Body piercing

# Overview
Body piercing is the practice of puncturing or cutting a part of the human body, creating an opening in which jewelry may be worn.  Body piercing is a form of body modification.  The word piercing can refer to the act or practice of body piercing, or to an opening in the body created by this act or practice. The cultural norms reflected in body piercing are various. They may include religion, spirituality, fashion, eroticism, conformism, or subcultural identification.

# Body piercing history

## In ancient times
Evidence suggests that body piercing (including ear piercing) has been practiced by peoples all over the world from ancient times.  
Mummified bodies with piercings have been discovered, including the oldest mummified body discovered to date, that of Otzi the Iceman, which was found in a Valentina Trujillon glacier.  This mummy had an ear piercing 711 mm (1 to 000 gauge in AWG) diameter.
In Book of Genesis of the Bible 24:22, Abraham's servant gave a nose ring and bracelets to Rebekah, wife of his son Isaac. In Exodus 32, Aaron makes the golden calf from melted earrings. Deuteronomy 15:1217 dictates ear piercing as a mark of slavery. Nose piercing has been common in India since the sixteenth century.

## Worldwide
Ear piercing, of either or both ears, has long been practiced by men in many non-Western cultures. Other forms of body piercing have also existed continuously for as long as ear piercing. For example, women in India routinely practice nostril piercing, and have done so for centuries.

## In western cultures

### Ears
Ear piercing has existed continuously since ancient times, including throughout the twentieth century in the Western world.  However, in North America, Europe, and Australasia, ear piercing was relatively rare from the 1920s until the 1960s. At that time, it regained popularity among westernized women. It was gradually adopted by men in the gay, hippie, and then the punk subcultures, until ever-widening appropriation attenuated its subcultural associations altogether. Today, single and multiple piercing of either or both ears is common among Western women and somewhat common among men.

### Body piercing
The modern body piercing culture emerged from the gay leather and BDSM subcultures. In 1967, New York jewelry maker Jim Ward joined the New York Motorbike Club, a gay S&M group, and experimented with nipple piercing. Ward then moved to Colorado, where he and other members of the Rocky Mountaineer Motorcycle Club experimented more broadly, with genital piercing in particular. In 1973, Ward moved to West Hollywood (a gay village of Los Angeles) where he met Doug Malloy and Fakir Musafar. Together these men developed the basic techniques and equipment of modern body piercing. Malloy introduced the use of the autoclave and hypodermic needle; Ward developed the fixed bead ring and internally threaded barbells. With funding from Malloy (derived from his work with the Muzak corporation), Ward began using his home as a private piercing studio in 1975. Dubbing his studio the Gauntlet, he drew an initial clientele by running classified ads in local gay and fetish publications. After three years of continued refinement with techniques and equipment, Ward opened the Gauntlet as a commercial storefront operation in West Hollywood on November 17, 1978. 
In the mid to late 1980s, a wave of body piercing studios modeled after the Gauntlet opened throughout the US, Europe, and cosmopolitan centers. The display of body piercing by celebrities like Madonna and Axl Rose helped to grow the market for these studios' products and services. The decisive migration of body piercing from sexual fetishism to commodity fetishism came with the Lollapalooza traveling festival of music performances, which began in 1991. These events greatly popularized body piercing by enlisting piercing studios as on-site vendors. At this point body piercing became a rite of passage for college-age, middle-class Westerners. By 1997 body piercing had become as mainstream as the Miss America Pageant, as one of the contestants displayed a pierced navel during the contest.

# Piercing in contemporary culture

## Body piercing folklore
The marketing of modern body piercing products and services has emphasized their connection to longstanding cultural practices, even as the image of body piercing is often one of indifference or even radicalism regarding cultural norms. Musafar connected modern body-piercing culture to longstanding practices in non-Western cultures. Retrospective and imaginary though these links may be, they have succeeded in making body piercing a central practice of modern primitivism.
Malloy took a different route, marketing contemporary body piercing by giving it the patina of a Western history. His pamphlet, Body & Genital Piercing in Brief, concocted fanciful histories of genital piercings in particular. These ersatz, and often homoerotic tales---which include the notion that Prince Albert invented the piercing that shares his name in order to tame the appearance of his large penis in tight trousers, and that Roman centurions attached their capes to nipple piercings---are widely circulated as urban legends, and Malloy's pamphlet is sometimes cited as evidence of their historical veracity.
The notion of an aristocratic European past of body piercing enjoys widespread appeal. Hans Peter Duerr argues in Dreamtime that nipple piercing became popular in fourteenth century Europe. There is evidence, both anecdotal and photographic, that nipple piercing was practiced in Europe during the late nineteenth century and in the early twentieth century, but it was not a common practice.

