Why Not?

I am often asked by prospective clients if I pierce ears and nostrils with a needle or gun. The answer? NEEDLE ONLY. Guns may be a quick, easy to operate, and popular method but they have significant drawbacks. The most pressing issues regarding gun piercings are inappropriate jewellery design, sterility of the implements, and tissue damage. In this post, I will explain these points in detail as I believe that educating others about the dangers of gun piercing is crucial.

Inappropriate Jewellery Design

The length of ear piercing studs is usually too short for most cartilage and some earlobes. The initial force of the implement is usually enough to force the earring to close over the tissue but after the piercing is completed and the jewellery is locked on there is not sufficient space for the tissue to decompress which can cause significant issues. In addition to irritation some of the lesser complications are decreased blood flow and air circulation to the area which can lead to scarring, minor complications, and increased healing time. If the jewellery is far too tight additional swelling and possible impaction can occur.

In my career, I have had countless clients who have experienced gun piercings come to my studio with stud gun jewellery totally embedded in the lobe, cartilage, nostril (and even some other locations). In some cases, the impaction is so severe that they need to be referred to a medical professional because they need to be surgically removed as one or both sides of the stud have disappeared completely under the skin. These consequences are far less likely to occur with needle piercings as the jewellery is selected to the unique anatomy of each client to allow ample room for swelling. The jewellery is also put in through the needle piercing process which is far less traumatic to the tissue and creates less swelling.

Additionally, when jewellery fits too closely against the skin it can prevent proper cleaning and hygiene practices. This increases the risk of infection as bodily fluids containing cellular discharge and other byproducts of the healing process that are excreted can become trapped around the hole. As the fluid coagulates and becomes sticky it traps bacteria against the skin. This can lead to secondary infections. Using implant-grade jewellery that is specifically designed for long-term wear and ease of cleaning can prevent this.

Sterility of the Implements

Piercing guns can come into contact with multiple bloodborne pathogens over the course of a day but are not sanitised in a medically recognised way. A plastic ear piercing gun cannot be put in an autoclave (it will melt) and are not able to be fully sterilised. Even if the isopropyl alcohol or clinical antiseptic wipes were able to eradicate all pathogens on contact they would still be unable to reach inside the working parts of the gun. A client’s blood can aresolise (become airborne in microscopic particles) which contaminates the inside parts of the gun. Due to this, the subsequent client’s jewellery and tissue are exposed to the contaminated surfaces. Per medical study reports, there is a possibility that bloodborne pathogens can be transferred through ear piercings performed in this method.

Some diseases such as Hepatitis and common staph infections can live for extended periods of time on inanimate surfaces and can remain on the gun for several weeks or potentially even longer. If you take into consideration the volume of clients whose initial piercings come in contact with the gun’s surface, it can pose a significant health risk. Those who are immunocompromised or immature immune systems such as babies, children, and the elderly can be at even higher risk.

Piercing guns can and do malfunction and it is not documented how often this occurs. It has been reported by some operators that the earring becomes wedged in the gun and does not release it, requiring it to be removed with pliers. These pliers come into contact with contaminated jewellery after it passes through the client’s tissue and can be used on multiple clients without proper sterilisation which increases the risk of infection. There are few gun piercing establishments and mobile services that possess the expensive sterilisation equipment (steam autoclave or chemclave) necessary for this procedure.

Tissue Damage

Gun piercing studs might appear quite pointed at first but in reality are rather dull. Due to this, piercings must be accomplished via putting excessive pressure over a larger surface area in order to force the metal jewellery through. This is referred to medically as “blunt force trauma,” which means that the effect on the body is similar to crush damage rather than a piercing and causes similar damage to the tissue. The most common scenario is significant pain and swelling for the client but in the worst cases scarring and potentially increased incidence of auricular chondritis, a severe tissue disfigurement, can occur.

Sometimes the intense pressure and speed of the gun’s spring-loaded mechanism is simply not sufficient to force the stud through the client’s tissue. In these cases the earring becomes lodged partway in the client’s anatomy. There are two options available to gun operators (who may or may not be trained to deal with an incident of this nature). They can either remove the stud and repierce the ear which can contaminate the surrounding tissue and gun due to the blood flow from the original piercing wound. The other possibility is for the operator to force the earring through which can cause significant tissue damage to the client and present the possibility of a needlestick-type injury to the operator.

