app brochures 2011

7/31/2019 APP Brochures 2011

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PickingYourPiercer

PP MeMbershiPP Members should have a certicate posted in the studio. Make

e the expiration date on it is current. For a list o APP members

ck out our member locator at saepiercing.org or call our oce

-888-888-1APP. I you nd a studio that claims to have an APP

cer and is not on this list, please call or email to let us know.

vidual studio requirements vary, but most will expect you to:

ring valid photo identication, even i you are clearly over the age

majority

e completely sober

e bathed with hair trimmed or tied back (where applicable)

Wear suitable, clean garments/underwear (where applicable)

ave eaten within 4 hours

possible, avoid taking aspirin or other blood thinners

ave addressed potential health issues, e.g., i you require antibioti cs

ior to dental work, see your doctor beore being pierced

odY JewelrYen choosing body jewelryespecially or a resh piercing

member that the quality can drastically a ect the health and healing

our piercing.

large selection o body jewelry is important. A studio carrying

nly a handul o styles or sizes will be unable to meet the needs

esented by the wide range o human anatomy.

he suraces and ends o body jewelry must be smooth, ree o

cks, scratches, burrs, and polishing compounds, and metals must

ave a consistent mirror nish.

PP members use only internally threaded jewelry or initial

ercings. This means that any screw threads used in closures are

n the removable end, such as the ball or spikenot on the shat o

e jewelry. Passing exposed threading through the skin can cause

nnecessary trauma. For detailed inormation on body jewelry,

cluding suitable materials, see the APPs brochures: Jewelry or

itial Piercingsand Jewelry or Healed Piercings.

tudio etiquette

the counter:

ont handle your piercings (even i they are healed) or jewelry as

ou may spread germs to the studios common areas, endangering

a and ellow patrons.

ring previously worn jewelry in a baggie or other sealed container;

ever place used jewelry on the counter.

This brochure is not intended to endorse only APP member piercers, and its use does not imply

membership in the APP. A current list of APP members can be found at safepiercing.org.

Dscam: These guidelines are based on a combination of vast professional experience, common

sense, research, and extensive clinical practice. These suggestions are not to be considered a

substitute for medical advice from a doctor.

The APP logo is the trademark of the Association of Professional Piercers. This brochure is licensed

under the Creative Commons Attribution-Noncommercial-No Derivative Works License. To view a copy

of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/

in the restrooM:

Dont handle your piercings or jewelry (see Studio Etiquette).

It is never appropriate to insert jewelry in the restroom or other area

o the studio. I you want to have your jewelry changed, it should be

done by studio sta in the piercing room.

in the Piercing rooM:

Turn o your cell phone. Beore setting anything down, allow your

piercer to direct you to the area where personal belongings should

be placed.

Camera fashes can be very distracting during a piercing procedure,

so check with your piercer beore taking pictures.

Text from The Piercing Bibleby Elayne Angel, www.piercingbible.com


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AutoclAve (Sterilizer)An autoclave is a device that sterilizes the jewelry and equipment

necessary to perorm piercings by eliminating germs and their spores.

No studio should be in operation without this vital piece o equipment!

The most common units in body art studios use a combination o

steam and pressure. Dry Heat or liquid soaks are notconsidered

suitable or sterilization. A Statim is a rapid-c ycle autoclave that may

also be used in a piercing studio.

sPore test resultsSpore tests (biological indicators) provide proo that an autoclave is

working properly. They test the autoclaves ability to kill even the most

dangerous and resistant organisms including hepatitis. The studio

should keep recent results on le and be willing to show them to you.

Good piercers will be impressed, not annoyed, when customers are

inormed and interested enough to ask about spore test results.

Piercing set-uPAsk i you can watch the piercer set-up or a piercing and be present

in the room when he or she sets up or yours. The piercer should

rst wash and glove his or her hands. The needles, tools, and jewelry

should be sealed in individual sterile packages and placed on a tray.

The piercer should change gloves i he touches anything in the room

other than you and the sterile equipment. These packages should be

opened while you are present. Neverlet a piercer use a needle on you

that was soaked in a liquid. A piercer using a Statim may work directly

rom the sterile cassette (rather than use packaged tools).

shArPs contAinerEach needle must be used to pierce only one client, and then be

careully discarded in an approved sharps disposala special

container or contaminated (used) piercing needles. This is usually a

small red box marked biohazard, oten mounted on the wall, like in a

doctors oce. I the studio doesnt have one, they may ail to dispose

o needles properlyor even be re-using them.

licensing And PerMitsIn many cases, a studio with a license to operate meets minimum

requirements and has passed some sort o inspectionthough it may

mean only that the owner has paid a ee to a city or state agency. To

nd out whether there are established standards and inspections in

your area, call your local health department. I a studio is operating

unlicensed in a location where permits are required, report them to

your health department and/or city business license division.

A license does not guarantee that the piercer has received training

to perorm the job properly. Even in regions with the most stringent

laws, there is usually no specic requirements regarding the abilities

or education o the piercer.

AftercAre instructionsThe guidelines you will need to ollow to care or your pierc

be explained to you verbally and provided in writing. Readbeforeyou have the piercing done! I you are advised to piercing with harsh soap, ointment, alcohol, or hydrogen

the studio is not keeping up with industry standards. (F

APP atercare suggestions, see our brochures: Suggested

Guidelines or Body Piercingsor Suggested Atercare Guid

Oral Piercings, or visit saepiercing.org.)

