The Hole Truth

"I sort of became an expert by default," said Meltzer, author of a widely cited article about the complications of body piercing published last year in the journal American Family Physician.

Meltzer, who said she is "neither for it nor against it," said she believes many patients don't appreciate the risks of piercing -- or realize that it leaves a permanent hole in the skin that doesn't close even after jewelry is removed. Most piercings are performed with a needle and without anesthetic, although sometimes a topical numbing agent such as lidocaine is used.

Doctors say that while pierced earlobes sometimes become infected, other sites are more often prone to complications because they tend to be subjected to friction or continuous moisture, which can contribute to the growth of bacteria. In other areas, such as the cartilage in the upper ear, the lack of blood vessels can retard healing. And the mouth is teeming with bacteria.

Meltzer said she is particularly concerned about the lack of sterility in some tattoo parlors, where many piercings are performed; the proliferation of teenage "piercing parties" where booze is used as an anesthetic; and, in most states, the lack of regulation of an invasive procedure capable of transmitting HIV and other blood-borne diseases. (The District has no regulations governing piercing, officials say. Virginia prohibits piercing of minors without parental consent, while neither Virginia nor Maryland requires routine inspection of shops performing piercing.)

John Rowan, a registered nurse who owns Rendezvous Tattoo and Body Piercing, one of at least five such shops in Blacksburg, Va., home of Virginia Tech, said he thinks the dangers are exaggerated.

"I don't think there have to be any medical risks at all if it's done correctly," said Rowan, who charges $50 for a nostril piercing -- one of the most popular adornments -- and has several piercings himself. "You've got to remember that the medical community only sees the downside. For every one infection they see, there are 1,000 that are trouble-free. Nobody comes into the ER to tell you how great their piercing is."

Rowan, who said he has pierced the navels of girls as young as 12 who were accompanied by their parents, said he thinks more regulatory oversight is needed. Many piercers, noted Rowan, a member of the nonprofit Association of Professional Piercers, learn the craft by apprenticing at a studio. And in Virginia, he notes, body piercers come under the jurisdiction of the board that regulates barbers, not the health department.

Fashion Statement

Lax regulation and potential risks were not uppermost in the mind of 19-year-old Sarah Mutnick, a sophomore at George Mason University, when she had her navel pierced at 17 in a nail salon near Potomac Mills Mall. After developing an infection caused by friction from her spandex high school field hockey uniform, she removed the jewelry. She got her second navel ring for her 18th birthday.

Body piercing, Mutnick said, is "a fashion statement -- something for the here and now -- not when I'm 30." Among her friends and classmates, she said, it is widely accepted and popular among the sorority girls at her school. Her boyfriend had a tongue stud, she said, her roommate just got her nose pierced, and her older brother wears an earring.

Mutnick said her parents were not opposed to her navel ring, "but my grandma doesn't understand it. She said, 'Didn't it hurt?' " Mutnick, who also has multiple ear piercings, said the major discomfort she experienced occurred when she caught the ring on her car trunk.

"I fell on the ground crying" because the pain was so intense, she recalled.

Alicia Funderburg, 18, said she decided to have her tongue pierced last year while attending John F. Kennedy High School in Montgomery County. She didn't go to a studio, but arranged with a friend to have a man who had pierced many of their classmates do it at a friend's home.