APP Brochures 2011
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Transcript of APP Brochures 2011
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PickingYourPiercer
PP MeMbershiPP Members should have a certicate posted in the studio. Make
e the expiration date on it is current. For a list o APP members
ck out our member locator at saepiercing.org or call our oce
-888-888-1APP. I you nd a studio that claims to have an APP
cer and is not on this list, please call or email to let us know.
vidual studio requirements vary, but most will expect you to:
ring valid photo identication, even i you are clearly over the age
majority
e completely sober
e bathed with hair trimmed or tied back (where applicable)
Wear suitable, clean garments/underwear (where applicable)
ave eaten within 4 hours
possible, avoid taking aspirin or other blood thinners
ave addressed potential health issues, e.g., i you require antibioti cs
ior to dental work, see your doctor beore being pierced
odY JewelrYen choosing body jewelryespecially or a resh piercing
member that the quality can drastically a ect the health and healing
our piercing.
large selection o body jewelry is important. A studio carrying
nly a handul o styles or sizes will be unable to meet the needs
esented by the wide range o human anatomy.
he suraces and ends o body jewelry must be smooth, ree o
cks, scratches, burrs, and polishing compounds, and metals must
ave a consistent mirror nish.
PP members use only internally threaded jewelry or initial
ercings. This means that any screw threads used in closures are
n the removable end, such as the ball or spikenot on the shat o
e jewelry. Passing exposed threading through the skin can cause
nnecessary trauma. For detailed inormation on body jewelry,
cluding suitable materials, see the APPs brochures: Jewelry or
itial Piercingsand Jewelry or Healed Piercings.
tudio etiquette
the counter:
ont handle your piercings (even i they are healed) or jewelry as
ou may spread germs to the studios common areas, endangering
a and ellow patrons.
ring previously worn jewelry in a baggie or other sealed container;
ever place used jewelry on the counter.
This brochure is not intended to endorse only APP member piercers, and its use does not imply
membership in the APP. A current list of APP members can be found at safepiercing.org.
Dscam: These guidelines are based on a combination of vast professional experience, common
sense, research, and extensive clinical practice. These suggestions are not to be considered a
substitute for medical advice from a doctor.
The APP logo is the trademark of the Association of Professional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
in the restrooM:
Dont handle your piercings or jewelry (see Studio Etiquette).
It is never appropriate to insert jewelry in the restroom or other area
o the studio. I you want to have your jewelry changed, it should be
done by studio sta in the piercing room.
in the Piercing rooM:
Turn o your cell phone. Beore setting anything down, allow your
piercer to direct you to the area where personal belongings should
be placed.
Camera fashes can be very distracting during a piercing procedure,
so check with your piercer beore taking pictures.
Text from The Piercing Bibleby Elayne Angel, www.piercingbible.com
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AutoclAve (Sterilizer)An autoclave is a device that sterilizes the jewelry and equipment
necessary to perorm piercings by eliminating germs and their spores.
No studio should be in operation without this vital piece o equipment!
The most common units in body art studios use a combination o
steam and pressure. Dry Heat or liquid soaks are notconsidered
suitable or sterilization. A Statim is a rapid-c ycle autoclave that may
also be used in a piercing studio.
sPore test resultsSpore tests (biological indicators) provide proo that an autoclave is
working properly. They test the autoclaves ability to kill even the most
dangerous and resistant organisms including hepatitis. The studio
should keep recent results on le and be willing to show them to you.
Good piercers will be impressed, not annoyed, when customers are
inormed and interested enough to ask about spore test results.
Piercing set-uPAsk i you can watch the piercer set-up or a piercing and be present
in the room when he or she sets up or yours. The piercer should
rst wash and glove his or her hands. The needles, tools, and jewelry
should be sealed in individual sterile packages and placed on a tray.
The piercer should change gloves i he touches anything in the room
other than you and the sterile equipment. These packages should be
opened while you are present. Neverlet a piercer use a needle on you
that was soaked in a liquid. A piercer using a Statim may work directly
rom the sterile cassette (rather than use packaged tools).
shArPs contAinerEach needle must be used to pierce only one client, and then be
careully discarded in an approved sharps disposala special
container or contaminated (used) piercing needles. This is usually a
small red box marked biohazard, oten mounted on the wall, like in a
doctors oce. I the studio doesnt have one, they may ail to dispose
o needles properlyor even be re-using them.
licensing And PerMitsIn many cases, a studio with a license to operate meets minimum
requirements and has passed some sort o inspectionthough it may
mean only that the owner has paid a ee to a city or state agency. To
nd out whether there are established standards and inspections in
your area, call your local health department. I a studio is operating
unlicensed in a location where permits are required, report them to
your health department and/or city business license division.
A license does not guarantee that the piercer has received training
to perorm the job properly. Even in regions with the most stringent
laws, there is usually no specic requirements regarding the abilities
or education o the piercer.
AftercAre instructionsThe guidelines you will need to ollow to care or your pierc
be explained to you verbally and provided in writing. Readbeforeyou have the piercing done! I you are advised to piercing with harsh soap, ointment, alcohol, or hydrogen
the studio is not keeping up with industry standards. (F
APP atercare suggestions, see our brochures: Suggested
Guidelines or Body Piercingsor Suggested Atercare Guid
Oral Piercings, or visit saepiercing.org.)
Age requireMentsEven i local legislation is more lenient, the ollowing is an a
minimum standards policy on piercing minors: a paren
guardian must be present to sign a consent orm. Proo
state-issued photo identication is required rom the lega
and a bona fdeorm o identication rom the minor. In the
parent has a dierent last name and/or address rom the c
documentation is needed to prove the relationshipi.e.,
adoption papers, or a marriage certicate. Under no circum
it appropriate to pierce the nipples or genitals o an individ
18 years o age.
