Moving the needle

Bacterial outbreak highlights safety risks of body piercings

An occupational medicine physician shares simple tips to help patients who are considering piercings avoid complications.


Four years ago, Lisa A. Klatka, DO, was working for Ohio’s Medina County Health Department when she learned that two teenagers had been hospitalized after receiving ear cartilage piercings. Both had perichondritis, or inflammation of cartilage.

Dr. Klatka and her department worked with several other agencies to pinpoint what caused the inflammation: the piercing establishment’s sea salt spray, sold to the teens as an aftercare product, was contaminated with pseudomonas aeruginosa, a bacteria that can cause serious infections.

During an OMED presentation, Dr. Klatka, who now works for the city health department in Shaker Heights, Ohio, explained the steps her department took to contain the outbreak and make sure other customers who had purchased the spray were notified of the risk of illness.

Dr. Klatka discussed several steps patients can take to ensure their safety before getting a piercing, information she obtained from piercing trade associations, including the Association of Professional Piercers.

“In public health, we really focus on reducing any risks of complication,” she said. “And risks can really be lowered significantly just by following some simple steps. We have also found that in most cases, the industry wants to promote safety, work within existing regulations and have their artists properly trained and in compliance with laws.”

DOs can provide the tips below to patients who are considering an ear, navel or lip piercing.

Questions to ask the piercer:

  • Do you wear gloves?
  • Do you sterilize your nondisposable equipment?
  • Can you remove needles from their packaging in front of me?
  • Do you sterilize the piercing station in between clients?
  • Are you recognized by the Association of American Piercers?
  • Do you have a permit to operate from your local or state health department?

When visiting the site, examine:

  • The cleanliness of the studio.
  • The current licensure.
  • The autoclave spore test results. An autoclave is a sterilization machine; a negative spore test will show that the machine is effectively sterilizing equipment.
  • The equipment and needles. Is the equipment sterile? Are the needles single-use?
  • The jewelry used.
  • “The jewelry needs to be sterile and should be made of a metal that’s not going to create any allergies,” Dr. Klatka said, noting that many state regulations require piercing salons to use jewelry made from certain high-quality metals such as 14-karat gold, platinum or implant-grade steel or titanium.

Commit to proper aftercare

Patients aren’t always aware that some piercings can take months to fully heal, Dr. Klatka says. During this time, patients need to keep the pierced area clean and avoid exposure to harsh chemicals or unsanitary conditions.

Dr. Klatka is a public health officer with the U.S. Army Reserve and notes that her views are her own and don’t necessarily reflect the views of the Army or the Defense Department.

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