Risks include infections, scarring,
and lifetime allergy to nickel
With the popularity of body piercing
growing among women and men, dermatologists are today warning
consumers of the health risks associated with this fashion statement
- risks that can include infection, massive scarring, the spread
of communicable diseases and the onset of a life-long allergic
reaction to common metals - especially nickel.
Dermatologists and health officials
generally favor regulation and, so far, eight states have legislation
governing body piercing already on the books or pending. In California,
both the state dental and medical associations strongly favor
the regulation of body piercing. The dental association is particularly
concerned with the permanent loss of sensation that can occur
- especially when tongues are pierced.
Dr. Peter Bendetsen, a Boston-area
Dermatologist, urges caution. Says Dr. Peter Bendetsen, "Body
parts such as navels, tongues, eyebrows and lips are far more
prone to infection and, the thicker the body part, the greater
the chance of uncontrollable bleeding. I recently had to give
a patient a stitch because he hit a vein when tried to pierce
his own lip." Many people with nickel allergies believe
wearing 14 kt. gold will prevent further outbreaks. However,
says Dr. Bendetsen, "I just saw a patient with a rash under
his gold watchband. Precious metal alloys are no protection once
a person has been sensitized to nickel." Dr. Bendetsen,
who has been practicing dermatology in the Boston area for over
20 years, adds, "Piercing is an invasive procedure. Every
precaution should be taken to insure that instruments are properly
sterilized and sanitary conditions prevail, otherwise, the risk
of infection is enormous. There should be regulations to insure
that body piercing is done in a sanitary fashion. Just boiling
instruments isn't enough - they should be sterilized in an autoclave."
Dr. Pamela Scheinman of the New
England Medical Center says "We are seeing an increase in
patients with allergies to nickel content and sometimes to cobalt
that may also be present," says Dr. Pamela Scheinman a dermatologist
and allergy specialist with the New England Medical Center. She
explains, "Cells in the body react to the presence of nickel
in the studs used to keep the pierced site open. The cells develop
a mechanism to react against the metal causing the skin to erupt.
Unfortunately these cells - known as T-Cells - develop a memory.
Every time nickel comes into contact with skin, the T- cells
think they are doing your body a favor by reacting. Eyelids,
a popular site for piercing are particularly sensitive."
In addition to developing a reaction to nickel in earring studs,
patients can become allergic in other ways. Eating foods high
in nickel such as shellfish, chocolate milk, and beans can set
off a reaction. "The allergy can even develop from something
as simple as chewing on pens and paper clips while at work,"
notes Dr. Scheinman. Some people become so sensitive to nickel
that their skin reacts to zippers, bra clasps, and eyeglass frames
around the back of their ears and nose. Reactions can even stem
from nickel in pots and pans and metal egg beaters, mixing spoons
and bowls.
Those suspecting nickel allergies
may obtain a jewelry testing kit from Allerderm in Mill Valley,
California. The kit includes DiMethyl Glyoxine and Ammonium Hydroxide
which are mixed together and daubed on the jewelry with a cotton
swab. If the metal turns pink, nickel is present.
Fisher's Contact Dermatitis,
edited by Fowler and
Riechtel, a standard guide for dermatologists cites Roman Research
in Hanson, Massachusetts as a reliable source for jewelry that
is nickel safe. The company invented the first one-step ear piercing
system that uses a surgical stainless steel stud to puncture
the lobe. The sterilized stud is used only once and remains in
the lobe until the puncture heals, thus there is no danger of
transferring pathogens from one individual to another. Surgical
stainless steel is recommended by the medical community because
it will not provoke a nickel allergy.
The British Journal of Dermatology,
in a 1996 study reported, "Between 9% and 48% of all people
may become sensitized to nickel at some point in their lives,
making nickel the most common source of contact allergies in
the industrialized world.... Even in small doses, nickel can
cause painful topical rashes and skin irritations." Nickel
reactions can be severe enough to keep someone home from work
for a week or more. The reason, according to this British medical
journal, "Nickel is often used as an interliner in gold-and-silver
plated objects, but comes into contact with the skin as sweat
erodes the precious metal."
Dr. Donald Belsito, professor of Dermatology at the University
of Kansas in Lawrence and a member of the North American Contact
Dermatitis Group, notes, "Nickel allergies are on the increase
- from 10.5 % cited in studies done from 1985 to 1989 to 14.3
% in studies done in 1996. More men are showing up with nickel
allergies; coincidentally more men are having their bodies pierced.
This indicates a possible correlation between piercing and allergies
to nickel." In addition to setting off allergic reactions,
Dr. Belsito, notes, "Piercing cartilage around the top of
the ear poses greater risks than piercing the lobe. Cartilage
is an inert material with very little blood supply and takes
a long time to heal from the puncture. Also, when cartilage becomes
infected, it is difficult to treat because of its low blood supply.
"Also, the growth of overwhelming
scars known as keloids can occur and the condition is particularly
prevalent among African Americans," says Dr. Belsito, adding,
"Keloids can grow to be as big as the ear itself. The cure
requires administering medication that reduces the tendency to
develop scars. If scars do develop, they need to be removed by
a plastic surgeon. The risk, of course, is that people who tend
to scar, may not fare well in surgery which can promote new scar
tissue." When it comes to protecting the consumer, Dr. Belsito
adds, "I think hypoallergenic is a bad term since it only
tells you that the product is manufactured without an ingredient
to which most people are allergic. But it doesn't tell you other
possible allergy provoking ingredients. For example, some rubber
gloves labeled hypoallergenic are made without certain chemicals.
However, these gloves could be made of latex which is lethal
to some people."
Drs. Bendetsen, Scheinman and
Belsito favor legislation governing body piercing due to the
risk of nickel allergies, loss of sensation and communicable
diseases resulting from poor sterilization procedures. To date,
Arizona, California, Georgia, Michigan and Washington have passed
legislation requiring parental consent for body piercing if you
are a minor. Several states including Delaware, Missouri, Texas
and Hawaii have legislation pending.
Seven Pillars of Piercing
Wisdom:
1) Read the label on jewelry items. All parts must be made of
nickel-free alloys such as surgical stainless steel, explains
Dale Southworth, president of Roman Research, a leading manufacturer
of nickel-safe jewelry and proponent of allergy-safe jewelry
manufacturing.
2) If you, or members in your
family scar easily, do not get your ears or other body parts
pierced. Clip on body jewelry is available as an alternative.
3) Piercing is not a do-it yourself
or group project. Home sterilization methods are unreliable and
flaming a stainless steel needle to sterilize it can release
nickel into the lobe set off a lifetime allergy.
4) One-step sterile ear piercing
systems, using surgical stainless steel studs to pierce the ear
are safe since the part that pierces the lobe is sterilized and
used only once.
5) Do not use nail polish or
powders to coat jewelry. It will only mask the piece with other
chemicals that may cause an allergic reaction.
6) 14kt. gold or sterling silver
are no guarantee against nickel allergies. Both metals may contain
significant amounts of nickel - enough to cause allergic reactions.
Obtain a nickel test kit if in doubt.
7) The entire jewelry pieces
or earring stud, not just the post, must be made of surgical
stainless to avoid the onset of a nickel allergy. Roman Research
of Hanson, Massachusetts makes safe surgical stainless steel
studs available free to all clinical dermatologists in North
America for their patients. |
