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Cartilage Piercing Riskier Than Earlobes

Infection From Stubborn Bacteria More Likely When Upper Ear Is Pierced

From the WebMD Archives

Feb. 24, 2004 -- Piercing the cartilage in the upper portion of the ear is more dangerous than earlobe piercings -- and a nasty infection that doesn't respond to many antibiotics may be a reason why.

In this week's Journal of the American Medical Association, Oregon health officials report on a cluster of infections caused by the Pseudomonas aeruginosa bacteria that occurred among customers at a jewelry kiosk. Of the 118 children and teens who had their ears pierced in the six weeks observed, seven developed confirmed cases of the infection and there were another 18 suspected infections.

None occurred from earlobe piercings; only from those done on ear cartilage. Of the confirmed cases, four patients needed surgery and several were cosmetically deformed.

Officials Blame 'Poor Procedures'

"This cluster of cases was attributed to people at the kiosk using poor procedures that led to multiple people getting infected at the same time," says lead researcher William E. Keene, PhD, MPH, of the Oregon Department of Human Services. "But it was because of the location where they were doing this."

These infections resulted from a number of events such as using the same type of piercing device employed at hundreds or thousands of mall piercing kiosks across the country -- an open, spring-loaded "gun" that shoots a stud into the ear. In Oregon, these guns have been banned for cartilage piercings. Now needles or newer encapsulated guns should be used instead.

"With the new encapsulated guns, the stud itself is inside a sealed unit that snaps into place," Keene tells WebMD. "There is no touching of the stud and it's more idiot-proof when people drop the gun on the floor and then use it."

That's especially important with cartilage piercings, because cartilage doesn't have its own blood supply. So if an infection does develop from bacteria on the inserted stud, commonly used antibiotics can be ineffective because there's no blood to transport the medication to cartilage. Earlobes have a blood supply that can better deliver these bacteria-killing drugs.

Stronger Antibiotics Necessary

That may be the real message of Keene's study: "One thing I learned is that infection that occurs in cartilage, in contrast to earlobes, is commonly caused by Pseudomonas," he says. "And everyone with the infection was initially treated with antibiotics that are not effective against Pseudomonas."