By FAQS.org and Primal staff

Table of Contents

• Is this normal? - The healing process
  
• Healing problems
  
• Follicular cysts
  
• Do I have an infection?
  
• I have a bump forming on my piercing. Is that normal?
  
• Piercing rejection
  
• Will nipple piercings affect my ability to breast feed?
• Do you test your Autoclave?

The Healing Process

General healing process:
The healing process consists of three phases -

• Inflammation
• Proliferation
• Maturation

During the inflammation phase, blood vessels contract and red blood cells clot the wound while white blood cells collect in the wound to fight infection.

During the proliferation phase, special skin cells migrate into the wound beneath the crust (the scab, or what we call crusties) and grow. Granulation tissue fills the wound and new capillaries form, giving the tissue its red color and granular texture. The wound then begins to contract and the granulation tissue is soon covered with a layer of epithelial tissue (new skin cells).

During the maturation phase, also known as the remodeling phase, new collagen is formed and creates a scar. The wound slowly regains strength as the scar reaches its final size and shape. Scar maturation usually takes at least a year. A scar is usually only 80% as strong as the original skin.

Piercing Healing process:
During the inflammation phase, the area surrounding the piercing will be slightly red, swollen, and may feel warm to the touch. These symptoms should not worsen and should last no longer than a week.

Unlike a wound such as a scratch or cut, a piercing cannot heal across tissue layers. A piercing can be thought of as a tunnel whose entire inner surface must heal. If the body is unable to reject a foreign object, in this case the jewelry, it begins the healing process in order to create a barrier against it.

Because the environment within the piercing is moist, the piercing cannot form a crust and will produce a discharge made of lymph and dead skin cells. The discharge is white to off-white in color and dries as a yellow crusty formation around the piercing opening and on the jewelry.

As the epithelial layer forms, the piercing may constrict around the jewelry. The epithelial layer can be easily torn or dislodged; do not force the jewelry to rotate. The piercing may need to be soaked in warm water to allow the skin to expand so the jewelry can rotate.

So if you're asking, "Epithelial what?"...while there are many types of epithelial layers on the body, like tooth enamel, the epithelial layer we are talking about is a thin layer of skin that the body produces to protect your piercing. Once the final layers of the skin cells form within the piercing, they must toughen and strengthen. This process can take 6 months to a year. As the piercing becomes fully healed, the entrances will round inwards like a donut hole and the piercing will become more flexible as it relaxes around the jewelry. The tissue surrounding your piercing will also soften.

If you plan to keep your piercing long term, do not remove your jewelry for any length of time while it's healing. Most piercings require at least six months to a year before the jewelry can be removed for any length of time without the risk of closing. After the piercing has fully healed, it will not close but will often shrink, in which case you will have to stretch it with an insertion taper to reinsert the jewelry.

Healing Problems

Dry Skin:
Over-cleaning the piercing, failure to thoroughly rinse the piercing after using a skin cleanser or soap, or using a skin cleanser or soap that is too drying can cause the openings of the piercing to become red, overly dry, or cracked. Most piercings do not require cleaning more than 2 or 3 times a day.

Sensitivity to aftercare products:
Sensitivity to aftercare products is usually indicated by extreme itching and burning upon application of the product, and may cause a rash of small bumps around the piercing. If you notice or suspect that you are allergic to your aftercare product, discontinue its use, thoroughly irrigate the piercing, and rinse the area with water. Then give us a call - or if the problem persists, consult your physician.

* Also, laundry detergent with stain-fighting enzymes should not be used to wash clothes which will come in in direct contact with the piercing.

Prolonged healing:
Prolonged healing is indicated by the failure of the piercing to complete the final stages of healing. The epithelial layer may be weak and easily dislodged, and the entrances of the piercing often remain ragged. If severely irritated, the piercing may be red and swollen.

The most frequent causes of prolonged healing include:

• Placing the piercing at an inappropriate depth or angle to the tissue
• Piercing in an area that changes shape with body movement
• Wearing jewelry of inappropriate design or dimensions (gauge, width, length)
• Friction or pressure against clothing / other body parts / other jewelry
• Injury to a piercing
• Chemical irritation or using inappropriate aftercare products

A darkening of the skin between the entrances indicates that the piercing is constricted by the jewelry. The jewelry may be too small in diameter or length, or too thick in gauge. The piercing may have been placed too deep or at an inappropriate angle to the tissue.

Prolonged healing may indicate migration, rejection, or metal sensitivity.

Follicular Cysts
Follicular cysts may affect both new and healed piercings. They are caused by a blocked pore adjacent to the piercing. Follicular cysts often appear as red bumps, like pimples, and will produce a discharge of pus and blood. Hot compresses or soaking the piercing in hot distilled water with sea salt (not boiling - just as warm as you can stand it) will encourage the cyst to drain.

Use 1/4 teaspoon of sea salt to 8 oz of h2o.

Do I have an infection?
The most frequent cause of an infection is touching the piercing or jewelry with unwashed hands or contact with unclean items such as clothing, bedding, or hair.

An infection should be treated seriously. Symptoms may include a discharge of yellow or green pus, pain, redness, swelling, and the area will feel hot to the touch. Infected piercings often bleed.