Age requireMentsEven i local legislation is more lenient, the ollowing is an a

minimum standards policy on piercing minors: a paren

guardian must be present to sign a consent orm. Proo

state-issued photo identication is required rom the lega

and a bona fdeorm o identication rom the minor. In the

parent has a dierent last name and/or address rom the c

documentation is needed to prove the relationshipi.e.,

adoption papers, or a marriage certicate. Under no circum

it appropriate to pierce the nipples or genitals o an individ

18 years o age.

PortfolioLook at the piercers photo portolio. Are piercings placed

the anatomy or do they look awkward and poorly match

individual? I the portolio eatures unusual piercings,

pictures o healed clients to show the viability o the placem

eAr Piercing gunsA number o states have made it illegal to use a piercing g

piercings besides the ear lobeand with good reason.

piercing guns cant be sterilized, and anyone being pierced

is at risk. A reputable proessional wont use a gun or any

even or ear lobes.

trust Your instinctsYour instincts are a valuable tool, and you should listen to th

it comes to selecting a piercer. Trust your intuition, and neve

situation that eels wrong. This isnt a haircut; your health is

use Your heAdDont act impulsively or be seduced by a low price. You ge

what you pay or (though some unskilled piercers charge p

reerrals on a piercing studio and piercer rom knowledgea

and/or the local health department.

ercer quAlificAtionsorming body piercing is not easy; it takes time and dedication

cquire the ability to saely and skillully perorm the procedure.

ing is a hands-on proession that must be learned through

ical experience, which generally involves trial and error. Sound

uction ideally involves a lengthy apprenticeship with a qualied

tor (though many piercers are sel-taught). It is advisable to

re how long your piercer has been piercing, how they learned,

what they do to keep their knowledge-base currentsuch as

g continuing education courses on anatomy, atercare, aseptic

nique, etc.

our potential piercer should earn your trust by demonstrating

wledge and competency. Beore taking your money, a piercer should

willing to provide a consultation to inspect your anatomy, discuss

lry selection, the procedure, potential risks and complications,

ealing process, and atercare guidelines. I you are not impressed

their qualications, think twice about having them pierce you.

udio set-uP And hYgienestudio premises and the sta should be noticeably clean.

king or drinking alcohol should never take place there. I studio

y permits customers to try on piercing jewelryrun!

studio should have ve separate zones including a retail counter,

ng area, and:

public bathroom that is never used or cleaning contaminated

rcing equipment.

separate room or perorming piercing that has bright lighting

d good ventilation. It should not be used or anything except

rcing. Ideally it will contain a hand-washing sink or the piercer

t is stocked with liquid soap and paper towels or an air dryer, not

sable cloth towels.

terilization room (separate enclosure or processing contaminated

ls and equipment). The public should not have access to this area.

brochure is brought to you by the Association of Professionalcers (APP) to help you get a safe, clean piercing.ecause it breaks the protective barrier of the skin, piercing

some health risksincluding the potential to transmitnfection or bloodborne disease (such as hepatitis). Thereno standardized piercing regulations in the United States;lation varies from state to state, and it is often different

one county to the next. In many cities, even minimal lawsot exist; in others, regulations are not enforced or they areective. Your safety is in your own hands, andyouneed to beducated consumer. The information below can help.

embers of the Association of Professional Piercers upholdtandards outlined in this brochure, and your piercer should

even he or she is not an APP member. Check out thewing aspects of any prospective piercer and studio:


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Disclaimer: These guidelines are based on a combination o vast proessional experience, common

sense, research, and extensive clinical practice. This is not to be considered a substitute or medical

advice rom a doctor. I you suspect an inection seek medical attention. Be aware that many doctors

have not received specifc training regarding piercing. Your local piercer may be able to reer you

to a piercing-riendly medical or dental proessional. For more inormation, see the APP Brochure

Troubleshooting For You and Your Healthcare Professional.

Use o this brochure does not imply membership in the APP. A current list o APP members can be ound

at saepiercing.org. False claims o membership should be reported to the APP.

The APP logo is the trademark o the Association o Proessional Piercers. This brochure is licensed


o this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/

2010 edition


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Avoid cleaning with Betadine, Hibiclens, alcohol, hydrogen

perozide, Dial or other harsh soaps, as these can damage cells.

Also avoid ointments as they prevent necessary air circulation.

OAP no more than once or twice a day. While showering, lather up a

earl size drop o the soap to clean the jewelry and the piercing . Leave

he cleanser on the piercing no more than thirty seconds.

RINSE thoroughly to remove all traces o the soap rom the pierc ing. It

s not necessary to rotate the jewelry through the piercing.

piercing may seem healed beore the healing process is complete.

his is because tissue heals rom the outside in, and although it

eels fne, the interior remains ragile. Be patient, and keep cleaning

hroughout the entire healing period.

Avoid submerging the piercing in unhygenic bodies o water such

as lakes, pools, hot tubs, etc. Or, protect your piercing using a

waterproo wound-sealant bandage (such as 3M Nexcare Clean

Seals). These are available at most drugstores.

Avoid Bactine, pierced ear care solutions and other products

containing Benzalkonium Chloride (BZK). These can be irritating

and are not intended or long term wound care.


