Infant ear piercing

Ear piercing is one of the oldest forms of body modification. It occurs when holes are created on the ear lobes or cartilage to allow the insertion of decorative ornaments, such as earrings. Ear piercing in children has been around for centuries as part of ritualistic and cultural traditions, but has continued to become a worldwide mainstream fashion statement.[1] Is very common in Nigeria, India, Brazil and Hispanic countries.[2] However, due to the inevitable pain and potential health risks associated with baby ear piercing, many are petitioning to ban the optional procedure with no medical benefits. The incidence of complications of piercing a baby's ears are still unknown, but because of its popularity, many parents and caregivers easily forget that any cosmetic piercing carries inherent dangers and health risks.[3]

Petitions

In the United States and the United Kingdom, the issue of whether or not parents and primary caregivers should consent to baby ear piercing is currently a hot debate. According to a petition-making website 38 Degrees, Susan Ingram implores the U.K. Minister of State for Children and Families to set a minimum age requirement for ear piercing and make the practice illegal. She claims that pierced ears is equivalent to physical abuse and child cruelty for the fear and pain inflicted.[4] To this day, to pierce or not to pierce a baby's ears, like many other aesthetic decision, is still firmly a parental prerogative.

Age Restrictions

Age restrictions, although not imposed, are not a result of medical evidence or physical complication, but rather to protect babies from potential risks in piercing their ears too early. Newborn infants have extremely small earlobes and the probability of misplaced piercings and infections would be higher. The immune system is also still developing, therefore creating a wound can open up the opportunity for infections.[5] Infants are unable to consent to having the procedure. By piercing their ears, parents are taking away the child's opportunity to have such a choice.[6] Additionally, pediatricians from the American Academy of Pediatrics (AAP) require parents to wait until their child is at least 6 months old to get their ears pierced.[7] The older the child, the more likely that they will be taking responsibility for keeping their ears clean of infection.

Precautions

Medical Ear Piercing

Many times, reputable dermatologists or pediatricians offer medical ear piercing services on a fee-for-service charge.[8] The professional ensures a truly sterile process for sanitation and follow basic safety protocols. Prior to piercing, the area to be punctured is thoroughly clean with an alcohol pad and pierced with a single-use sterile tool from its previously unopened packaging to prevent cross-contamination. Furthermore, the American Academy of Pediatrics (AAP) stated that if the piercing is performed in a sterile environment and is cared for, there is little risk.[9]

Pain Relief

Ear piercing will always be somewhat painful, even if it is over in a matter of seconds. Dermatologists or pediatricians can prescribe a topical numbing with lidocaine derivatives or apply ice to anesthetize and numb the pain receptors in the earlobes to reduce sensation. According to a journal article in Behaviour Research and Therapy, children often under predict their pain on their ears and reported significant procedural pain and anxiety.[10] While these interventions do reduce the brief, painful stimulus, it will not completely diminish or eliminate pain.

Mental Health Risks for Children

Piercings in children have been seen in religious and cultural ceremonies around the world. A national study of students showed that those with a single ear piercing can symbol a badge of identity or a sign of rebellion, leading to further body modification activities, such as more body piercings, tattoos, daring clothing, and extreme hairstyles.[11]

This causal relationship is very difficult to prove i.e. girls with piercings were two and a half times more likely than other girls to have used marijuana and to have smoked cigarettes in the past month.[12] Some take this even further and state that ear piercing may lead to more body piercing, which serves as a marker for peer substance abuse, potential problem behavior associated with sexual intercourse, truancy, running away from home, and suicidal ideation.[13]

Physical Health Risks for Children

Infections

Redness, swelling, itching, pain, and/or tenderness are all signs of possible infection. The risk of an ear piercing becoming infected is the highest during warm weather and shortly after the piercing has taken place. Case studies show that normal ear piercing infections may develop into serious infections caused by Pseudomonas and Staphylococcus, which are reported at rates of 10-30%.[14] Although rare, there is also a theoretical risk of viral infection with hepatitis B, C, and HIV, if ears are pierced by contaminated tools. Furthermore, infected deep soft tissue and abscess at the site of infection have to be surgically drained or it can lead to ear deformities.[15]

Allergic Reactions

At a recent seminar sponsored by the American Academy of Dermatology, Alexander Fisher of New York University said that metal allergies are activated after a trauma to the skin.[16] Such allergies, with visible symptoms, such as an itchy rash, weeping skin, pain, and in extreme cases, bleeding and pus, are most often caused by exposure to nickel and cobalt. These are common allergens present in quality jewelry as well as in cheap costume jewelry. A baby can easily develop a condition called contact dermatitis from skin contact with material they have become sensitised to. To avoid metal allergies, Fisher recommends that ears be pierced only with stainless steel or titanium needle.[17]

