Thursday, June 10, 2004
Ear cartilage piercing can cause serious infections

By Dr. Anthony Policastro
Nanticoke Memorial Hospital

One of the reasons that the FDA looks at drugs is consistency. They make sure that each drug is the same regardless of which company makes it. There are many forms of acetaminophen (Tylenol) and Ibuprofen (Motrin). You can be sure that no matter what brand you buy 100 mg of one pill is the same as 100 mg of another pill. There are many things that we do that are not as tightly regulated as drugs. One of those recently made the headlines. It involved ear piercing. A jewelry kiosk in a mall in Oregon had several complications from its techniques. The investigation showed poor hand washing practices. It showed poor equipment disinfection practices. It showed using improper devices to pierce the ears. Three of the individuals had piercing of the cartilage of the upper ear. The result was that the cartilage got infected. A cartilage infection is more serious than a skin infection. The ear lobe might become infected, but there is no cartilage. Therefore, the treatment is usually a few days of oral antibiotics. When cartilage gets infected, it requires much longer treatment. It sometimes has bacteria that do not respond to typical antibiotics. It frequently will require intravenous antibiotics in the hospital. It frequently will form an abscess that has to be cut open to drain. These infections usually begin within a few hours to three days after the procedure. That means that they are caused by the piercing rather than the subsequent use of ear rings.
  All of this can be avoided by having piercings done only in the ear lobe area. The cartilage should be avoided. We have known about this type of complication for a long time. What we did not know was how frequently it occurred. The recent report went back and looked at the infection rate for cartilage piercings. It appears that about one out of every seven individuals who get the cartilage pierced goes on to get some type of infection in the cartilage. Of interest is that the rate appears to be highest with the use of an open, spring loaded piercing gun. In this study every one of the confirmed infections had the procedure done with that type of device. Therefore, if you decide to take a chance on this type of piercing, make sure they are not using this potentially dangerous device. This infection is a disease of young people. All the patients with infections were between the ages of 10 and 19. Since they were as young as 10 years of age, there is no reason for parents to take a chance on this kind of infection with children who are not old enough to give permission themselves. That means that my recommendation would be that parents should not allow children under 18 to have their cartilage pierced. As a parent you cannot depend on agencies such as the FDA to tell you what is right for your children. You have to depend on your own knowledge to avoid complications such as these.

Dr. Anthony Policastro is medical director at Nanticoke Memorial Hospital.