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OralPiercingrisks &saFeTYMeasUres

nt the Mouth DIrty?the main portal or material entering the body, the oral cavity

exposed to a variety o toxins, bacteria, and other noxious

stances on a near-constant basis. Drinking or eating anything

taminated with disease-causing microbes can potentially cause

ess and inection. Breathing air that contains airborne pathogens

y lead to other types o systemic disease. How can we maintain

lth despite this continual microbial assault? The answer lies in the

ign o the oral cavity and its deensive strategies.

Salvia contains numerous antimicrobial actors that directly attack

deactivate harmul microbes. Among them:

Lysozyme Myeloperoxidase

Lactoerrin Agglutinins

Salivary peroxidase Immunoglobulins

Because saliva is produced only within the oral cavity, the mouth

at a distinct advantage over other parts o the body when it

mes to warding o inection. The extremely high turnover rate

oral mucosa makes it one o the astest healing sites in the body.

l mucosa maintains its structural integrity through a system o

tinuous cell renewal in which cells are produced by division,

rate to the surace o the tissue, and replace the cells that are

d. The cellular turnover rate or oral mucosa o the cheek is 25

s compared to 52-75 days or skin. Compared to many other body

cings, the relatively brie healing time o the average oral piercing

vides a much shorter window o opportunity or exposure to

ction. For instance, a tongue piercing usually heals in 6 8 weeks,

mpared to 6 9 months or longer or a navel piercing.

The head and neck region houses a highly concentrated system o

ns, arteries, and lymph vessels allowing or rapid transportation o

-inective agents to attack inective agents in a swit manner.

nection rates or oral piercings are negligible when sterile equipment,

per aseptic protocol, and appropriate jewelry selection are combined

h conscientious atercare. This requires the education o both piercer

piercee to ensure a sae and successul experience.

nforMatIon Is the Keyae, unethical, and uneducated piercers thrive in areas where

mplete, accurate inormation is not made available to the general

lic and those who seek to protect them. Only by supporting the

semination o accurate inormation and the eorts o conscientious

essionals can the risks o piercing truly be controlled. Making

piercings illegal orces consumers who seek them to patronize

egulated, underground establishments.

Since many individuals st ill desire oral piercings and intend to get them,

ar more constructive to provide sound inormation on how to choose

actitioner and specic guidelines on sae piercing procedures.

The APP is a non-prot organization dedicated to health, education,

saety o piercers and the public. We are a group o committed

essionals who uphold a high standard o saety and hygiene. We

port the development o appropriate regulations and standards

nsure the improvement o our art orm and the continued saety

our clientele.

RENCES

artment o Cariology, Institute o Dentistry, University o Turku (Finland): Salivary peroxidase systems and l ysozyme

ense against cariogenic microorganisms. Lenager-Lumikari (1992)

Cate AR: Oral histology: Development, structure, and unction (2 nd ed). C.V. Mosby Company (St. Louis). 1985

nes N, Brosto J and James K: Introducing immunology (2nd ed). C.V. Mosby Company (St. Louis). 1994.



advice rom a doctor. I you suspect an inection seek medical attention. Be aware that many doctors

have not received specifc training regarding piercing. Your local piercer may be able to reer you

to a piercing-riendly medical or dental proessional. For more inormation, see the APP Brochure

Troubleshooting For You and Your Healthcare Professional.


at saepiercing.org. False claims o membership should be reported to t he APP.



o this lisense, visit http://creativecommons.org/licenses/by-nc-nd/3.0/


10/17

ral Piercing riskssaFeTY MeasUres

ll-inormed and discerning consumer is subject to ar ewer dangers

one with incomplete or inaccurate inormation.

hen properly perormed, the piercing procedure itsel takes only

w seconds and involves minimal discomort and oten no blood.

ng is commonly rapid and uneventul.

ost o the concerns about oral piercings center on one o three areas:

ar o an unsae procedure

ential or damage to teeth and oral structures

k o inection

e potential hazards are diminished when the ollowing steps are taken.

Jewelry must be accurately sized to the area. The longer jewelry that

allows or initial swellingmust be replaced with a shorter piece ater

swelling has dissipated to reduce the chance o harm to the teeth and

oral structures.

Quality jewelry in an appropriate materialSee the APP Minimum

Jewelry Standards or detailed jewelry material and design

specications. www.saepiercing.org

Balls made o acrylic rather than metal can be worn on tongue barbells

to minimize the risk o damage to the teeth.

Check that threaded ends are on securely. Tighten them daily to insure

that your jewelry stays in place.

Wearing a smaller ball on the underside o the tongue helps to reduce

jewelry contact with the sublingual portion o the oral cavity.

Playing with oral jewelry is the most requent cause o tooth and gumdamage and should be avoided.

PlaceMenT

Proper placement is absolutely critical or health and comort.

traDItIonal placeMent for a tongue pIercIng:

Along the midline o the tongue, essentially in the center o the

mouth;

Approximately 3/4 back rom the tip o the tongue;

Commonly placed with the top a little urther back than the bottom

(This allows the top o the jewelry to lean slightly back, away rom the

teeth, and toward the higher part o the upper palate where there is

more room in the mouth);

Usually placed just in ront o the attachment o the lingual renulum

(web under the tongue).

traDItIonal placeMent for lIp anD cheeK pIerc

Should be placed relatively perpendicular so the jewelry d

at a sharp angle.

Position must be chosen so that the jewelry rests in a n

inside the mouth.

