1. To be pierced in a hygienic environment by a clean, conscientious, sober piercer wearing a fresh pair of disposable medical examination gloves.

2. To be pierced with a brand new, completely sterilized single-use needle that is immediately disposed of in a medical Sharps container after use on one piercing.

3. To be touched only with freshly sterilized and appropriate implements, properly used and disposed of, or re-sterilized (where applicable) in an autoclave before use on anyone else.

4. To know that piercing guns are NEVER appropriate and are often dangerous when used on anything — including earlobes.

5. To the peace of mind that comes from knowing that their piercer knows and practices the very highest standards of sterilization and hygiene.

6. To have a knowledgeable piercer evaluate and discuss appropriate piercings and jewelry for their anatomy and lifestyle.

7. Before making any decisions, one must be fully informed of all risks and possible complications involved in their piercing choice.

8. To seek and receive a second opinion from another piercer within the studio or another studio.

9. To have initial piercings fitted with jewelry of appropriate size, material, design, and construction to promote healing best. Gold-plated, gold-filled, or sterling silver jewelry is never suitable for any new or unhealed piercing.

10. To see pictures, be given a tour of the piercing studio, and have all questions thoroughly and politely answered before making or following through on any decision.

11. To be fully informed about proper aftercare, both verbally and in writing, and to have continuing access to the piercer for assistance throughout the healing process.

12. To be treated with respect, sensitivity, and knowledge regardless of gender, sexual orientation, race, religion, ethnicity, ability, health status, or piercing choice.

13. To change her/his/their mind, halt the procedure, and leave at any point if the situation seems uncomfortable or improper.

Performing body piercing is not easy; it takes time and dedication to acquire the ability to safely and skillfully perform the procedure! Piercing is a hands-on profession that must be learned through practical experience, which generally involves a bit of trial and error. Sound instruction ideally involves a lengthy apprenticeship with a qualified mentor, though some piercers are self-taught. It is advisable to inquire how long your piercer has been piercing, how they learned, and what they do to keep their knowledge-base current – such as taking continuing education courses through the Association of Professional Piercers on anatomy, aftercare, aseptic technique, etc.

Your potential piercer should earn your trust by demonstrating knowledge and competency. Before taking your money, a piercer should be willing to provide a consultation to inspect your anatomy and discuss jewelry selection, the procedure, potential risks and complications, the healing process, and aftercare guidelines. If you are not impressed with their qualifications, it’s okay to think twice about having them pierce you!

In many cases, a studio with a license to operate meets minimum requirements and has passed some inspection, though it may mean only that the owner has paid a fee to a city or state agency. Contact your local health department to find out whether there are established standards and inspections in your area.

Unfortunately, applying for a license does not guarantee that the piercer has received training to perform the job correctly. Even in regions with the most stringent laws, there are usually no specific requirements regarding the abilities of the piercer.

Normal, no. Common, yes!

Inappropriate aftercare is the most common cause of an irritated piercing. Alcohol, hydrogen peroxide, Betadine, Hibiclens, harsh soaps, and ointment(s) are not appropriate products for the care of a healing piercing. Over-cleaning and using strong products can also irritate piercings and delay healing.

Ointments are not preferred for topical treatments of piercings. They are occlusive and limit oxygen circulation to the area, which can delay the healing of this type of wound. They also leave a sticky residue, making cleaning the healing tissue more difficult.

If the jewelry moves closer to the surface of the tissue and gets narrower between the openings of a piercing, this is termed “migration.” If the piercing migrates past a point of remaining viable or comes to the surface, this is termed “rejection.” A piercing should have at least 5/16” (8mm) of tissue between the entrance and exit for safety and longevity. A body piercing should be abandoned if the tissue between the entry and exit progressively gets smaller or thinner over time.

Routine healing may have the following characteristics:

Discoloration: reddish, brownish, pinkish, or purplish; can remain for many months on the navel, surface, and other piercings.

Swelling/Induration: localized; may be significant with oral piercings such as the lip or tongue and usually lasts for several days following the initial piercing.

Excretion: exudate of interstitial fluid, dead cells, etc., that forms a small amount of crystalline-appearing crust at the openings of the piercing; should not be copious, malodorous, or green.

Disclaimer: The suggestions in this tab are not to be considered a substitute for medical advice from a doctor; they are intended to assist you and your healthcare provider in troubleshooting problematic piercings. The information is based on a combination of vast professional experience, common sense, research, extensive clinical practice, and input from piercing-friendly medical professionals.

Body piercers learn in various manners, but none is as tried and true as a body piercing apprenticeship under the mentorship of an experienced piercer!

The following numbers are provided as a minimum standard based on input from active APP Members. No number of hours or procedures can accurately say what an individual apprentice may need to become competent. That being the case, the numbers listed below are presented as industry-standard minimums before an apprentice be allowed to pierce the public without a mentor:

Apprentices are expected to be 18 years of age or older. Even if local laws allow it, the nature of body piercing requires apprentices to be adults.

A total of 1200 hours working with a mentor piercer: documented daily, co-signed by both apprentice and mentor.