PortfolioLook at the piercers photo portolio. Are piercings placed
the anatomy or do they look awkward and poorly match
individual? I the portolio eatures unusual piercings,
pictures o healed clients to show the viability o the placem
eAr Piercing gunsA number o states have made it illegal to use a piercing g
piercings besides the ear lobeand with good reason.
piercing guns cant be sterilized, and anyone being pierced
is at risk. A reputable proessional wont use a gun or any
even or ear lobes.
trust Your instinctsYour instincts are a valuable tool, and you should listen to th
it comes to selecting a piercer. Trust your intuition, and neve
situation that eels wrong. This isnt a haircut; your health is
use Your heAdDont act impulsively or be seduced by a low price. You ge
what you pay or (though some unskilled piercers charge p
reerrals on a piercing studio and piercer rom knowledgea
and/or the local health department.
ercer quAlificAtionsorming body piercing is not easy; it takes time and dedication
cquire the ability to saely and skillully perorm the procedure.
ing is a hands-on proession that must be learned through
ical experience, which generally involves trial and error. Sound
uction ideally involves a lengthy apprenticeship with a qualied
tor (though many piercers are sel-taught). It is advisable to
re how long your piercer has been piercing, how they learned,
what they do to keep their knowledge-base currentsuch as
g continuing education courses on anatomy, atercare, aseptic
nique, etc.
our potential piercer should earn your trust by demonstrating
wledge and competency. Beore taking your money, a piercer should
willing to provide a consultation to inspect your anatomy, discuss
lry selection, the procedure, potential risks and complications,
ealing process, and atercare guidelines. I you are not impressed
their qualications, think twice about having them pierce you.
udio set-uP And hYgienestudio premises and the sta should be noticeably clean.
king or drinking alcohol should never take place there. I studio
y permits customers to try on piercing jewelryrun!
studio should have ve separate zones including a retail counter,
ng area, and:
public bathroom that is never used or cleaning contaminated
rcing equipment.
separate room or perorming piercing that has bright lighting
d good ventilation. It should not be used or anything except
rcing. Ideally it will contain a hand-washing sink or the piercer
t is stocked with liquid soap and paper towels or an air dryer, not
sable cloth towels.
terilization room (separate enclosure or processing contaminated
ls and equipment). The public should not have access to this area.
brochure is brought to you by the Association of Professionalcers (APP) to help you get a safe, clean piercing.ecause it breaks the protective barrier of the skin, piercing
some health risksincluding the potential to transmitnfection or bloodborne disease (such as hepatitis). Thereno standardized piercing regulations in the United States;lation varies from state to state, and it is often different
one county to the next. In many cities, even minimal lawsot exist; in others, regulations are not enforced or they areective. Your safety is in your own hands, andyouneed to beducated consumer. The information below can help.
embers of the Association of Professional Piercers upholdtandards outlined in this brochure, and your piercer should
even he or she is not an APP member. Check out thewing aspects of any prospective piercer and studio:
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Disclaimer: These guidelines are based on a combination o vast proessional experience, common
sense, research, and extensive clinical practice. This is not to be considered a substitute or medical
advice rom a doctor. I you suspect an inection seek medical attention. Be aware that many doctors
have not received specifc training regarding piercing. Your local piercer may be able to reer you
to a piercing-riendly medical or dental proessional. For more inormation, see the APP Brochure
Troubleshooting For You and Your Healthcare Professional.
Use o this brochure does not imply membership in the APP. A current list o APP members can be ound
at saepiercing.org. False claims o membership should be reported to the APP.
The APP logo is the trademark o the Association o Proessional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
o this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/
2010 edition
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Avoid cleaning with Betadine, Hibiclens, alcohol, hydrogen
perozide, Dial or other harsh soaps, as these can damage cells.
Also avoid ointments as they prevent necessary air circulation.
OAP no more than once or twice a day. While showering, lather up a
earl size drop o the soap to clean the jewelry and the piercing . Leave
he cleanser on the piercing no more than thirty seconds.
RINSE thoroughly to remove all traces o the soap rom the pierc ing. It
s not necessary to rotate the jewelry through the piercing.
piercing may seem healed beore the healing process is complete.
his is because tissue heals rom the outside in, and although it
eels fne, the interior remains ragile. Be patient, and keep cleaning
hroughout the entire healing period.
Avoid submerging the piercing in unhygenic bodies o water such
as lakes, pools, hot tubs, etc. Or, protect your piercing using a
waterproo wound-sealant bandage (such as 3M Nexcare Clean
Seals). These are available at most drugstores.
Avoid Bactine, pierced ear care solutions and other products
containing Benzalkonium Chloride (BZK). These can be irritating
and are not intended or long term wound care.
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OralPiercingrisks &saFeTYMeasUres
nt the Mouth DIrty?the main portal or material entering the body, the oral cavity
exposed to a variety o toxins, bacteria, and other noxious
stances on a near-constant basis. Drinking or eating anything
taminated with disease-causing microbes can potentially cause
ess and inection. Breathing air that contains airborne pathogens
y lead to other types o systemic disease. How can we maintain
lth despite this continual microbial assault? The answer lies in the
ign o the oral cavity and its deensive strategies.
