Mr Parikh, piercings just like tattoos are quite fashionable.
Can they be the cause of problems as well?
Yes, so in my field of work I do see patients with piercings, ear piercings, nose piercings
and also tongue piercings.
So we see all three of them.
Ear piercings are of course the commonest and there are two different types.
So the commonest one is of course the earlobe piercing.
And the second one is the piercing to the rest of the ear and they are two different
kinds because the earlobe piercing goes through the skin and the soft tissue.
And the soft tissue in the earlobe is essentially fat.
Whereas piercings in the rest of the ear goes through the skin and the stiff material which
is cartilage.
So there are slightly different problems that arise with piercings in these two areas.
Both are prone to infections and the infection in the earlobe can be slightly easily managed,
but if the infection in the cartilage gets out of hand then it can be a problem.
Cartilage derives it's nutrition from it's cover which is called perichondrium and if
there is any infection in this region it's called chondritis or perichondritis.
Then the nutrition to this cartilage becomes compromised and you can even have areas of
the cartilage that can die or necrose and, therefore, you can potentially have a deformity
that can arise.
It can be a minor deformity which can be just around the piercing, or if the infection spreads
then of course it can be a major problem.
Not that common fortunately.
Most outlets that do piercing nowadays use single use needles.
So they are sterile needles and they are thrown away after being used on someone.
But post piercing hygiene is the important thing, because in these in the ear particularly
it takes about 6-8 weeks to heal and to form the mature hole.
And during that period of time the person who's had the piercing has to be careful.
And there is a very good leaflet on the internet from NHS UK about piercings, particularly
the ear piercings, and how to look after it.
What I would say is that whichever outlet you go to just make sure that they are very
clean and that they are using single use needles and they give you some instructions post piercing
as to what you should do and not do.
The long term problems we see, the main one is what we call keloid formation.
Keloid is a big scar, so it's like a lump of scar that forms because the tissue has
been traumatised and it is seen, I wouldn't say commonly, but it is seen more often in
patients who have dark skin so Afro- Caribbean patients or even Asian patients.
And they develop these big keloids and that is a real problem because they come to us
and they've gone so that they can wear earrings and that is replaced with this big lump of
tissue.
And the biggest problem with it is we can remove it, but there is a huge recurrence
rate and in my experience most of them recur.
So it comes back?
So it just comes back.
And it comes back fairly quickly.
So within a year the patient is back with an equally big lump and the more we remove
the more deformed the earlobe becomes, because we are cutting into normal skin and normal
tissue.
So patients are left with some deformity.
So that's a very big problem that we have with piercings.
Yes, and which you don't hear quite as much as the risk of infection.
Yes, that's right.
And tongue piercings?
Tongue piercings usually there isn't a big issue, but things that we come across is sometimes
we see patients who require say some form of throat surgery, say a tonsillectomy or
something else, and they have a tongue piercing and we do like the tongue piercing removed,
because sometimes if we use what is called a diaphony it's like an electrical current
to stop bleeding, we don't want a metal bit in the tongue.
And so if it doesn't come out then it becomes an issue and we have to find different ways
of a haemostatus of stopping the bleeding.
One other issue with, well particular with nose piercings that I've seen is that the
stud becomes embedded in the skin.
So sometimes the men or women have the stud on the inside and then that just migrates
under the skin and it becomes stuck.
So skin grows over it so it's under the skin and sometimes it rubs against the skin and
causes problems so then they want it removed.
And there we have to make a cut, we have to go into the nasal's soft tissues and take
the stud out.
So those are the sort things, but the commonest ones that I would say is the infection with
the ear and the keloid formation.
So you're not encouraging people to go for multiple piercings?
Well I think it's the fashion, so it's beyond me to tell them what to do and not do, but
yes just be careful and aware of these potential complications.
Mr Parikh, thank you very much.
Thank you.