Ear and face piercing infections
Conventional piercing of the ear lobe normally heals in six to eight weeks without infection, provided that the piercing practitioner is scrupulously clean, has good aseptic technique, and the piercing is cared for appropriately using twice daily salt water soaks.4
It is normal to have some redness, tenderness and swelling around a piercing for the first few weeks. There can also be some oozing of fluid and crusting. Poor hygiene and inadequate aftercare can result in infection of the piercing site. Signs of infection include increasing swelling and redness, increased tenderness and pain on touching, burning and throbbing around the site, and an unusual discharge that may be yellow or green with an offensive smell. If signs of infection are present the patient should be referred to a doctor.
Ear cartilage piercing (involving the upper parts of the external ear) can take longer to heal than ear lobe piercing and the risk of infection is greater. This is thought to be because the cartilage has a low blood supply.
Perichondritis (inflammation of the perichondrium that overlies the cartilage) develops when the perichondrium is infected with bacteria. This starts with redness and inflammation around the piercing site but the infection can pass into deeper layers of cartilage, causing it to become very tender and painful. There may be an unusual yellowgreen discharge. Infected cartilage piercings will need antibiotic treatment.
One complication of infected cartilage is overgrowth of the tissue resulting in ‘cauliflower ear’. Surgical intervention may be necessary to correct the damage.
Two outbreaks of pseudomonas infection after cartilage piercings have been reported in the UK in recent years. One was linked to pseudomonas contamination of the water supply in the piercing studio and the other was linked to the use of an aftercare solution that was contaminated with pseudomonas.
Genital piercing and microdermal implants are beyond the scope of this module. For further information see leaflets from PHE.