Keloids

Keloids are raised, reddened, fibrous growths that usually occur after surgical procedures or trauma and can cause significant cosmetic deformity. The ear is one of the most common sites of keloid formation, usually associated with the wearing of earrings caused by ear piercing.[18] The scars, which usually take form of an inappropriately hard lump of tissue, are larger than the initial wound. There is still no definite treatment protocol described for keloids due to an incomplete understanding of the pathogenesis of its formation. Even if it is surgically removed, keloid recurrence rate ranges from 40-100% of the population.[19]

References
  1. Fijalkowska, Marta; Pawel, Pisera; Kasielska, Anna; Antoszewski, Boguslaw (2011). "Should we say no to body piercing in children? Complications after ear piercing in children". International Journal of Dermatology. 50 (4): 467–469. doi:10.1111/j.1365-4632.2010.04778.x. PMID 21413962.
  2. https://www.bbc.co.uk/news/blogs-trending-44885213
  3. Marcer, Hilary; Finlay, Fiona; Jordan, Natasha (2006). "Body piercing in school children: a review of the issues". Community Practitioner. 79 (10): 328–330.
  4. Peters, Terri. "Petition aims to ban baby ear piercing". Today Parents.
  5. Macgregor, D.M. (2001). "The risks of ear piercing in children". Scottish Medical Journal. 46 (1): 9–10. doi:10.1177/003693300104600104. PMID 11310362.
  6. Wellener, Mary Ann (2013). "Piercing baby's ears a parent's prerogative". Pittsburgh Post - Gazette. ProQuest 1266995751.
  7. Urist, Jacoba. "Cute or cruel? Parents debate whether it's ok to pierce babies' ears". Today Parents.
  8. Kale, Satish; Patil, Surendra; Jaiswal, Sumeet; Khare, Nishant (2010). "A novel technique of piercing ears". Indian Journal of Plastic Surgery. 43 (2): 230. doi:10.4103/0970-0358.73475. PMC 3010795. PMID 21217993.
  9. Dennis, Zach. "Petition looks to make baby ear piercing illegal". KRMG News.
  10. von Baeyer, Carl; Carlson, Gisele; Webb, Louise (1997). "Underprediction of pain in children undergoing ear piercing". Behaviour Research and Therapy. 35 (5): 399–404. doi:10.1016/s0005-7967(96)00127-1. PMID 9149448.
  11. Poe, Susannah; Cronin, Anne (2014). "Health risks associated with tattoos and body piercing". Journal of Clinical Outcomes Management. 21 (7): 315–320.
  12. Roberts, TA; Auinger, P; Ryan, SA (2004). "Body piercing and high-risk behavior in adolescents". J Adolesc Health. 34 (3): 224–229. doi:10.1016/j.jadohealth.2003.06.005.
  13. Braithwaite, Ronald; Stephens, Torrance; Sterk, Claire; Braithwaite, Keisha (1999). "Risks associated with tattooing and body piercing". Journal of Public Health Policy. 20 (4): 459–470. doi:10.2307/3343131. JSTOR 3343131.
  14. Stapleton, F Bruder (2004). "Infection after ear piercing". Pediatrics and Adolescent Medicine.
  15. Cicchetti, S; Skillman, J; Gault, D (2002). "Piercing the upper ear: a simple infection, a difficult reconstruction". British Journal of Plastic Surgery. 55 (3): 194–197. doi:10.1054/bjps.2001.3799.
  16. Fors, Ronny; Stenberg, Berndt; Stenlund, Hans; Maurits, Persson (2012). "Nickel allergy in relation to piercing and orthodontic applicances - a population study". Contact Dermatitis. 67 (6): 342–350. doi:10.1111/j.1600-0536.2012.02097.x.
  17. Berg, Paul (1986). "Ear piercing can spark allergy to metals".
  18. Hochman, Bernardo; Isoldi, Felipe; Silveira, Tiago; Borba, Graizela; Ferreira, Lydia (2015). "Does ear keloid formation depend on the type of earrings or piercing jewelry?". Australasian Journal of Dermatology. 56 (3): 77–79.
  19. Bhat, Vadisha (2014). "Ear piercing: the sad story behind ear lobule keloid". International Journal of Health and Allied Sciences. 3 (3): 210. doi:10.4103/2278-344x.138612.
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