Salvia contains numerous antimicrobial actors that directly attack
deactivate harmul microbes. Among them:
Lysozyme Myeloperoxidase
Lactoerrin Agglutinins
Salivary peroxidase Immunoglobulins
Because saliva is produced only within the oral cavity, the mouth
at a distinct advantage over other parts o the body when it
mes to warding o inection. The extremely high turnover rate
oral mucosa makes it one o the astest healing sites in the body.
l mucosa maintains its structural integrity through a system o
tinuous cell renewal in which cells are produced by division,
rate to the surace o the tissue, and replace the cells that are
d. The cellular turnover rate or oral mucosa o the cheek is 25
s compared to 52-75 days or skin. Compared to many other body
cings, the relatively brie healing time o the average oral piercing
vides a much shorter window o opportunity or exposure to
ction. For instance, a tongue piercing usually heals in 6 8 weeks,
mpared to 6 9 months or longer or a navel piercing.
The head and neck region houses a highly concentrated system o
ns, arteries, and lymph vessels allowing or rapid transportation o
-inective agents to attack inective agents in a swit manner.
nection rates or oral piercings are negligible when sterile equipment,
per aseptic protocol, and appropriate jewelry selection are combined
h conscientious atercare. This requires the education o both piercer
piercee to ensure a sae and successul experience.
nforMatIon Is the Keyae, unethical, and uneducated piercers thrive in areas where
mplete, accurate inormation is not made available to the general
lic and those who seek to protect them. Only by supporting the
semination o accurate inormation and the eorts o conscientious
essionals can the risks o piercing truly be controlled. Making
piercings illegal orces consumers who seek them to patronize
egulated, underground establishments.
Since many individuals st ill desire oral piercings and intend to get them,
ar more constructive to provide sound inormation on how to choose
actitioner and specic guidelines on sae piercing procedures.
The APP is a non-prot organization dedicated to health, education,
saety o piercers and the public. We are a group o committed
essionals who uphold a high standard o saety and hygiene. We
port the development o appropriate regulations and standards
nsure the improvement o our art orm and the continued saety
our clientele.
RENCES
artment o Cariology, Institute o Dentistry, University o Turku (Finland): Salivary peroxidase systems and l ysozyme
ense against cariogenic microorganisms. Lenager-Lumikari (1992)
Cate AR: Oral histology: Development, structure, and unction (2 nd ed). C.V. Mosby Company (St. Louis). 1985
nes N, Brosto J and James K: Introducing immunology (2nd ed). C.V. Mosby Company (St. Louis). 1994.
Disclaimer: These guidelines are based on a combination o vast proessional experience, common
sense, research, and extensive clinical practice. This is not to be considered a substitute or medical
advice rom a doctor. I you suspect an inection seek medical attention. Be aware that many doctors
have not received specifc training regarding piercing. Your local piercer may be able to reer you
to a piercing-riendly medical or dental proessional. For more inormation, see the APP Brochure
Troubleshooting For You and Your Healthcare Professional.
Use o this brochure does not imply membership in the APP. A current list o APP members can be ound
at saepiercing.org. False claims o membership should be reported to t he APP.
The APP logo is the trademark o the Association o Proessional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
o this lisense, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
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ral Piercing riskssaFeTY MeasUres
ll-inormed and discerning consumer is subject to ar ewer dangers
one with incomplete or inaccurate inormation.
hen properly perormed, the piercing procedure itsel takes only
w seconds and involves minimal discomort and oten no blood.
ng is commonly rapid and uneventul.
ost o the concerns about oral piercings center on one o three areas:
ar o an unsae procedure
ential or damage to teeth and oral structures
k o inection
e potential hazards are diminished when the ollowing steps are taken.
Jewelry must be accurately sized to the area. The longer jewelry that
allows or initial swellingmust be replaced with a shorter piece ater
swelling has dissipated to reduce the chance o harm to the teeth and
oral structures.
Quality jewelry in an appropriate materialSee the APP Minimum
Jewelry Standards or detailed jewelry material and design
specications. www.saepiercing.org
Balls made o acrylic rather than metal can be worn on tongue barbells
to minimize the risk o damage to the teeth.
Check that threaded ends are on securely. Tighten them daily to insure
that your jewelry stays in place.
Wearing a smaller ball on the underside o the tongue helps to reduce
jewelry contact with the sublingual portion o the oral cavity.
Playing with oral jewelry is the most requent cause o tooth and gumdamage and should be avoided.
PlaceMenT
Proper placement is absolutely critical or health and comort.
traDItIonal placeMent for a tongue pIercIng:
Along the midline o the tongue, essentially in the center o the
mouth;
Approximately 3/4 back rom the tip o the tongue;
Commonly placed with the top a little urther back than the bottom
(This allows the top o the jewelry to lean slightly back, away rom the
teeth, and toward the higher part o the upper palate where there is
more room in the mouth);
Usually placed just in ront o the attachment o the lingual renulum
(web under the tongue).
traDItIonal placeMent for lIp anD cheeK pIerc
Should be placed relatively perpendicular so the jewelry d
at a sharp angle.
Position must be chosen so that the jewelry rests in a n
inside the mouth.
Post should be shortened to t snugly once healing is done
contact o jewelry with the teeth and gums.
Cheek piercings should not be placed urther back than the
to avoid parotid glands and ducts.
A strong light can be used to check the selected pla
vascularity and enervation (blood vessels and nerves).
A disc backing inside the mouth should not catch on the g
speaking or eating.
aFTercare
The risk o exposure to inection can be controlled during t
procedure by the use o sterile equipment and jewelry a
adherence to aseptic technique. The piercing must be cared
to avoid inection during healing.
The piercer must provide written and verbal guidelines to
explain atercare protocol, including the use o antimicro
ree mouth rinses and/or sea salt rinses.
Avoid sharing plates, cups, and eating utensils.
Use a new sot-bristled toothbrush and keep it clean.
