Q. This year, my daughter moved away from home for her freshman year in college. A few weeks after she was there, she got her tongue pierced. She knows her father and I do not understand why she would want to do this, but I wondered if you knew of any possible medical reason that she should not have had this done. I'd like to tell her some legitimate medical reason to get this "tongue stud" out of her mouth and not to get anything else pierced.
A. I'm afraid I can't give you a strong argument to convince your daughter to remove the stud from her tongue. Even if I could, that would be similar to telling people reasons why they shouldn't smoke. Simply having a good reason not to do something isn't always convincing.
Body piercing among adolescents and young adults is an growing fad of the '90s. It seems to stem from a mixture of forces: part counterculture, part youthful rebellion, part style and part group identity. However, the practice of body piercing goes back thousands of years.
Besides the conventional site of the earlobe, other popular sites include the eyebrow, lip, nose, tongue and outer ear, as well as the navel, nipples and genital area. If done properly, body piercing carries a very low risk of serious complications. However, there are growing reports in the medical literature about complications of body piercing, from minor to serious.
It's hard to get good estimates of the number of people who get body piercings, or the risk of complications. As an example, though, between 10 and 35 percent of people who pierce their ears develop a minor complication. The most common type is an infection that responds to simple remedies, including local cleansing, topical antibiotics and, in some cases, antibiotic pills.
The next most common complication is an allergic reaction to the metal stud. To avoid this, it's best to use stainless steel studs, which have a low risk of allergic reactions. Another complication that occurs occasionally is a keloid scar--large, rubbery scar tissue. Keloids particularly tend to develop in African Americans, though they can occur in anyone.
Other rare but serious complications of body piercing include infections that spread to other parts of the body through the bloodstream. There are reports of infections of the heart, bones, joints and kidney that have resulted from body piercing. Infections of the ear cartilage (within the outer ear) can sometimes lead to destruction of ear tissue and a permanent deformity of the ear--as if someone had taken a bite out of it.
As for tongue piercing, there are rare reports of serious infection spreading throughout the mouth area. There are also rare reports of the tongue swelling so much that it threatens the ability to eat or breathe.
Besides common bacteria, other germs can be transmitted in rare instances if proper piercing technique isn't followed. For example, you can develop hepatitis B or hepatitis C, as you can from any exposure to blood from contaminated needles or piercing instruments. To avoid this, use sterile, disposable needles; if a piercing gun is used, it's essential that it be properly sterilized between customers.
Because of their moist, covered location, the navel and genital areas are prone to yeast infection, in addition to infection from common skin bacteria. You may need treatment for both. Also, you may need a culture to tell for sure what type of germ is causing the infection, so you can take the right treatment for it. There's even a case of genital warts being spread from a penis piercing.
To prevent infections from initially developing, the area to be pierced should be cleaned with an antiseptic liquid. For tongue piercings, it's recommended that you rinse with an antiseptic mouthwash several times a day afterward. For skin piercings that later become infected, some physicians recommend that you leave the ring in place, and clean and treat the area until the infection clears. If you take the ring out, the hole will close up, which might lead to a deeper infection--an abscess--which would then need to be drained.
After a piercing, it can take weeks or months for the site to heal. During this time, you're more prone to an infection setting in. The ears, lips and eyebrows heal within six to eight weeks, the tongue within three to six weeks. Navel piercings take the longest, in some cases up to nine months.
Jay Siwek, chairman of the department of family medicine at Georgetown University Medical Center, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.
Consultation is a health education column and is not a substitute for medical advice from your physician. Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, DC 20071. Questions cannot be answered personally.