This training involves observing the mentor perform piercings, maintain paperwork, process tools (if applicable), and do client consultations and other piercing studio-related responsibilities.

One hundred hours of documented procedure observation. This should include no fewer than 100 piercing procedures. Those 100 piercing procedures should feature a variety of piercing locations and techniques.

At a minimum, 50 piercings are performed under mentor supervision. The apprentice should never attempt a piercing they haven’t done before without mentor supervision.

The following classes, available in person and online, must be completed by the apprentice before working in the piercing facility and maintained as a requirement:

-Body art-specific OSHA-approved Bloodborne Pathogens Training; renewed annually.

-CPR; is renewed biannually.

-First Aid; renewed biannually.

-APP Exposure Control Plans.

-APP Infection Control Plans.

-APP Personal Protective Equipment Standard.

-Any state, province, or country-specific training required by law.

While piercing guns may seem a quick, easy and convenient way of creating holes, they have significant drawbacks regarding sterility, tissue damage, and inappropriate jewelry design.

Although they can become contaminated with bloodborne pathogens dozens of times in one day (ew, gross!), ear-piercing guns are often not sanitized in a medically recognized way. Plastic ear piercing guns cannot be autoclave sterilized and may not be sufficiently cleaned between use on multiple clients. Even if the antiseptic wipes used could kill all pathogens on contact, simply wiping the external surfaces of the gun with isopropyl alcohol or other antiseptics does not kill pathogens within the working parts of the gun. As many medical studies report, there is a possibility of transmitting bloodborne disease-causing microorganisms through this ear-piercing method.

As is now well known, the Hepatitis virus can live for extended periods on inanimate surfaces and could be harbored within a piercing gun for several weeks or more. Hepatitis and common staph infections on such surfaces constitute a severe public health threat if introduced into even one reusable piercing gun. Considering the dozens of clients whose initial piercings may have direct contact with a single gun in one day, this is a cause for concern.

Additionally, it is not documented how often piercing guns malfunction. Some operators report that the earring adapter that holds the jewelry will often not release the earring, requiring its removal with pliers. These pliers, which contact contaminated jewelry immediately after it has passed through the client’s tissue, may be reused on multiple customers without complete sterilization. Few gun piercing establishments possess the expensive sterilization equipment necessary for such a procedure.

Most ear piercing studs are not made of materials certified by the FDA or ASTM as safe for long-term implant in the human body. Even when coated in gold plating, materials from underlying alloys can leach into human tissue through corrosion, scratches, and surface defects, causing cytotoxicity and allergic reaction. Medical literature considers only implant grade (ASTM F138) steel and titanium (ASTM F67 and F136) appropriate for piercing stud composition. Studs made of any other materials, including non-implant grade steel (steel not certified as ASTM F138), should not be used, regardless of the presence of surface plating.

Considering that many gun piercers’ clientele is minors, it is not surprising that few gun piercing complications are reported to medical personnel. Many clients may have been pierced without the knowledge or consent of parents or guardians who provide healthcare access. Therefore, most infections, scarring, and minor complications may go unreported and untreated. Furthermore, because of the ease of acquiring a gun piercing and the lack of awareness of risk, many consumers fail to associate their negative experiences with the stud gun itself. They believe that, since it is quicker and easier to acquire a gun piercing than a manicure, gun piercing must be inherently risk-free.

Despite these pronounced risks associated with gun piercing, most areas allow establishments using piercing guns to operate without supervision. Recent legislation has begun to prohibit the use of guns on ear cartilage and other locations, and the state of New Hampshire has made all non-sterile equipment illegal, but these changes are not yet nationwide. We hope that, with accurate and adequate information, consumers and the legislatures will understand and reject the risks of gun piercing in the interests of public health.

Choosing jewelry for a new piercing is quite different from shopping for a ring to wear on your finger. Because body jewelry is worn inside a wound and is in contact with your internal tissues, only certain products are suitable. The look of the jewelry placed in your fresh piercing must be secondary to aspects that affect safety and compatibility with your body. The size, style, material, and quality of the initial piece of jewelry all affect your ability to heal. Remember that the piercing location is fixed, but the jewelry can be changed after you have successfully healed. Because the body jewelry industry is saturated with substandard products, piercers and clients may forget that cost alone should never be the key factor in your purchase. Consider the following when selecting body jewelry for a new piercing:

It must be of appropriate length or diameter for your unique anatomy and the placement of the piercing. Too tight Jewelry does not allow for air and blood circulation or the expulsion of normal secretions from the piercing. Ill-fitting jewelry increases the likelihood of swelling, embedding, and other complications if too minor or excessive trauma if too large.

It must be of an appropriate gauge (thickness). The body may treat jewelry that is too thin in gauge like a splinter, resulting in migration or rejection.

It must be of a style suited to your build and the location of the piercing. Rings are best for some areas, straight or curved bars for others and specialty jewelry—such as a nostril screw or labret stud—for specific placements.

Stainless Steel is made of a variety of alloys. Many of them are used for body jewelry, but only a few specific grades are proven biocompatible: steel that is ASTM F-138 compliant or ISO 5832-1 compliant; ISO 10993-(6,10, or 11) compliant; or (EEC [European] Nickel Directive compliant.