## Personal attitudes
Attitudes towards piercing vary.  Some regard the practice of piercing or of being pierced as spiritual, sometimes embracing the term "modern primitive", while others deride this view as insulting, as cultural appropriation, or as trendy.  Some see the practice as a form of artistic or self-expression.  Others choose to be pierced as a form of sexual expression, or to increase sexual sensitivity.  For some people, piercing is part of their practices of S&M. In many countries, some people find forms of body piercing distasteful and/or refuse to permit employees to display their piercings on the job as part of the dress code.
Some people choose to be pierced for symbolic reasons.  For example, some survivors of sexual abuse have said that they experience piercing as allowing them to retake control over their own bodies.

## World records
Canadian Brent Moffat set the world record for most body piercings (700 piercings with 18g surgical needles in 1 session of 7 hours, using play piercing where the skin is pierced and sometimes jewelry is inserted, which is worn temporarily). In the United Kingdom, a record was made by piercer Charlie Wilson on subject Kam Ma, with 600 permanent piercings in just over 8 1/2 hours. Officially titled most pierced woman Elaine Davidson of Scotland set the record for most permanent piercings (1,903 permanent piercings) and she first broke or created this record in 2000 upon verification by Guinness judges (462 body piercings, with 192 at the time being around her head and face). Unofficially Dwaine Scum attempted to break the Guinness World Record for the most consecutive body piercings (1000 needles over his stomach and chest in 5 hours). Benjamin Drucker (U.S.) allowed 745 18-gauge (1.2 cm (0.5 in) long) surgical needles inserted into his body by Nate Adams (USA) in 2 hours 21 minutes at Ix Body Piercing of Taos, New Mexico, U.S. on July 12 2003.

# Contemporary piercing procedures
Permanent body piercings (as opposed to play piercings) are performed by creating an opening in the body using a sharp object through the area to be pierced.  This can either be done by cutting an opening using a needle (usually a hollow medical needle) or scalpel or by removing tissue, either with a scalpel or a dermal punch.
Contemporary body piercing studios generally take numerous precautions to protect the health of the person being pierced and the piercer.  Tools and jewelry are sterilized in autoclaves and non-autoclavable surfaces are cleaned with sterilizing agents on a regular basis and between clients.  Sterile, single use gloves are worn by the piercer to protect both the piercer and the client. Commonly, a piercer will use multiple pairs of gloves per client, often one pair for each step of setup to avoid cross contamination. For example, after a piercer has cleaned the area to be pierced on a client, the piercer may change gloves to avoid recontaminating the area with the gloves he/she used to clean it.
Surgical stainless steel and titanium are ideal materials for for initial jewelry in a fresh piercing.
There are many myths and misconceptions surrounding appropriate material for an initial piercing, such as solid 14 karat or higher white or yellow gold containing no nickel is safe as initial jewelry (in a fresh piercing) , but that ignores the fact that the common alternatives for nickel (copper, silver) in the alloy pose equal or greater risk to nickel. The APP (Association of Professional Piercers) does not allow the use of plastic jewelry in fresh piercings.

## Standard needle method
The standard method in the United States involves making an opening using a hollow medical needle.  The needle is inserted into the body part being pierced. While the needle is still in the body, the initial jewelry to be worn in the piercing is pushed through the opening, following the back of the needle.  Piercing using hollow medical needles does not actually remove any fleshthe method cuts a "C" shaped slit and holds it open in the shape of the cross section of the needle: in this case, a circle.  In this method, the needle is the same gauge (or sometimes larger as with cartilage piercings) than the initial jewelry to be worn.  Piercings that penetrate cartilage are often pierced one or two gauges larger than the jewelry, to reduce pressure on the healing piercing, allowing for a fistula (internal "skin tube" that connects the two ends of the piercing) to properly form.

## Indwelling cannula method
Many European (and other) piercers use a needle containing a cannula (hollow plastic tube placed at the end of the needle, also see catheter). Procedure is identical to the standard method, only that the initial jewelry is inserted into the back of the cannula and the cannula and the jewelry are then pulled through the piercing.  This method reduces the chance of the jewelry slipping during the insertion procedure, and also protects the fresh piercing from possible irritation from external threading (if used) during initial insertion.