Post should be shortened to t snugly once healing is done

contact o jewelry with the teeth and gums.

Cheek piercings should not be placed urther back than the

to avoid parotid glands and ducts.

A strong light can be used to check the selected pla

vascularity and enervation (blood vessels and nerves).

A disc backing inside the mouth should not catch on the g

speaking or eating.

aFTercare

The risk o exposure to inection can be controlled during t

procedure by the use o sterile equipment and jewelry a

adherence to aseptic technique. The piercing must be cared

to avoid inection during healing.

The piercer must provide written and verbal guidelines to

explain atercare protocol, including the use o antimicro

ree mouth rinses and/or sea salt rinses.

Avoid sharing plates, cups, and eating utensils.

Use a new sot-bristled toothbrush and keep it clean.

Dont chew gum, tobacco, ngernails, pencils, sunglasse

oreign objects that could harbor bacteria.

Avoid undue trauma; excessive talking or playing with

during healing can cause the ormation o unsightly and un

scar tissue, migration, and other complications.

For detailed care inormation see the APP brochure: Aftercare

For Oral Piercings.

What about sWellIng?When the piercing is perormed properly and approved care

are ollowed, most piercees experience little or no blee

minimum o swelling or a ew days.

Allow small pieces o ice to dissolve in the mouth.

Take an over-the-counter, non-steroidal anti-infammato

Ibuproen or naproxen sodium according to package instruc

Sleep with your head elevated above your heart during t

nights.

ercer

eDuce rIsKs of an unsafe proceDure, you Must fIrstct the rIght pIercer, one Who:

rained, skilled, experienced, clean, and proessional;

ctices sae piercing technique and cross-contamination control;

rks in a hygienic environment that conorms to relevant local and/

state regulations;

ows OSHA Bloodborne Pathogens standards;

s all applicable licenses and permits;

ore tests autoclave (sterilizer) regularly and can provide documentation;

es appropriate sterile instruments and jewelry, and sterile disposable

edles;

kes the time to verbally instruct in proper care guidelines and

vides written instructions;

vailable or ollow-up and questions post-piercing, so any developing

blems can be resolved beore damage occurs.

the APPs Picking Your Piercer brochure or additional details and

mation.

welrY

potential or intra-oral damage rom piercings can be dramatically

ced by wearing appropriate jewelry. Complications may result

e jewelry is inappropriately sized, improperly placed, or poorly

uactured. Things to consider:

welry must be the correct style or the anatomy and piercing placement;


11/17

JewelryforINITIAlPIercINgs

ewelry QuAlITyNd oTher ThINgs To kNow)

he suraces and ends o body jewelry must be ree o nicks,

cratches, burrs, and polishing compounds. Suitable pieces have

o irregular suraces that could endanger the delicate healing

ssue o a resh piercing. Metal body jewelry should be polished

a smooth, mirror nish. I you wear jewelry that has a porous or

neven surace, the new cells that orm during healing grow into

e irregularities. Then, when the jewelry shits or moves, these

eas tear. As this cycle is repeated, scar tissue orms and healing

delayed. A aulty nish can also introduce bacteria into the wound

nd cause inection.

uality rings are annealed, which is a heat treatment that makes the

etal more pliable. When rings can be opened or closed without

e use o pliers it reduces the risk o damaging the metal. For

icker rings (especially in smaller diameters) the use o tools may

e necessary. Tools should have brass jaws or be covered with tape

gauze to protect the jewelry rom damage.

reAdINg

eaded jewelry uses tiny screw threads or their closures. One

e has male screw threads that t into a emale hole that is tapped

led out) with the matching thread pattern on the other. One or

h ends unscrew.

< Internally threaded jewelry is part o the APP

standard or initial piercing jewelry: the part o 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

welry avoids any possibility o scraping your tissue with sharp

reads, which is especially important with resh piercings.

< Alternatively, externally threaded jewelry

has the screw pattern cut into the post, and this

comparatively rough surace may be passed throughthe tissue to insert and remove the jewelry.

< Threadless (or press-t) jewelry is an

acceptable alternative that uses a pin coupling

on the ornamental end, and there are no screw

threads at all.

achining o the jewelry aects how it perorms. Losing your jewelry

n result in the closure o your piercing. Threaded ends should be

hecked or tightness daily with clean hands. I they come loose

ten, you may have a deective piece. See your piercer or options

a replacement part. I the ball on your captive ring comes o or is

ose, you may need a new ball, or to have the tension on the ring

djusted. Jewelry should t together well. Threaded attachments

hould t completely onto posts without gaps. Threads on screw-

n ends and dimples on captive pieces should be centered or a

oper t.



advice rom a doctor. I you suspect an inection, seek medical attention. Be aware that many doctors

have not received specifc training regarding piercing. Your local piercer may be able to reer you to a

piercing-riendly medical proessional. For more i normation, see a qualifed piercer.


at saepiercing.org. False claims o membership should be reported to the APP.



o this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/

Not all piercings have an entrance and an exit. Surace Anchors are

very common now and the jewelry sits below the surace o the skin

rom a single point. The threaded top may be changed. Removing

the base o the jewelry causes the loss o the piercing, so this is not

normally done. See your piercer or assistance i the piece shits or

migrates.