If the piercing is draining pus, do not remove the jewelry. If it is removed, the openings of piercing will close and the infection will close, making it unable to drain, which can result in an abscess.

An abscess is an infection that is trapped under the skin. An abscess is indicated by a darkening and hardening of the surrounding tissue, swelling, and pain.

Cartilage piercings are particularly prone to abscesses because of the different layers of tissue involved.

Occasionally an abscess will form even if the jewelry is left in place, particularly if the piercing is extremely swollen and constricting around the jewelry. In this case you may want to switch to a smaller gauge jewelry to allow the abscess to drain.

An abscess usually requires treatment with oral antibiotics and may even require surgical removal.

An infection that does not clear within 2 to 3 days, or any sign of an abscess, should be seen by a doctor.

To help out the infection:
Hot compress - this does does two things -

1. Encourages the infection to drain

2. Increases blood circulation to the piercing to promote healing

Use 1/4 teaspoon of sea salt to 8 oz of h2o.

Hyper Granulation

I have bump on my piercing...What is it and is it normal?

During the proliferation phase of the healing process, granulation tissue forms along the inner surface of the piercing. Occasionally a piercing will develop excess granulation tissue, a condition described as hyper granulation (in slang we call it a keloid).

Granulation tissue can be red to a dark pink color. It often forms a raw looking, visibly layered bump that appears to erupt from the entrances of your piercing. Capillaries will grow into the tissue and hence the tissue will often bleed when disturbed. This condition is usually not painful but the piercing may be more susceptible to infection. Hyper granulation prevents epithelization (producing a thin layer of skin to protect your piercing) and the healing process is arrested.

While hyper granulation can affect any piercing, piercings in moist areas which are also subjected to prolonged physical irritation appear to be particularly vulnerable.

Prolonged pressure or physical irritation exerted on the piercing may push the granulation tissue out of the piercing where it continues to form. Removing the source of the irritation and keeping the piercing dry will often allow the piercing to heal.

Because the granulation tissue is very delicate, it can sometimes be removed by wiping with a cotton swab or gauze sponge. Excess tissue may also be excised. Leave that to your doc if it comes to that.

In plain English:

Imagine your skin as a bunch of tiny threads all woven together. Well when hyper granulation occurs (or what we call keloiding), your body starts producing more layers of that woven thread. Its signal is that there is trauma and it needs to protect the area. And as said above, this is usually happening because there is some sort of irritation going on (i.e. over-cleaning, cleaning products, jewelry, lifestyle...just to name a few). So by process of elimination, you can usually figure out what is causing this to happen.

Hot compresses help out a lot. Do not let this problem go on for a long period of time. If left untreated, the bump may become permanent and you will have to have it medically removed.

The best way to get these things to disappear is to hot soak them in 1/4 tsp of sea salt to 1 cup of water. If you notice that this dries out your piercing too much, you will want to cut down on the salt.

Hot soak it two to three times a day. Put the sea salt solution in a clean cup, microwave it to get it as hot as you can stand it (but not so hot that you burn yourself), then take a clean paper towel (like Viva, because they are thick) and dip it into the solution. Using CLEAN HANDS, put it directly on your piercing or just submerge the piercing in the solution if you can. Make sure you do either for at least 5 or more minutes.

Once you notice the bump disappearing, keep hot soaking it for another week, at least once a day.
If you live out of town, go to the Association of Professional Piercers web site and look up a shop in your area if you want to have a known reputable piercer take a look at it. But like I said, it is pretty common for cartilage piercings to form keloids.

Piercing rejection
Yes, sometimes a piercing will just decide it doesn't want to be there.

A good analogy is to think of a splinter. Your body knows there is something foreign in it and will try to push it out over time. Well, your body will sometimes do the same with a piercing.

This is common among navels, nipples, and eyebrows, mostly because these piercings experience constant irritation and pressure. (Now when I say "common," I have only seen about a dozen piercings reject in the 5 years I have been here.)

If the piercing is done right and with the appropriate jewelry, and if the proper aftercare procedures are followed, you should have a successful piercing. But keep in mind rejection is possible and if you do experience this you may want to consider trying a different piercing.

There really are all sorts of reasons your piercing could reject. When you first notice this happening, come on in and we will help you out with it and let you know if you can save it. If you live out of town, find a reputable piercing studio and seek their help.

Will nipple piercings affect my ability to breast feed?
Nope. Your breast have many many milk ducts, and actually some women find that more milk comes out of the piercings. However, there are things to consider.

Make sure that your piercings are fully healed before you begin breast feeding. This is for two reasons: your jewelry is a choking hazard for the baby so you will want to be able to take it in and out. Also, your hormones are going through so many changes, it will be almost impossible for your piercings to heal.

Addressing issue number one: because you are going to be removing your jewelry a lot, you are going to want to follow a few steps:

• make sure your hands are clean
• have a clean place to put your jewelry
• lubricate your jewelry to help ease the insertion

Do you test your autoclave?

Yes we do! Every week we send in a spore test and every batch we do a pressure heat test.

Toodles and please feel free to e-mail or call ( 707) 445-2609 if you have any more questions.

Thanks,
Primal Crew