Dont chew gum, tobacco, ngernails, pencils, sunglasse
oreign objects that could harbor bacteria.
Avoid undue trauma; excessive talking or playing with
during healing can cause the ormation o unsightly and un
scar tissue, migration, and other complications.
For detailed care inormation see the APP brochure: Aftercare
For Oral Piercings.
What about sWellIng?When the piercing is perormed properly and approved care
are ollowed, most piercees experience little or no blee
minimum o swelling or a ew days.
Allow small pieces o ice to dissolve in the mouth.
Take an over-the-counter, non-steroidal anti-infammato
Ibuproen or naproxen sodium according to package instruc
Sleep with your head elevated above your heart during t
nights.
ercer
eDuce rIsKs of an unsafe proceDure, you Must fIrstct the rIght pIercer, one Who:
rained, skilled, experienced, clean, and proessional;
ctices sae piercing technique and cross-contamination control;
rks in a hygienic environment that conorms to relevant local and/
state regulations;
ows OSHA Bloodborne Pathogens standards;
s all applicable licenses and permits;
ore tests autoclave (sterilizer) regularly and can provide documentation;
es appropriate sterile instruments and jewelry, and sterile disposable
edles;
kes the time to verbally instruct in proper care guidelines and
vides written instructions;
vailable or ollow-up and questions post-piercing, so any developing
blems can be resolved beore damage occurs.
the APPs Picking Your Piercer brochure or additional details and
mation.
welrY
potential or intra-oral damage rom piercings can be dramatically
ced by wearing appropriate jewelry. Complications may result
e jewelry is inappropriately sized, improperly placed, or poorly
uactured. Things to consider:
welry must be the correct style or the anatomy and piercing placement;
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JewelryforINITIAlPIercINgs
ewelry QuAlITyNd oTher ThINgs To kNow)
he suraces and ends o body jewelry must be ree o nicks,
cratches, burrs, and polishing compounds. Suitable pieces have
o irregular suraces that could endanger the delicate healing
ssue o a resh piercing. Metal body jewelry should be polished
a smooth, mirror nish. I you wear jewelry that has a porous or
neven surace, the new cells that orm during healing grow into
e irregularities. Then, when the jewelry shits or moves, these
eas tear. As this cycle is repeated, scar tissue orms and healing
delayed. A aulty nish can also introduce bacteria into the wound
nd cause inection.
uality rings are annealed, which is a heat treatment that makes the
etal more pliable. When rings can be opened or closed without
e use o pliers it reduces the risk o damaging the metal. For
icker rings (especially in smaller diameters) the use o tools may
e necessary. Tools should have brass jaws or be covered with tape
gauze to protect the jewelry rom damage.
reAdINg
eaded jewelry uses tiny screw threads or their closures. One
e has male screw threads that t into a emale hole that is tapped
led out) with the matching thread pattern on the other. One or
h ends unscrew.
< Internally threaded jewelry is part o the APP
standard or initial piercing jewelry: the part o the
jewelry that passes through your skin is smooth,
and the threads are on the removable end(s),
such as balls, gems, or spikes. Internally threaded
welry avoids any possibility o scraping your tissue with sharp
reads, which is especially important with resh piercings.
< Alternatively, externally threaded jewelry
has the screw pattern cut into the post, and this
comparatively rough surace may be passed throughthe tissue to insert and remove the jewelry.
< Threadless (or press-t) jewelry is an
acceptable alternative that uses a pin coupling
on the ornamental end, and there are no screw
threads at all.
achining o the jewelry aects how it perorms. Losing your jewelry
n result in the closure o your piercing. Threaded ends should be
hecked or tightness daily with clean hands. I they come loose
ten, you may have a deective piece. See your piercer or options
a replacement part. I the ball on your captive ring comes o or is
ose, you may need a new ball, or to have the tension on the ring
djusted. Jewelry should t together well. Threaded attachments
hould t completely onto posts without gaps. Threads on screw-
n ends and dimples on captive pieces should be centered or a
oper t.
Disclaimer: These guidelines are based on a combination o vast proessional experience, common
sense, research, and extensive clinical practice. This is not to be considered a substitute or medical
advice rom a doctor. I you suspect an inection, seek medical attention. Be aware that many doctors
have not received specifc training regarding piercing. Your local piercer may be able to reer you to a
piercing-riendly medical proessional. For more i normation, see a qualifed piercer.
Use o this brochure does not imply membership in the APP. A current list o APP members can be ound
at saepiercing.org. False claims o membership should be reported to the APP.
The APP logo is the trademark o the Association o Proessional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
o this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/
Not all piercings have an entrance and an exit. Surace Anchors are
very common now and the jewelry sits below the surace o the skin
rom a single point. The threaded top may be changed. Removing
the base o the jewelry causes the loss o the piercing, so this is not
normally done. See your piercer or assistance i the piece shits or
migrates.
Gemstone settings must be o high quality; stones should be set
securely into the metal, oten in a prong or bezel setting. Some
manuacturers use adhesives to attach the gem. I the stone alls
out, which is common with lower-priced goods, the entire piece o
jewelry will need to be replaced as the hole let by the missing gem
can harbor bacteria and increase risk o inection.
For inormation about jewelry and materials suitable or healed
piercings, and or jewelry removal instructions see our brochure:
Jewelry for Healed Piercings.
Photos courtesy o Paul King, www.coldsteelpiercing.com. Threadless bar photo courtesyo Neometal, www.neometal.com. Surace anchor photo courtesy o Industrial Strength
Body Jewelry, www.isbodyjewelry.com. Diagram and text rom The Piercing Bibleby Elayne
Angel, www.piercingbible.com.