Gemstone settings must be o high quality; stones should be set

securely into the metal, oten in a prong or bezel setting. Some

manuacturers use adhesives to attach the gem. I the stone alls

out, which is common with lower-priced goods, the entire piece o

jewelry will need to be replaced as the hole let by the missing gem

can harbor bacteria and increase risk o inection.

For inormation about jewelry and materials suitable or healed

piercings, and or jewelry removal instructions see our brochure:

Jewelry for Healed Piercings.

Photos courtesy o Paul King, www.coldsteelpiercing.com. Threadless bar photo courtesyo Neometal, www.neometal.com. Surace anchor photo courtesy o Industrial Strength

Body Jewelry, www.isbodyjewelry.com. Diagram and text rom The Piercing Bibleby Elayne

Angel, www.piercingbible.com.


12/17

osing jewelry or a new piercing is obviously quite dierent

shopping or a ring to wear on your fnger. Because body

lry is worn inside a wound and is in contac t with your internal

es, only certain products are suitable. The look o the jewelryis placed in your resh piercing must be s econdary to aspects

aect saet y and compatibility with your body. The size, style,

erial, and quality o the initial piece o jewelry all aect your

ty to heal. Remember that the piercing location is fxed, but

ewelry can be changed ater you have successully healed.

use the body jewelry industry is saturated with substandard

ucts, piercers and clients alike may orget that cost alone

uld never be the key actor in your purchase. Consider the

wing when selecting body jewelry or a new piercing:

Jewelry MATerIAlO the numerous materials availab le, ew have been proven appropriateor wear in resh body piercings. Some metal alloys (mixtures) have

been approved based on medical usage (oten as medical implants)

and have specic designations that represent a precise standard

or the alloy and its quality as determined by the American (now

International) Society or Testing and Materials Standard (ASTM) and/

or the International Standards Organization (ISO). Other materials,

such as gold and obsidian (natural glass) have a long history o use

in piercings dating back hundredsand sometimes thousandso

years.

The material worn in a healing piercing:

Should be able to withstand the heat and pressure o autoclave

sterilization.

Should be inert and compatible with the body so it doesnt cause

irritation, allergy, or inection.

Mill test certicates (or mill certs) are documents that provide

evidence o a specic grade o metal with an ASTM or ISO

code designation. These are provided to jewelry makers by the

manuacturers o the raw materials. Some jewelry companies alsohave biocompatibility testing done by independent labs. Your piercer

may have copies o these certicates available or you to review. You

dont need to understand what the numbers mean, but the document

should warrant that the metal is one o the grades listed below. It is not

possible to know whether the piece o jewelry youre buying is rom

the batch indicated on the paper, but the presence o documentation

listing the appropriate materials means that your piercer is more likely

to be purchasing rom reputable sources and is conscientious about

their jewelry quality.

Surgical Steel is made o a variety o alloys. Many o them are

used or body jewelry, but only a ew specic 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 that is ideal or people with

concerns about nickel sensitivity. This material can be anodized

to create jewelry o dierent colors without aecting the saety.

Look or implant certied titanium (Ti6Al4V ELI) that is ASTM F-136

compliant or ISO 5832-3 compliant, or commercially pure titanium

that is ASTM F-67 compliant.

niobium has been widely used by piercers with gooor many years. It is very similar to titanium, but does no

implant-grade designation. Like titanium, niobium can be

to produce dierent colors. (And, unlike titanium, it can be

black.) Anodized niobium and titanium may ade due

chemistry or when worn in riction-prone areas, but t

harmul.

gold (yellow or white) is appropriate or initial piercings i

higher, nickel-ree, and alloyed or biocompatibility. Gold h

18k is too sot or body jewelry because it can easily be

or nicked. Gold plated, gold-lled, or gold overlay/verm

is not acceptable or resh piercings. All o these involv

a base metal with a layer o gold. The gold surace (whi

thinmeasured in millionths o an inch) can wear or chip

Platinum is a heavy precious metal that is extremely

excellent or wear in body piercings. However, body

this material is rare and very expensive due to the high c

material and greater diculty in manuacturing jewelry ro

biocomPatible PolymerS (plastics) including Tygon

Surgical Tubing S-50HL or S-54HL, PTFE (Tefon), or Bare considered suitable or new piercings. Tygon is a bio-c

medical tubing that is highly fexible. It should be chan

ew months as it stiens and discolors rom extended w

a white plastic, is widely accepted within the industry. Bi

created specically or piercings and is similar to PTFE,

in an array o colors and shapes. These may be worn as a s

or metal jewelry. With new polymer products coming

marketplace, check that the product you are purchasing, i

above, is USP VI compliant. These can be sterilized in an

GlassFused quartz glass, lead-ree borosilicate, and

soda-lime glass are inert and considered sae or initial

They can also be sterilized in an autoclave.

welry sIze ANd sTylest be o appropriate length or diameter or your unique anatomy

d the placement o the piercing. Jewelry that is too tight does

allow or air and blood circulation or or the expulsion o normal

cretions rom the piercing. Ill-tting jewelry increases the likelihood

swelling, embedding, and other complications i too small, or

ching and excessive trauma, i too large.

st be o an appropriate gauge (thickness). The body may treat

welry that is too thin in gauge like a splinter, resulting in migration

rejection.

st be o a style suited to your build and the location o the piercing.

gs are best or some areas, straight or curved bars or others, and

ecialty jewelrysuch as a nostril screw or labret studor specic

cements.

ow measurements are taken on a straight barbell, captive bead ring, and a curved bar.

