Piercing? Stick to Earlobe

Upper Ear More Prone to Infection and Disfigurement

From the WebMD Archives

Oct. 24, 2002 -- Piercing the upper ear is a hot look for many, but it can cause serious problems. If not done correctly, the wound can take months to heal -- and there's greater risk of infection. In fact, you could end up with a disfigured ear.

A report of an outbreak in Oregon was presented at the Infectious Disease Society of America annual meeting held in Chicago this week.

"Kids don't seem to realize that ear piercing is, in its own small way, an invasive procedure, and until it heals, any pierced body part is at risk for infection," says the report's lead author, William E. Keene, PhD, an epidemiologist at the Oregon Department of Human Services Acute and Communicable Disease Program, in a news release.

He led the investigation of the outbreak, which began at a piercing kiosk in a small-town shopping mall. Both lobe and cartilage piercings were being done with a spring-loaded "gun," which shoots a flat-ended stud through the ear tissue.

The guns are not recommended for cartilage piercing. In fact, in some states, including Oregon, they are illegal for that use, says the news release.

In the Oregon outbreak, seven adolescents developed infections within three days of having the upper-ear cartilage pierced. Five of them were hospitalized and had surgery; four had ear deformities after surgery. More than 1/3 of the 53 others who had cartilage piercings reported that the site drained pus for weeks and eventually healed.

The cause of infection was "most likely from the inappropriate use of contaminated disinfectant," Keene writes.

Cartilage takes longer to heal because there is less blood circulation than in the lobe, says Keene in the news release. Also, the shock of gun piercing is much more traumatic in cartilage than in the ear lobe. When infection develops, it can cause the ear cartilage to erode, resulting in the outer ear tissue sagging and losing its normal shape.

Signs of infection include pain, tenderness, redness, and drainage of pus or blood at the piercing site, Keene says.

"It's a cautionary tale," he says. "Obviously, the safest thing to do is not to get pierced at all. But if you are determined to have your upper ear pierced, be sure the operator uses a disposable needle, not a gun, and be sure that he or she practices good hygiene and technique."