repiercing could be more difficult if you permit the jewelry to be completely expelled from your body.rejecting piercing

A body piercing should be abandoned if the tissue between the entry and exit progressively gets smaller or thinner over time and any of the following happen:
•    The skin between the openings is flaking and peeling, red and inflamed, or hard and calloused-looking.
•    You have less than 1/4 inch of tissue between the openings.
•    Just a thin filament of nearly transparent tissue is left, and you can virtually see the jewelry right through your skin.
These issues can arise long after you are healed. I know of piercings that were stable for ten to twenty years, and then migration or rejection occurred without any indication as to why. This is especially distressing when it happens to a piercing you’ve had for a long time because it feels like you are losing a part of yourself. Whether your piercing is old or new, if you catch the problem before the point of no return, there are some measures that might help.

Check the fit, quality, and condition of your jewelry. Wearing inferior metal or a piece with a scratched finish can cause serious trouble. Even if the jewelry seems okay, swapping it out is sometimes all you need to stop the movement of your piercing. Wearing inert plastic may calm a piercing that has started to migrate, whether jewelry was the apparent cause or not.

If ring-style jewelry won’t rest flat against your body (after the first few weeks of healing), or barbell ends sink into your tissue, these are signs that your jewelry is too small. Inserting a piece that fits properly often stops migration that has been caused by constriction, if the change is made while sufficient tissue remains.
 

Repiercing After Loss
When trauma, migration, or rejection results in the loss of a piercing, you can often be repierced—unless you were left with an excessive amount of scarring or lack of tissue pliability. After losing or abandoning your piercing under difficult circumstances, it is prudent to wait a year or more before repiercing.

Consider what caused your problem and what you can do differently so that it doesn’t happen again. When you do repierce, it is best to try a different size or style of jewelry, or alternate material or care regimen if you are not sure what went wrong pre- viously. In cases of migration or rejection, ask yourself relevant questions: Did I sleep on the piercing? Did I experience an unusual amount of physical or emotional stress? Did I care for the piercing properly? Was my jewelry suitable?

Navel Repiercing ProblemYour piercer will usually position the new piercing behind any scar tissue, though this does not assure success, because scar tissue is weaker than regular skin, contrary to what many piercers believe.

Sometimes a migrated piercing that has been abandoned will remain an open channel, but it is too shallow to safely support jewelry. You can ignore an empty hole because it does not represent a health risk. But, when it comes to repiercing, sometimes an old channel becomes inflamed or infected after a new piercing is placed nearby. Due to continuous secretion or irritation from the previous piercing, occasionally these situations cannot be resolved satisfactorily and you will not be able to wear jewelry in the site. (See image at left.)

Swallowed Jewelry
Much more frequently than being aspirated into the lungs, jewelry is swallowed and then passed through to the stomach and intestines. This seldom causes any negative consequences in the digestive tract. The aftermath may include some anxiety, the loss of your adornment, and the expense of buying a replacement.

If you swallow jewelry, do not attempt to induce vomiting. A lost ball will simply pass on through; a ring or barbell post usually will, too. If you were wearing a treasured piece of jewelry, whether precious in price or sentiment, you may wish to hunt for it over the next few days by checking your stool. A strainer can be helpful for this process. An advantage of finding your jewelry is that you can be assured it is not stuck inside. It is doubtful that a ball smooth enough to be worn safely in your mouth will cause internal damage on the way through. Barbell posts are less apt to be ingested but could be more dangerous.

Identifying Intestinal Damage from Swallowed Jewelry:
Abdominal pain or vomiting
Abnormal bowel sounds emanating from your abdomen
Dark stools containing blood

Jewelry can pass though the digestive tract, all the way to the end, where you might encounter a rare (perhaps hypothetical) complication: it gets lodged on the way out.

Identifying Jewelry Stuck in the Rectum:
•    Sudden, sharp pain when eliminating
•    Fresh red blood in the stool
Should you experience any of the above symptoms after swallowing jewelry, seek immediate medical attention. Diagnostic tools such as X-rays can determine the position of lodged jewelry, and a variety of methods are available to remove it, depending on its location.

Prevention is best: check threaded ends daily to ensure that they are securely fastened.

Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.