NosTrIl screw lAbreT sTud cIrculAr bArbell ThreAdless curVed bArbell fIXed beAd rINg surfAce ANch


13/17

JewelryforHealedPiercings

ls

ng Expanding Pliers/Ring Opening Pliers Can be used to spread a

ptive ring open enough to get the bead in or out. Place the head o

e pliers inside o the r ing and slowly squeeze on the handle to spread

e jaws open, widening the ring just enough to pull the ball out

ng Closing Pliers Can be used to close the gap on a captive ring that

s opened too wide by Ring Expanding Pliers, or i you are inserting a

ad that is smaller than the one that was previously in the ring

ainers

t piercers oer a selection o retainers:

me are specic to a particular type o piercing, while others can be

ed in a variety o placements

tainers can be worn to conceal piercings

tainers can be worn to keep piercings open when metal jewelry

ust be removed, such as or sports or medical care

dical or denTal Procedures

y health-care workers insist that you remove body jewelry or all

edures or tests, especially when the area in question is adjacent to

rcing. I you think it may be dicult to put jewelry back in once it is

oved, take precautions to preserve your piercing:

scuss your piercing with your doctor or dentis t prior to scheduling an

pointment in which the presence o your jewelry may be an issue

ur piercer may be able to supply recommendations or practitioners

o are knowledgeable about piercing, or help you to educate your

wnand perhaps your jewelry can stay

quire about whether you will be permitted to wear a non-metallicplacement when you must remove metal rom your body

tain a retainer beore your appointment and arrange or an insertion

ou will need help

ou cannot get a retainer in advance, a sterile foss threader (available

a dental oce) or sterile tubing rom a catheter needle (available in a

spital) can unction as a retainer

elry reinserTion afTer reMoval

e hole is still open and hasnt shrunk too much, a piercer can use

ol called an insertion taper to insert jewelry in the channel without

ercing. Initially, you may need to wear a smaller jewelry gauge i the

is too tight to immediately put back in your prior size.

Disclaimer: These guidelines are based on a combination of vast professional experience, common

sense, research, and extensive clinical practice. These suggestions are not to be considered a

substitute for medical advice from a doctor.

Use of this brochure does not imply membership in the APP. A current list of APP members can be found

at safepiercing.org. False claims of membership should be reported to the APP.



of this license, visit http:// creativecommons.org/licenses/by-nc-nd/3.0/

Jewelry eMergencies

Mishaps occur on occasion, even with quality pieces. To minimize the

likelihood o losing your jewelry, check threaded ends regularly or

tightness, and see to it that captive beads are inserted properly. I you

lose a ball, a temporary measure may prevent your jewelry rom alling

out until you can obtain a replacement:

Eraser Use a small piece o clean pencil eraser and cut it to the desired

size and shape. Press it onto the end o a barbell post or between the

ends o your empty captive ring to keep jewelry in place

Band-Aid or surgical tape Apply it to your jewelry and/or body in a way

that keeps the piece rom alling out

*For oral piercings such as tongue and lip, initial jewelry must be

downsized once swelling is gone. See the APP brochure: Oral Piercing

Risks and Saety Measuresor more inormation.

Photos courtesy of Paul King, www.coldsteelpiercing.com; Neometal, www.neometal.com;

and Industrial Strength Body Jewelry, www.isbodyjewelry.com. Text from The Piercing Bibleby

Elayne Angel, www.piercingbible.com


14/17

Type 2: pc tt t tt mut u

Threaded Jewelry(straight, curved, and circular barbell;

J-curve, labret stud, screw-on-ball

ring, fesh tunnel, and surace bar)

Barbells and their variations have

threaded ends that can be unscrewed. Like most threaded o

tighten to the right and loosen to the let.

Type 3: pc tt tot u t

press-fiT Jewelry(commonly threadless barbells and curved bars)

The pieces simply pull apart. I you are trying to

remove jewelry that will not unscrew counter-

clockwise as expected, you may be dealing with

a press-t piece.

Type 4: pc tt -t,

j, o t O-; t m out o com

free sTanding(single [or non-] fare plug/eyelet, nipple

shield, shaped ear ornament, eyebrow

retainer)

These pieces are easily removed by

simply sliding them out. Remove O-ring

or additional jewelry as needed. I the

piece doesnt move easily, a little bit o

lubricant may be helpul.

Type 5: pc tt t cu o t (m

om u to mo

held in by shape(nostril screw, septum retainer,

double-fare plug/eyelet, notchedseptum piece, shaped ear

ornament)

These pieces are held in by

virtue o their shape. Over time

they may become loose. Some

may require the assistance o a

piercer or removal.

held in by shape(surace anchors)

Surace anchors have become

very popular. The tiny L-shaped

jewelry base that is inserted

into the tissue remains in place,

though generally the ornament is

threaded and can be changed.

u like the body jewelry youre wearing, it fts properly*, and isgh quality, then it can be worn indefnitely. But the orm andtion o initial body jewelry are all about saety, so your choicesimited. Ater your piercing has healed, you have countless

ons and it should be sae to replace your jewelry when all o thewing conditions are met:

not tender

minimum initial healing time has passed

r piercing is no longer secreting and getting crusty

he size, material, quality, and style (along with the weight andh) contribute to whether a piece o jewelry is suited or dailyr in the body. Some are acceptable or only a ew hours o

s-up un.