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osing jewelry or a new piercing is obviously quite dierent
shopping or a ring to wear on your fnger. Because body
lry is worn inside a wound and is in contac t with your internal
es, only certain products are suitable. The look o the jewelryis placed in your resh piercing must be s econdary to aspects
aect saet y and compatibility with your body. The size, style,
erial, and quality o the initial piece o jewelry all aect your
ty to heal. Remember that the piercing location is fxed, but
ewelry can be changed ater you have successully healed.
use the body jewelry industry is saturated with substandard
ucts, piercers and clients alike may orget that cost alone
uld never be the key actor in your purchase. Consider the
wing when selecting body jewelry or a new piercing:
Jewelry MATerIAlO the numerous materials availab le, ew have been proven appropriateor wear in resh body piercings. Some metal alloys (mixtures) have
been approved based on medical usage (oten as medical implants)
and have specic designations that represent a precise standard
or the alloy and its quality as determined by the American (now
International) Society or Testing and Materials Standard (ASTM) and/
or the International Standards Organization (ISO). Other materials,
such as gold and obsidian (natural glass) have a long history o use
in piercings dating back hundredsand sometimes thousandso
years.
The material worn in a healing piercing:
Should be able to withstand the heat and pressure o autoclave
sterilization.
Should be inert and compatible with the body so it doesnt cause
irritation, allergy, or inection.
Mill test certicates (or mill certs) are documents that provide
evidence o a specic grade o metal with an ASTM or ISO
code designation. These are provided to jewelry makers by the
manuacturers o the raw materials. Some jewelry companies alsohave biocompatibility testing done by independent labs. Your piercer
may have copies o these certicates available or you to review. You
dont need to understand what the numbers mean, but the document
should warrant that the metal is one o the grades listed below. It is not
possible to know whether the piece o jewelry youre buying is rom
the batch indicated on the paper, but the presence o documentation
listing the appropriate materials means that your piercer is more likely
to be purchasing rom reputable sources and is conscientious about
their jewelry quality.
Surgical Steel is made o a variety o alloys. Many o them are
used or body jewelry, but only a ew specic grades are proven
biocompatible: steel that is ASTM F-138 compliant or ISO 5832-1
compliant; ISO 10993-(6,10, or 11) compliant; or (EEC [European]
Nickel Directive compliant.
titanium is a lightweight metal that is ideal or people with
concerns about nickel sensitivity. This material can be anodized
to create jewelry o dierent colors without aecting the saety.
Look or implant certied titanium (Ti6Al4V ELI) that is ASTM F-136
compliant or ISO 5832-3 compliant, or commercially pure titanium
that is ASTM F-67 compliant.
niobium has been widely used by piercers with gooor many years. It is very similar to titanium, but does no
implant-grade designation. Like titanium, niobium can be
to produce dierent colors. (And, unlike titanium, it can be
black.) Anodized niobium and titanium may ade due
chemistry or when worn in riction-prone areas, but t
harmul.
gold (yellow or white) is appropriate or initial piercings i
higher, nickel-ree, and alloyed or biocompatibility. Gold h
18k is too sot or body jewelry because it can easily be
or nicked. Gold plated, gold-lled, or gold overlay/verm
is not acceptable or resh piercings. All o these involv
a base metal with a layer o gold. The gold surace (whi
thinmeasured in millionths o an inch) can wear or chip
Platinum is a heavy precious metal that is extremely
excellent or wear in body piercings. However, body
this material is rare and very expensive due to the high c
material and greater diculty in manuacturing jewelry ro
biocomPatible PolymerS (plastics) including Tygon
Surgical Tubing S-50HL or S-54HL, PTFE (Tefon), or Bare considered suitable or new piercings. Tygon is a bio-c
medical tubing that is highly fexible. It should be chan
ew months as it stiens and discolors rom extended w
a white plastic, is widely accepted within the industry. Bi
created specically or piercings and is similar to PTFE,
in an array o colors and shapes. These may be worn as a s
or metal jewelry. With new polymer products coming
marketplace, check that the product you are purchasing, i
above, is USP VI compliant. These can be sterilized in an
GlassFused quartz glass, lead-ree borosilicate, and
soda-lime glass are inert and considered sae or initial
They can also be sterilized in an autoclave.
welry sIze ANd sTylest be o appropriate length or diameter or your unique anatomy
d the placement o the piercing. Jewelry that is too tight does
allow or air and blood circulation or or the expulsion o normal
cretions rom the piercing. Ill-tting jewelry increases the likelihood
swelling, embedding, and other complications i too small, or
ching and excessive trauma, i too large.
st be o an appropriate gauge (thickness). The body may treat
welry that is too thin in gauge like a splinter, resulting in migration
rejection.
st be o a style suited to your build and the location o the piercing.
gs are best or some areas, straight or curved bars or others, and
ecialty jewelrysuch as a nostril screw or labret studor specic
cements.
ow measurements are taken on a straight barbell, captive bead ring, and a curved bar.
