If you're going to get yourself pierced in the name of style, you should know about the risks involved. Photograph: Claro Cortes IV/Reuters

Body piercing, a cosmetic procedure popular in antiquity, has become very fashionable again in recent years. Apart from the ears and nose, other areas like the eyebrows, lips, chin, nipples, navel, tongue and even the genitals may be subjected to it.

If you are contemplating getting a piercing done, however, remember that these attention-grabbing procedures come with risks.

Possible complications

These are some of the complications associated with body piercing:

• Blood loss: This can occur due to bleeding in areas with lots of blood vessels, such as the tongue.
• Inflammation of heart valves: Called endocarditis, this serious condition can occur in people who already have heart valve problems.
• Ear cartilage damage: Piercing can lead to an infection, followed by a painful abscess, which may require surgery. A botched piercing of the ear cartilage can also lead to tearing and deformation.
• Delayed healing: This is commonly seen in patients with certain conditions such as inborn connective tissue disease or diabetes. Jewellery in the pierced area also interferes with the healing process. Areas such as the belly button may heal slowly due to accumulation of moisture.
• Haemorrhage: This is common in haemophilia (a condition that impairs clotting), or in people who are on anticoagulants that prevent clotting.
• Infections: Contaminated instruments can transmit a wide range of bacterial or viral infections including Hepatitis B, HIV or tetanus.
• Scarring: The site of piercing often develops scars. This can happen when the body reacts to the procedure. Sometimes keloids, which are fibrous, rubbery formations, may also develop on the skin.
• Dental problems: Metal jewellery in tongue piercings can cause chipping of teeth and gum damage.
• Trauma: This is common in external ear piercing
• Pain: Piercing in certain spots such as the belly button causes intense pain that can lead to disturbed sleep.
• Nerve damage: Incorrectly done piercings can penetrate a nerve and numb the adjoining area.
• Allergies: These are mainly due to costume jewellery containing nickel sulfate (a common allergen) rather than the actual piercing.

Precautions before piercing

Anyone considering body piercing must take the following steps to ensure safety:

• Get the piercing done by a trained and licensed professional. Medico-legally speaking, the written consent of the person getting the piercing -- or in the case of a minor, that of a parent or guardian -- is necessary for carrying out the procedure.
• Ensure that instruments used are sterilised in an autoclave (at 246º C for 30 minutes). Instruments that cannot be sterilised should be disinfected thoroughly.
• Ensure that fresh and sterile needles are used.
• Insist on an anaesthetic to reduce the pain.
• Check that the person carrying out the procedure has washed his/her hands and put on a fresh pair of latex gloves.
• Check that the person wears a mask during the procedure to lessen risks of infection.

Precautions after piercing

• Keep healing wounds clean to prevent infection. Use a few drops of hydrogen peroxide mixed with Betadine skin solution to minimise the risk of bacteria at the site. You can then apply a skin ointment to prevent local infection.
• After the procedure, do not touch the site, except for cleaning it, till the wound heals.
• Do not switch jewellery before the wound has healed
• Avoid using a chlorinated swimming pool or hot tubs as chlorine irritates and retards healing.
• Select only jewellery made from implant grade stainless steel, gold (minimum 18 karat), titanium, or niobium to prevent allergies.

Reviewed by Dr Vishnu Mulchandani, a practicing general physician and surgeon based in Mumbai.