They may not be sae to wear during sports or sleep, and should be

removed or bathing and swimming

Adornments that are extremely heavy will seldom be appropriate or

everyday wear

Etched, twisted, or matte nish items have the potential to cause

irritation

Cracks, pits, and uneven suraces are not uncommon in natural

materials, and they may encourage the growth o microbes, so keep

an eye on the health o your piercing

Jewelry reMoval

Even momentary removal o the jewelry rom a healed piercing may

result in rapid shrinkage o the piercing, and make reinsertion dicult

or impossible. Most holes shrink airly rapidly and can continue to do

so over time. Over the ensuing weeks, the area will stabilize and the

channel is apt to remain in whatever state it has achieved within a month

or twosmaller, or ully closed.

Careully consider whether you are truly done with a piercing beore

leaving the hole empty. Reinserting jewelry in a piercing that has shrunk

can be more painul than the original stick but i a hole is still present

and can be stretched, then repiercing is not usually appropriate. I the

initial placement was correct, relocating the piercing is undesirable.

I you end up with a piercing complication, it is ot better to takeout your jewelry now and try to get it reinserted or repierced later. Scar

tissue, delayed healing, and other issues can occur rom repiercing ater

unnecessarily abandoning a piercing.

THere are several PriMary sTyles of body Jewelry and

Many variaTions on THose sTyles. for reMoval PurPoses

THey are:

Type 1: r tt tot to qu

/o t mo o m o ot ct c

fixed bead ring(also continuous or seamless

ring)

On a xed bead ring, the bead is

attached to one side o the ring. Grasp the ring on each side o the bead,

pull gently and one end will pop out o the bead. Push one end away

rom you and pull the other end toward you to open the ring like a spiral.

The beadless variation also opens by twisting.

CapTive Jewelery

(also segment ring, captive tube,

and other captive ornaments)

The bead or captive piece o

a captive ring is held in by the

tension o the ring. Grasp the ring with one hand near the bead, and

with the other hand grasp the bead itsel. Gently pull the ring and bead

in opposite directions and the bead should pop out o the ring. To remove

it, twist the ring a little (as in opening a bead ring) and rotate the jewelry

to slide it out o the piercing.

Note: Pliers may be needed to open and/or close captive jewelry

depending on material, diameter, gauge, and jewelry quality. (See

Tools on reverse side.)

welry inserTions

customary or a piercer to put new jewelry in or ree or to charge

all ee when you make a purchase. They can help you to select the

size and type o jewelry or your anatomy, and they have a sanitary

onment with access to appropriate tools i needed.

tting in new jewelry at home:

ke sure the piercing site, your hands, the jewelry, and your work

a are clean

ak your piercing and/or lubricate the jewelry to aci litate removal and

ertion, because piercings are oten tight

ver try to orce or push your jewelry in; this can tear your tissue

ewelry doesnt go in easily, visit a piercer or assistance

kly replace any jewelry that causes irritation, itching, swelling, oress, no matter how much you like the way it looks.

lTernaTive MaTerials

dition to the materials commonly used or resh body piercings,

ed piercings may tolerate (or even thrive with) jewelry crated o

native materials including horn, bone, wood, amber, stone, and

rs created by Mother Nature. Sometimes reerred to as natural

organic jewelry, these materials have been worn in piercings

ghout the ages and all around the globe.

dditionally, there are man-made options such as certain types o

c (including acrylic and silicone) and glass. Like all body jewelry,

e products vary in quality and wearability.

hoose your jewelry to suit your liestyle as well as your budget and

hetic preerences:

ny alternative materials are ragile compared to metal, so jewelry

h pointy or narrow areas or in thin gauges may be easily broken


15/17

Body PiercingTrouBleshooTinFor you andyour healThcarProFessional

ocalized Piercing PimPleingle pustule occurs adjacent a piercingoten in a recurrent

e

mPToms:

mall, slightly elevated pustule

ed and inamed, but contained locally

ay be tender, itch, or burn, though some are painless

ecretes pus and/or blood when drained or popped

eaTmenT:

eat as a minor localized inection

ver-the-counter antihistamines can diminish itching and infammation

Warm saline soaks or hot compresses several times daily; these

hould be continued daily or two weeks ater the problem seems

solved

ght localized massage may help break up the pocket and prevent

rom reflling

recurrences continue, a culture may be needed to identiy the

vading microorganism so you can prescribe medication to target

e problem

yPergranulaTion Tissueess granulation tissue is most common on piercings o navels,

trils, outer labia, and the mucosal surace o lips--though it may

o occur on other piercings

eaTmenT:

he same treatments used on inants umbilical granulomas may

e used or piercing-related hypergranulation tissue: silver nitrate,

ectrocautery, or liquid nitrogen; a ligature technique can be used i

e lesion is pedunculatedome aected piercings do heal successully, but i the problem

oves intractable ater treatment, the piercing should be

bandoned

omPounded ProBlemsy one o the above problems can make additional or secondary

blems more likely; i.e. an allergic reaction to a particular jewelry

erial or care product can make a piercee more vulnerable to

ondary inection. Multiple causes are sometimes responsible or

mplications; i.e. ill-ftting jewelry and poor atercare. In addition,

rall health and stress levels can impact the healing process and

uld be evaluated and dealt with as a potential cause or piercing

mplications.

