The Hole Truth

When it comes to body piercing, the formerly fringe procedure that has moved into the mainstream, medical experts have a message: Don't try this at home. Or maybe at all.

Those warnings by groups representing dermatologic surgeons, dentists and other medical authorities have acquired new urgency after two cases in which teenage girls nearly died as a result of infections they developed from botched piercings.

Three weeks ago Indiana surgeons removed the breast of an 18-year-old diabetic whose torso was invaded by flesh-eating bacteria surrounding the nipple rings she acquired at a salon to celebrate her birthday. A few days later a Boston mother was sentenced to 18 months in prison for failing to seek medical attention for her 13-year-old daughter, who suffered major organ damage from an infection that resulted after the girl pierced her own belly button.

Other reports in medical journals include a sewing needle that disappeared during a do-it-yourself tongue piercing and had to be extracted by oral surgeons; a variety of serious, drug-resistant bacterial infections; hepatitis and tetanus; fractured teeth and nerve damage from tongue studs; as well as permanent scarring.

"People think it's hip and cool, but they don't realize that it's not like getting your ears pierced," said Eugene Giannini, president of the D.C. Dental Society, who, like the American Dental Association, opposes oral piercings. Giannini said he has seen gum damage and speech problems among his nearly two dozen patients who have tongue studs. "I think people need to be informed consumers if they're going to have it done."

For nearly half a century, earlobe piercing -- one hole in each ear -- has been a rite of passage for American teenage girls. In the past decade, the practice of using a needle to make tiny holes in the upper ear, nose, tongue, lip, eyebrow, nipples or even genitals for the purpose of wearing body jewelry has become more common, doctors say, particularly among those under 30.

For some wearers, piercing is a statement of rebellion or of self-expression; for others the adornment is purely decorative. Body piercing is widespread in some cultures.

It's impossible to determine how many Americans have piercings -- or how many have problems as a result. A study published two months ago in the Journal of the American Academy of Dermatology involving more than 500 participants between 18 and 50 found that 24 percent had tattoos and 14 percent had piercings other than in an earlobe. Piercings were more common among women.

"It's become remarkably popular," said Jeffrey S. Dover, a dermatologic surgeon in Boston who says he routinely sees patients, most of them young and female, sporting hoops on their upper ears, barbell-shaped tongue studs or jeweled navel rings. "A lot of my nursing staff have them," he added, attributing the popularity in part to the influence of numerous celebrities with piercings, among them Britney Spears, Lindsay Lohan, Tommy Lee and Dennis Rodman.

Twenty years ago, observed Dover, who is affiliated with the Yale University School of Medicine, it was rare to see a man wearing an earring. These days many professional football players sport at least one glittery diamond stud the size of a nickel.

Those under 30 are not the only devotees of piercing, said Doris J. Day, a cosmetic dermatologist who practices on Manhattan's posh Upper East Side. "I do skin cancer checks on my patients every year, and some of the most buttoned-down CEO types -- people you'd never expect to have piercings -- have them where you least expect it," said Day, who estimates that at least 50 of her patients wear jewelry in places other than the earlobe.

Risky Business

Donna I. Meltzer, an associate professor of family medicine at the State University of New York at Stony Brook, said she became interested in the subject about seven years ago after treating a spate of pregnant women with infections from navel rings -- and could find virtually nothing in the medical literature.