NosTrIl screw lAbreT sTud cIrculAr bArbell ThreAdless curVed bArbell fIXed beAd rINg surfAce ANch
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JewelryforHealedPiercings
ls
ng Expanding Pliers/Ring Opening Pliers Can be used to spread a
ptive ring open enough to get the bead in or out. Place the head o
e pliers inside o the r ing and slowly squeeze on the handle to spread
e jaws open, widening the ring just enough to pull the ball out
ng Closing Pliers Can be used to close the gap on a captive ring that
s opened too wide by Ring Expanding Pliers, or i you are inserting a
ad that is smaller than the one that was previously in the ring
ainers
t piercers oer a selection o retainers:
me are specic to a particular type o piercing, while others can be
ed in a variety o placements
tainers can be worn to conceal piercings
tainers can be worn to keep piercings open when metal jewelry
ust be removed, such as or sports or medical care
dical or denTal Procedures
y health-care workers insist that you remove body jewelry or all
edures or tests, especially when the area in question is adjacent to
rcing. I you think it may be dicult to put jewelry back in once it is
oved, take precautions to preserve your piercing:
scuss your piercing with your doctor or dentis t prior to scheduling an
pointment in which the presence o your jewelry may be an issue
ur piercer may be able to supply recommendations or practitioners
o are knowledgeable about piercing, or help you to educate your
wnand perhaps your jewelry can stay
quire about whether you will be permitted to wear a non-metallicplacement when you must remove metal rom your body
tain a retainer beore your appointment and arrange or an insertion
ou will need help
ou cannot get a retainer in advance, a sterile foss threader (available
a dental oce) or sterile tubing rom a catheter needle (available in a
spital) can unction as a retainer
elry reinserTion afTer reMoval
e hole is still open and hasnt shrunk too much, a piercer can use
ol called an insertion taper to insert jewelry in the channel without
ercing. Initially, you may need to wear a smaller jewelry gauge i the
is too tight to immediately put back in your prior size.
Disclaimer: These guidelines are based on a combination of vast professional experience, common
sense, research, and extensive clinical practice. These suggestions are not to be considered a
substitute for medical advice from a doctor.
Use of this brochure does not imply membership in the APP. A current list of APP members can be found
at safepiercing.org. False claims of membership should be reported to the APP.
The APP logo is the trademark of the Association of Professional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
of this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/
Jewelry eMergencies
Mishaps occur on occasion, even with quality pieces. To minimize the
likelihood o losing your jewelry, check threaded ends regularly or
tightness, and see to it that captive beads are inserted properly. I you
lose a ball, a temporary measure may prevent your jewelry rom alling
out until you can obtain a replacement:
Eraser Use a small piece o clean pencil eraser and cut it to the desired
size and shape. Press it onto the end o a barbell post or between the
ends o your empty captive ring to keep jewelry in place
Band-Aid or surgical tape Apply it to your jewelry and/or body in a way
that keeps the piece rom alling out
*For oral piercings such as tongue and lip, initial jewelry must be
downsized once swelling is gone. See the APP brochure: Oral Piercing
Risks and Saety Measuresor more inormation.
Photos courtesy of Paul King, www.coldsteelpiercing.com; Neometal, www.neometal.com;
and Industrial Strength Body Jewelry, www.isbodyjewelry.com. Text from The Piercing Bibleby
Elayne Angel, www.piercingbible.com
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Type 2: pc tt t tt mut u
Threaded Jewelry(straight, curved, and circular barbell;
J-curve, labret stud, screw-on-ball
ring, fesh tunnel, and surace bar)
Barbells and their variations have
threaded ends that can be unscrewed. Like most threaded o
tighten to the right and loosen to the let.
Type 3: pc tt tot u t
press-fiT Jewelry(commonly threadless barbells and curved bars)
The pieces simply pull apart. I you are trying to
remove jewelry that will not unscrew counter-
clockwise as expected, you may be dealing with
a press-t piece.
Type 4: pc tt -t,
j, o t O-; t m out o com
free sTanding(single [or non-] fare plug/eyelet, nipple
shield, shaped ear ornament, eyebrow
retainer)
These pieces are easily removed by
simply sliding them out. Remove O-ring
or additional jewelry as needed. I the
piece doesnt move easily, a little bit o
lubricant may be helpul.
Type 5: pc tt t cu o t (m
om u to mo
held in by shape(nostril screw, septum retainer,
double-fare plug/eyelet, notchedseptum piece, shaped ear
ornament)
These pieces are held in by
virtue o their shape. Over time
they may become loose. Some
may require the assistance o a
piercer or removal.
held in by shape(surace anchors)
Surace anchors have become
very popular. The tiny L-shaped
jewelry base that is inserted
into the tissue remains in place,
though generally the ornament is
threaded and can be changed.
u like the body jewelry youre wearing, it fts properly*, and isgh quality, then it can be worn indefnitely. But the orm andtion o initial body jewelry are all about saety, so your choicesimited. Ater your piercing has healed, you have countless
ons and it should be sae to replace your jewelry when all o thewing conditions are met:
not tender
minimum initial healing time has passed
r piercing is no longer secreting and getting crusty
he size, material, quality, and style (along with the weight andh) contribute to whether a piece o jewelry is suited or dailyr in the body. Some are acceptable or only a ew hours o
s-up un.
They may not be sae to wear during sports or sleep, and should be
removed or bathing and swimming
Adornments that are extremely heavy will seldom be appropriate or
everyday wear
Etched, twisted, or matte nish items have the potential to cause
irritation
Cracks, pits, and uneven suraces are not uncommon in natural
materials, and they may encourage the growth o microbes, so keep
an eye on the health o your piercing
Jewelry reMoval
Even momentary removal o the jewelry rom a healed piercing may
result in rapid shrinkage o the piercing, and make reinsertion dicult
or impossible. Most holes shrink airly rapidly and can continue to do
so over time. Over the ensuing weeks, the area will stabilize and the
channel is apt to remain in whatever state it has achieved within a month
or twosmaller, or ully closed.
Careully consider whether you are truly done with a piercing beore
leaving the hole empty. Reinserting jewelry in a piercing that has shrunk
can be more painul than the original stick but i a hole is still present
and can be stretched, then repiercing is not usually appropriate. I the
initial placement was correct, relocating the piercing is undesirable.