Cartilage and other structural tissue such as nostrils can lead to more serious complications including auricular chondritis, shattered cartilage and excessive scarring. To get medically technical, gun piercings can result in the separation of subcutaneous fascia from cartilage tissue, creating spaces in which fluids collect. The result of this is swelling that is temporary and permanent lumps of tissue on or near the piercing site. The lumps can range from mildly annoying to seriously disfiguring and in some cases can require surgery to correct. Piercing with a single-use, sharp, sterile medical grade needle slides smoothly through the tissue and causes less separation. Trained piercers also use a post-piercing pressure technique used to minimise the formation of these hypertrophic scars.

Cartilage has less blood flow that other types of tissue which means that the healing time for these piercings is longer. Due to this, infections in the tissue are more common and can become more severe than those that occur in lobe piercings. Non-sterile piercing equipment and improper aftercare can result in the previously mentioned auricular chondritis. This is a severe and disfiguring infection of the cartilage tissue which can result in the collapse of structural tissue and deformity. Antibiotics and reconstructive surgery can be required to correct this.

Medical literature has many documented reports of such cases and some incidences can be found in the materials cited section at the end of this post.

Further Facts and Conclusion

Gun piercing establishments usually train their operators, but many times this training is limited to an instructional video, reading a training booklet, and/or practising on cosmetic sponges or other employees. A few allegations have been made that some establishments do not inform their employees of the serious risks involved in both performing and receiving gun piercings, and do not instruct staff on how to deal with situations such as client medical complications or gun malfunction. There are surveys conducted in jewellery stores, beauty parlours and mall kiosks in England that revealed that many employees had little knowledge of risks and risk management related to gun piercing.

The terrifying truth is that piercing guns can be obtained through Amazon, eBay, and at beauty supply stores which means that training may not be given to an operator at all. I’ve even seen kits available on AliExpress and Wish.com that include a gun and jewellery!

Worryingly, most ear piercing studs are not made with materials certified by the ASTM as safe for long term implantation in the human body. Even when coated in non-toxic gold or other coloured plating, materials from underlying alloys can leach into human tissue through corrosion, scratches and surface defects, causing cytotoxicity and allergic reaction. Since manufacturing a durable corrosion and defect-free coating for such studs is extremely difficult, medical literature considers only implant grade (ASTM F138) steel and titanium (ASTM F67 and F136) to be appropriate for piercing stud composition. Studs made of any other materials, including non-implant grade steel (steel not batch certified as ASTM F138), should not be used, regardless of the presence of surface plating.

Though there are significant risks associated with gun piercing, lack of awareness and education about potential complications means many clients may not associate their negative experience(s) to the gun implement itself. As gun piercings are easy to obtain, they are usually assumed to be risk-free. Usually the connection is only made after medical attention is required.

Despite these risks there is not a great deal of regulation in regard to gun piercing compared to other cosmetic procedures such as needle piercing, tattooing, microblading, acupuncture, and permanent makeup. Hopefully with education and a more readily available wealth of information the risks associated with gun piercings the public will be able to understand why this piercing implement is dangerous and opt for the safer option of needle piercing.

Sources

  1. Scottish Medical Journal. 2001 February 46(1): 9-10.
    The risks of ear piercing in children.
    Macgregor DM.
  2. British Journal of Plastic Surgery. 2002 April 55(3): 194-7. Piercing the upper ear: a simple infection, a difficult reconstruction. Cicchetti S, Skillman J, Gault DT.
  3. Pediatric Emergency Care. 1999 June 15(3): 189-92. Ear-piercing techniques as a cause of auricular chondritis. More DR, Seidel JS, Bryan PA.
  4. International Journal of Pediatric Otorhinolaryngology. 1990 March 19(1): 73-6. Embedded earrings: a complication of the ear-piercing gun. Muntz HR, Pa-C DJ, Asher BF.
  5. Plastic and Reconstructive Surgery. 2003 February 111(2): 891-7; discussion 898. Ear reconstruction after auricular chondritis secondary to ear piercing. Margulis A, Bauer BS, Alizadeh K.
  6. Contact Dermatitis. 1984 Jan; 10(1): 39-41. Nickel release from ear piercing kits and earrings. Fischer T, Fregert S, Gruvberger B, Rystedt I.

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