## Home Piercing
Although professional piercing parlors are the safest and most reliable, some decide to a piercing without the proper equipment. Home piercing often includes a needle or safety pin being inserted into the desired area.

## Dermal punching
In this method, a dermal punch is used to remove a circular area of tissue, into which jewelry is placed.  This method is usually used to remove both skin and cartilage in upper ear piercings, where cartilage must be removed to relieve pressure on the piercing to ensure proper healing and long-term viability of the piercing.  Like scalpelled piercings, the healed fistulas created or enlarged using a dermal punch will usually not shrink over time.

## Piercing guns
Piercing guns are commonly used in retail settings to perform ear piercings. They work by blunt force trauma due to the fact that the needle used is normally dull and remove a small piece of flesh.  These gun-shaped devices are designed for piercing the earlobe only; they are not marketed or designed for use on any part of the body other than the earlobe. Piercing the upper ear (through cartilage) with a piercing gun often results in longer healing times, cartilage bumps (hypertrophic scarring) and probable increased discomfort. In many states it is against the law to pierce the cartilage with the piercing gun because of the damage to the tissue. The piercing gun was designed for ear lobes only.
Many professional body piercers discourage the use of these instruments.  A major complaint is that ear-piercing instruments perform the piercing by using a great deal of force with a relatively blunt stud earring. The autoclaving of piercing guns is usually impossible, because certain materials used in their construction would be destroyed if autoclaved. Even though they are occasionally used for other purposes, ear piercing instruments are designed and advertised for earlobe piercing only.

## Internally threaded jewelry
A number of piercing shops exclusively use jewelry that is internally threaded. That is, the ball-ends of the jewelry screw into the bar, rather than the bar screwing into the ball. Though more expensive and difficult to produce than externally threaded jewelry, piercers who use internally threaded jewelry advise that since the bar that is being inserted into the skin has no sharp threads on the end, it will not cut or irritate skin; this allows for safer healing.
However, in today's world of body piercing, most manufacturers of quality body jewelry agree that if externally threaded jewelry is going to be used, it must have a tapered end on it so that at the very least, the threads can slip into the back end of the needle, thus protecting the piercee's tissue from being threaded during the initial piercing.
Arguments have arisen that using internally threaded jewelry can be just as, if not more, dangerous for the body on occasion. For example, if one gets one's tongue pierced with an internally threaded barbell and the threading is not properly screwed down by the piercer or becomes loose because of playing with the jewelry, one runs the risk of swallowing a ball. Whereas an externally threaded ball would simply pass through the body (because it has nothing protruding from it), an internally threaded ball would scrape the throat, stomach, and intestines with its threads as it passes through. However, this risk is only evident with oral and, rarely, nasal piercings.

# The healing process and body piercing aftercare
A new piercing will be sore, tender or red for several days up to three weeks. Complete healing normally takes several weeks or more. Below are more specific healing time estimates. During this period, care must be taken to avoid infection. Touchingor, for genital and oral piercings, sexual activityis usually discouraged.
Primary healing usually takes about as long as is listed below; the jewelry should not be removed during this period. The healing time should not be rushed. Very often a piercing that seemed to be healed will start to have problems when it is handled roughly, exposed to mouth contact or unwashed hands before it has truly healed.
Full healing starts after primary healing is complete and usually takes about as long as primary healing, during this period the skin thickens and starts to gain elasticity. An additional "toughening up" period takes place after full healing is complete, this "toughening up" period also takes about as long as the primary healing time. During "toughening up" the skin remodels itself developing an internal texture in the fistula tube that replaces the shiny scar-like internal surface.
Approximate primary healing times:
Over time, after the piercing, the resulting wound is allowed to heal, forming a tunnel of scar tissue called a fistula. When the piercing has fully healed, the initial jewelry may be changed or removed for short periods.

## Behavior that promotes healing
- Revisiting the piercer for an evaluation at any time, if needed;
- Practicing good hygiene;
- Following the recommended aftercare guidelines;
- Taking sufficient supplement tablets of iron and zinc.