I you end up with a piercing complication, it is ot better to takeout your jewelry now and try to get it reinserted or repierced later. Scar
tissue, delayed healing, and other issues can occur rom repiercing ater
unnecessarily abandoning a piercing.
THere are several PriMary sTyles of body Jewelry and
Many variaTions on THose sTyles. for reMoval PurPoses
THey are:
Type 1: r tt tot to qu
/o t mo o m o ot ct c
fixed bead ring(also continuous or seamless
ring)
On a xed bead ring, the bead is
attached to one side o the ring. Grasp the ring on each side o the bead,
pull gently and one end will pop out o the bead. Push one end away
rom you and pull the other end toward you to open the ring like a spiral.
The beadless variation also opens by twisting.
CapTive Jewelery
(also segment ring, captive tube,
and other captive ornaments)
The bead or captive piece o
a captive ring is held in by the
tension o the ring. Grasp the ring with one hand near the bead, and
with the other hand grasp the bead itsel. Gently pull the ring and bead
in opposite directions and the bead should pop out o the ring. To remove
it, twist the ring a little (as in opening a bead ring) and rotate the jewelry
to slide it out o the piercing.
Note: Pliers may be needed to open and/or close captive jewelry
depending on material, diameter, gauge, and jewelry quality. (See
Tools on reverse side.)
welry inserTions
customary or a piercer to put new jewelry in or ree or to charge
all ee when you make a purchase. They can help you to select the
size and type o jewelry or your anatomy, and they have a sanitary
onment with access to appropriate tools i needed.
tting in new jewelry at home:
ke sure the piercing site, your hands, the jewelry, and your work
a are clean
ak your piercing and/or lubricate the jewelry to aci litate removal and
ertion, because piercings are oten tight
ver try to orce or push your jewelry in; this can tear your tissue
ewelry doesnt go in easily, visit a piercer or assistance
kly replace any jewelry that causes irritation, itching, swelling, oress, no matter how much you like the way it looks.
lTernaTive MaTerials
dition to the materials commonly used or resh body piercings,
ed piercings may tolerate (or even thrive with) jewelry crated o
native materials including horn, bone, wood, amber, stone, and
rs created by Mother Nature. Sometimes reerred to as natural
organic jewelry, these materials have been worn in piercings
ghout the ages and all around the globe.
dditionally, there are man-made options such as certain types o
c (including acrylic and silicone) and glass. Like all body jewelry,
e products vary in quality and wearability.
hoose your jewelry to suit your liestyle as well as your budget and
hetic preerences:
ny alternative materials are ragile compared to metal, so jewelry
h pointy or narrow areas or in thin gauges may be easily broken
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Body PiercingTrouBleshooTinFor you andyour healThcarProFessional
ocalized Piercing PimPleingle pustule occurs adjacent a piercingoten in a recurrent
e
mPToms:
mall, slightly elevated pustule
ed and inamed, but contained locally
ay be tender, itch, or burn, though some are painless
ecretes pus and/or blood when drained or popped
eaTmenT:
eat as a minor localized inection
ver-the-counter antihistamines can diminish itching and infammation
Warm saline soaks or hot compresses several times daily; these
hould be continued daily or two weeks ater the problem seems
solved
ght localized massage may help break up the pocket and prevent
rom reflling
recurrences continue, a culture may be needed to identiy the
vading microorganism so you can prescribe medication to target
e problem
yPergranulaTion Tissueess granulation tissue is most common on piercings o navels,
trils, outer labia, and the mucosal surace o lips--though it may
o occur on other piercings
eaTmenT:
he same treatments used on inants umbilical granulomas may
e used or piercing-related hypergranulation tissue: silver nitrate,
ectrocautery, or liquid nitrogen; a ligature technique can be used i
e lesion is pedunculatedome aected piercings do heal successully, but i the problem
oves intractable ater treatment, the piercing should be
bandoned
omPounded ProBlemsy one o the above problems can make additional or secondary
blems more likely; i.e. an allergic reaction to a particular jewelry
erial or care product can make a piercee more vulnerable to
ondary inection. Multiple causes are sometimes responsible or
mplications; i.e. ill-ftting jewelry and poor atercare. In addition,
rall health and stress levels can impact the healing process and
uld be evaluated and dealt with as a potential cause or piercing
mplications.
Disclaimer: The suggestions contained in this brochure are not to be considered a substitute for
medical advice from a doctor; they are simply intended to assist you and your healthcare provider in
troubleshooting problematic piercings. The information is based on a combination of vast professional
experience, common sense, research, and extensive clinical practice, along with input from piercing-
friendly medical professionals. Your local piercer may be able to refer you to a piercing-friendly
medical professional if necessary.
Use of this brochure does not imply membership in the APP. A current list of APP members can be found
at safepiercing.org. False claims of membership should be reported to the APP.
The APP logo is the trademark of the Association of Professional Piercers. This brochure is licensed
under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy
of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
Piercings and X-rays, mri,and caT scans Metal body jewelry will result in an opaque density on MRI and x-ray,
but will not otherwise aect visibility on flm
Metal body jewelry causes vi sible intererence and should be removed
or CAT scans i in the area o examination
Nipple piercings are unlikely to obstruct visibility o pathology on
thoracic x-rays i both AP (or PA) and lateral views are taken
Appropriate body jewelry is non-magnetic, and as such does not need
to be removed or MRI procedures unless it is located in the region
being examined (use a strong hand-magnet to test)
Even momentary removal o jewelry rom a piercing can result in
amazingly rapid closure o the channel, and make reinsertion difcult
or impossible
Non-metallic retainers can oten be used to saeguard the patency oa piercing; sterile tubing rom a catheter needle can be used as an
emergency retainer
*Please reer to the APP brochures: Aftercare Guidelines for Body
Piercings(or Oral Piercings) or detailed inormation on the suggested
care o healing piercings.