Titanium is a lightweight metal ideal for people concerned about nickel sensitivity. This material can be anodized to create jewelry of different colors without affecting safety. Look for implant-certified titanium (Ti6Al4V ELI) that is ASTM F-136 compliant, ASTM F1295, ISO 5832-3 compliant, or commercially pure titanium that is ASTM F-67 compliant.

Niobium has been widely used by piercers with good results for many years. It is similar to titanium but does not have an implant-grade designation. Like titanium, niobium can be anodized to produce different colors. (And, unlike titanium, it can be anodized black.) Anodized niobium and titanium may fade due to body chemistry or when worn in friction-prone areas, but this is not harmful.

Gold (yellow, white, or rose) is appropriate for initial piercings only if it is 14k or higher, nickel and cadmium-free, and alloyed for biocompatibility. Gold higher than 18k is much too soft for body jewelry because it can easily be scratched or nicked. Gold-plated, gold-filled, or gold overlay/vermeil jewelry is not acceptable for fresh piercings. All of these involve coating a base metal with a layer of gold. The gold surface (very thin—measured in millionths of an inch) can wear or chip off.

Platinum is a heavy, precious metal that is highly inert and excellent for wear in body piercings. However, body jewelry made in this material is rare and very expensive due to the high cost of the material and the greater difficulty in manufacturing jewelry from it.

Glass, fused quartz glass, lead-free borosilicate, and lead-free soda-lime glass are inert and considered safe for initial piercings. They can also be sterilized in an autoclave!

Of the numerous materials available, few have been proven appropriate for wear in fresh body piercings. Some metal alloys (mixtures) have been approved based on medical usage (often as medical implants) and have specific designations that represent a precise standard for the alloy and its quality as determined by the American (now International) Society for Testing and Materials Standard (ASTM) and the International Standards Organization (ISO). Other materials, such as gold and obsidian (natural glass), have a long history of use in piercings dating back hundreds—and sometimes thousands—of years! The material worn in a healing piercing:

-It should withstand the heat and pressure of autoclave sterilization.

-It should be inert and compatible with the body, so it doesn’t cause irritation, allergy, or infection.

Downsizing refers to switching jewelry in a piercing to a shorter post once the initial swelling has subsided.

Because of how piercings heal, most require initial jewelry with a noticeable extra room to allow the tissue to swell in the early phases of healing. This is crucial to avoid jewelry embedding in the skin.

However, once the initial stages have passed, this initial swelling will have gone away. This will reveal the initial extra room and results in the initial jewelry now being too long. Too long Jewelry can snag easily and move around excessively, leading to irritation and renewed swelling. At this stage, it’s essential to return to your piercer to have shorter jewelry installed to reduce these issues. The piercing is not healed enough to safely change your jewelry by yourself at this point in healing.

If this window for downsizing is missed for piercings such as the helix, the excessive length may lead to migration or a change of angle of piercing, especially if the piercing gets slept on. This damage is irreversible and can get bad enough to result in the piercing failing.

Internally threaded jewelry is part of the APP standard for initial piercing jewelry: the piece of the jewelry that passes through your skin is smooth, and the threads are on the removable end(s), such as balls, gems, or spikes. Internally threaded jewelry avoids any possibility of scraping your tissue with sharp threads, which is especially important with fresh piercings.

Threadless, sometimes known as “press-fit” jewelry, is an acceptable alternative that uses a pin coupling on the ornamental end, and there are no screw threads at all.

The length and design of gun studs are inappropriate for healing piercings.

Ear piercing studs are too short for some earlobes and most cartilage. Initially, the pressure of the gun’s mechanism is sufficient to force the pieces to lock over the tissue. However, once they are locked on, the compressed tissue cannot return to its normal state, is constricted, and is further irritated. At the least, the diminished air and blood circulation in the compressed tissue can lead to prolonged healing, minor complications, and scarring. More disturbingly, the pressure of such tight jewelry can result in additional swelling and impaction.

Both piercers and medical personnel have seen stud gun jewelry wholly embedded in ear lobes and cartilage (as well as navels, nostrils, and lips), even when pierced “properly” with a gun. This may require the jewelry to be cut out surgically, particularly in cases where one or both sides of the gun stud have entirely disappeared beneath the skin's surface. Such consequences are minimal when jewelry is custom fit to the client, allows sufficient room for swelling, and is installed with a needle piercing technique, creating less trauma and swelling.

Jewelry that fits too closely also increases the risk of infection because it does not allow for thorough cleaning. During routine healing, body fluids containing cellular discharge and other products of the healing process are excreted from the piercing. But with inappropriate jewelry, they can become trapped around the hole. The fluid coagulates, becoming sticky and trapping bacteria against the skin. Unless thoroughly and frequently removed, this becomes an invitation to secondary infection. The design of most gun studs' “butterfly” clasp can exacerbate this problem. Again, these consequences can be avoided with implant-grade jewelry designed for easy cleaning and long-term wear.