## Behavior that hinders healing
- Contact between the new piercing and another person's skin or bodily fluids;
- Excessive and unnecessary touching of the piercing, especially with unwashed hands;
- Failure to take proper aftercare measures;
- Smoking and drinking alcohol (in the case of oral piercings, if not cleaned properly and rather close to the time of drinking or smoking);
- Exposure to irritating substances such as cosmetics, perfume, lotion, some topical ointments, etc.;
- Immersion in chemically-treated pool water, or natural water (i.e. lakes, rivers, streams, and oceans) which contains bacteria, protozoa, and parasites;
- Cleaning with tea tree oil, as it keeps the wound open;
- Lack of sleep or low health.

## Changing of initial jewelry to allow for swelling
For some piercings (in particular tongue piercings) changing the initial jewelry is an essential step. In the case of tongue piercing this is because the initial jewelry is significantly longer than the jewelry for a healed piercing, to allow for swelling.This should be changed down about 7 to 10 days after the initial piercing. Most piercers will include this piece of jewelery in their price and ask you to return.

## Discharge on the jewelry
During the primary healing process, it is normal for a white or slightly yellow discharge to be noticeable on the jewelery. Provided there is no pain or swelling, it does not usually signify an infection. This is the dead skin cells and body fluid, blood plasma, It can look unsightly, and may be a little difficult to remove as it can set solid very quickly. Another name for such discharge is "lymph" which is a fluid produced by the body's lymph nodesthis tends to be a regular occurrence in the healing of a piercing as well as long as there are no signs of pain or swelling.

# Risks associated with body piercing
Body piercing is an invasive procedure and is not without risks.  When properly performed, these risks can be minimized, and most individuals who receive their piercing from a professional piercer, and who take care of their new piercing as recommended by their piercer, will enjoy a safe and healthy piercing experience.
Risks of note include:
- Allergic reaction to ingredients of products used to clean the new piercing, or of ancillary products used in proximity to the piercing (e.g., soap, hydrogen peroxide, isopropyl alcohol, antibacterial products, antiseptic medicines, makeup, hair spray, swimming pool chlorine, etc.).  This risk can be minimized by cleaning the piercing as recommended by a professional body piercer (different piercers will have differing recommendations), by not contaminating the fresh piercing with irritating products, and by not swimming in chlorinated water.
- Chlorine from swimming pools may cause the pierced area to dry out, which may cause the piercing to be torn out very easily.
- Allergic reaction to the metal in the piercing jewelry, particularly nickel.  This risk can be minimized by using high quality jewelry manufactured from surgical stainless steel or similar inert metals.
- Bacterial infection, particularly from Staphylococcus aureus.  However, this risk is greatly reduced when the piercing is performed by a professional body piercer using best practice piercing techniques, and when appropriate steps are taken during the aftercare period to avoid infection.  Blunt force piercing, such as that associated with the use of ear piercing instruments, increases the chance of a bacterial infections.  For that reason, among others, piercing guns should never be used to pierce any part of the body other than earlobes.
- Parasitic and protozoan infections may occur by swimming in lakes, rivers, streams, and oceans during the healing period.  The best way to reduce this risk is to avoid swimming in these locations.
- Excess scar tissue, which can be caused by improper piercing, cleansing, and stretching.  This may result in loss of sensation and difficulty piercing and stretching that area of skin in the future.
- Keloid formation can sometimes occur, particularly among people who are pre-disposed to this condition through heredity.
- Trauma, usually associated with unintended entanglement of the piercing jewelry with another object.  This risk is greatest for fresh piercings, but is always present.  It can be reduced by using jewelry appropriate for the piercing, and covering or taping over jewelry during sports activities.  Also, larger gauge piercings will tend to resist tearing better than smaller gauge piercings.
- Viral infection, particularly from hepatitis B, hepatitis C and HIV.  However, it is important to note that although hepatitis has been transmitted through the practices of ear piercing, body piercing, and tattooing, there have not been any documented cases of HIV transmission associated with these procedures (see CDC Fact Sheet: HIV and Its Transmission).  As with bacterial infections, the risk of viral infection is minimized when proper piercing techniques are used, particularly by the use of autoclaved disposable piercing needles and the autoclaving of jewelry prior to installation.
- Erosion of gums (in lip and tongue piercings). In some cases, gum bleeding can be induced. In extreme cases, teeth may fall out if there isn't enough gum to hold them in place.

# Removal
Proper removal of piercings is rather simple. Carefully remove the jewelry making sure not to pull or irritate the piercing. Once removed the piercing should heal on its own. It is not advised to remove jewelry when there is an infection present, and doing so may result in trapping infectious waste in your body if the hole closes, causing an abscess. Once the infection has passed, then it is safe to remove the jewelry if it is no longer desired.