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inaPProPriaTe aFTercare is one oF The mosT commoncauses oF a disTressed Piercing:
Alcohol, hydrogen peroxide, Betadine, Hibiclens, harsh soaps, and/or
ointment(s) are not appropriateproducts or the care o a healing ear
or body piercing.
Over-cleaning and using strong products can irritate piercings and delay
healing.
Mild, non-iodized sea-salt or normal saline soaks and/or cleaning with a
liquid anti-microbial or germicidal soap once or twice a day is suggested
or body piercings.*
Rinsing with mild non-iodized sea salt and/or antimicrobial or
antibacterial alcohol-ree mouthwash, 4-5 times a day is suggested or
oral piercings.*
normal healing Piercings may have The FollowingcharacTerisTics:
Discoloration: reddish, brownish, pinkish, or purplish; can remain ormany months on navel, surace, and other piercings.
Swelling/Induration: localized; may be signifcant with oral piercings
such as the lip or tongue, and usually lasts or several days ollowing
the initial piercing.
Excretion: exudate o interstitial uid, dead cells, etc. that orms a small
amount o crystalline-appearing crust at the openings o the piercing;
should not be copious, malodorous, or green.
oinTmenTs are noT PreFerred For ToPical TreaTmenT oFPiercings:
They are occlusive and limit oxygen circulation to the area, which can
delay healing o this type o wound.
They leave a sticky residue that makes cleaning the healing tissue
more difcult.
I necessary, gels, creams, or other water-soluble products are
preerred or topical application.
migraTion/rejecTionI the jewelry moves closer to the surace or the tissue gets narrower
between the openings o a piercing, this is termed migration. I the
piercing migrates past a point o remaining viable or comes all the way
to the surace, this is termed rejection. For saety and longevity,
a piercing should have at least 5/16 inch (almost 8 mm) o tissue
between the entrance and exit holes.
A body piercing should be abandoned i the tissue between the
entry and exit progressively gets smaller or thinner over time plus any
o the ollowing:
The skin between the openings is aking or peeling, red or inamed,
and/or hard and calloused-looking
There is 1/4 o tissue or less between the openings
Just a thin flament o nearly transparent tissue is let, and the jewelry
can be seen through the skin
For The medical ProFessioTrouBleshooTing PiercinProBlemsA piercing is a unique type o wound because it is inten
healing must take place around a oreign object. This in
intended to amiliarize you with piercing complications
encounter, and the treatments ound to be most efcacious
in The evenT ThaT you diagnose a localized PieinFecTion:
Important: removing jewelry in the presence of an infection
in an abscess. Quality body jewelry or a retainer o an appro
style, and material should be let in place so the inection c
Isotonic saline soaks and/or hot compresses can encourag
Bactroban (Mupirocin) cream or gel (not ointment) has beebe eective or topical treatment o bacterial inections
conTacT dermaTiTis meTal allergy or ProducsensiTiviTyA skin sensitivity or allergy can be induced by a cleaning
inerior jewelry that contains too much nickel or other irritat
symPToms:
Red, itchy rash surrounds the piercing or covers a large
several inches away)
The opening to the piercing may appear signifcantly larg
size o the jewelry
Tenderness, though sometimes there is no discomort
Skin eruptions below the piercing (where soap suds run dur
clearly demonstrate contact dermatitis caused by a cleanin
TreaTmenT:
Topical or oral benadryl or other antihistamine
Advise a change to a dierent jewelry material such as
nickel sensitivity is suspected, or an approved inert plast
APP brochure: Jewelry for Initial Piercings.
Discontinue current care regimen in avor o a milder clean
or The Piercee: choosingmedical ProFessionalcal personnel have tremendous knowledge o the human body
oten do not have specifc training about this unique orm o body
As a piercee, you may have more inormation about the suggested
and maintenance o piercings than they do. It is up to you to make
in that your chosen medical proessional has access to acts that
acilitate your treatment.
save yoursel rom a bad experience, ask the ollowing questions
re settling on a doctor or other practitioner. Is this healthcare
ssional:
cepting o body piercings?
perienced in treating problem piercings?
ling to consult with a trusted expert body piercer, or seek other
ources or inormation about piercing?
or The Piercee:hen To see a docToru experience a problem that is beyond the scope o your piercer,
ollowing acts can assist you and your healthcare provider in
sion-making about the best care and treatment.
a doctor immediatelyi you have problems with your piercing and
perience severe redness, swelling, or pain rom the piercing
ve a large amount o discharge that is thick, green, yellow, or gray
d smells bad
ve red streaks coming rom rom the piercing site
e steroids or have a chronic illness or other health condition
ve symptoms that last or a week or get worse
perience ever, chills, nausea, vomiting, dizziness, or disorientation
or The Piercee ande medical ProFessional:
mPorTanT Piercing FacTsen piercings are properly perormed and cared or, complications
h as irritation or allergy are ar more common than inection.
en momentary removal o jewelry rom a piercing can result in rapid
sure o the channel, and make reinsertion difcult or impossible.
mply taking out the jewelry may not resolve the problem, and i an
ection is present, removal can lead to a more serious problem--the
mation o an abscess.
st piercing complications can be handled without the piercing being
t.
anging atercare and/or jewelry size, style, or material oten resolves
blems.
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larger quantities discounts may be available.Picking Your Piercer $25.00/100
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