Disclaimer: The suggestions contained in this brochure are not to be considered a substitute for

medical advice from a doctor; they are simply 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, and extensive clinical practice, along with input from piercing-

friendly medical professionals. Your local piercer may be able to refer you to a piercing-friendly

medical professional if necessary.

Use of this brochure does not imply membership in the APP. A current list of APP members can be found

at safepiercing.org. False claims of membership should be reported to the APP.



of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/

Piercings and X-rays, mri,and caT scans Metal body jewelry will result in an opaque density on MRI and x-ray,

but will not otherwise aect visibility on flm

Metal body jewelry causes vi sible intererence and should be removed

or CAT scans i in the area o examination

Nipple piercings are unlikely to obstruct visibility o pathology on

thoracic x-rays i both AP (or PA) and lateral views are taken

Appropriate body jewelry is non-magnetic, and as such does not need

to be removed or MRI procedures unless it is located in the region

being examined (use a strong hand-magnet to test)

Even momentary removal o jewelry rom a piercing can result in

amazingly rapid closure o the channel, and make reinsertion difcult

or impossible

Non-metallic retainers can oten be used to saeguard the patency oa piercing; sterile tubing rom a catheter needle can be used as an

emergency retainer

*Please reer to the APP brochures: Aftercare Guidelines for Body

Piercings(or Oral Piercings) or detailed inormation on the suggested

care o healing piercings.


16/17

inaPProPriaTe aFTercare is one oF The mosT commoncauses oF a disTressed Piercing:

Alcohol, hydrogen peroxide, Betadine, Hibiclens, harsh soaps, and/or

ointment(s) are not appropriateproducts or the care o a healing ear

or body piercing.

Over-cleaning and using strong products can irritate piercings and delay

healing.

Mild, non-iodized sea-salt or normal saline soaks and/or cleaning with a

liquid anti-microbial or germicidal soap once or twice a day is suggested

or body piercings.*

Rinsing with mild non-iodized sea salt and/or antimicrobial or

antibacterial alcohol-ree mouthwash, 4-5 times a day is suggested or

oral piercings.*

normal healing Piercings may have The FollowingcharacTerisTics:

Discoloration: reddish, brownish, pinkish, or purplish; can remain ormany months on navel, surace, and other piercings.

Swelling/Induration: localized; may be signifcant with oral piercings

such as the lip or tongue, and usually lasts or several days ollowing

the initial piercing.

Excretion: exudate o interstitial uid, dead cells, etc. that orms a small

amount o crystalline-appearing crust at the openings o the piercing;

should not be copious, malodorous, or green.

oinTmenTs are noT PreFerred For ToPical TreaTmenT oFPiercings:

They are occlusive and limit oxygen circulation to the area, which can

delay healing o this type o wound.

They leave a sticky residue that makes cleaning the healing tissue

more difcult.

I necessary, gels, creams, or other water-soluble products are

preerred or topical application.

migraTion/rejecTionI the jewelry moves closer to the surace or the tissue gets narrower

between the openings o a piercing, this is termed migration. I the

piercing migrates past a point o remaining viable or comes all the way

to the surace, this is termed rejection. For saety and longevity,

a piercing should have at least 5/16 inch (almost 8 mm) o tissue

between the entrance and exit holes.

A body piercing should be abandoned i the tissue between the

entry and exit progressively gets smaller or thinner over time plus any

o the ollowing:

The skin between the openings is aking or peeling, red or inamed,

and/or hard and calloused-looking

There is 1/4 o tissue or less between the openings

Just a thin flament o nearly transparent tissue is let, and the jewelry

can be seen through the skin

For The medical ProFessioTrouBleshooTing PiercinProBlemsA piercing is a unique type o wound because it is inten

healing must take place around a oreign object. This in

intended to amiliarize you with piercing complications

encounter, and the treatments ound to be most efcacious

in The evenT ThaT you diagnose a localized PieinFecTion:

Important: removing jewelry in the presence of an infection

in an abscess. Quality body jewelry or a retainer o an appro

style, and material should be let in place so the inection c

Isotonic saline soaks and/or hot compresses can encourag

Bactroban (Mupirocin) cream or gel (not ointment) has beebe eective or topical treatment o bacterial inections

conTacT dermaTiTis meTal allergy or ProducsensiTiviTyA skin sensitivity or allergy can be induced by a cleaning

inerior jewelry that contains too much nickel or other irritat

symPToms:

Red, itchy rash surrounds the piercing or covers a large

several inches away)

The opening to the piercing may appear signifcantly larg

size o the jewelry

Tenderness, though sometimes there is no discomort

Skin eruptions below the piercing (where soap suds run dur

clearly demonstrate contact dermatitis caused by a cleanin

TreaTmenT:

Topical or oral benadryl or other antihistamine

Advise a change to a dierent jewelry material such as

nickel sensitivity is suspected, or an approved inert plast

APP brochure: Jewelry for Initial Piercings.

Discontinue current care regimen in avor o a milder clean

or The Piercee: choosingmedical ProFessionalcal personnel have tremendous knowledge o the human body

oten do not have specifc training about this unique orm o body

As a piercee, you may have more inormation about the suggested

and maintenance o piercings than they do. It is up to you to make

in that your chosen medical proessional has access to acts that

acilitate your treatment.

save yoursel rom a bad experience, ask the ollowing questions

re settling on a doctor or other practitioner. Is this healthcare

ssional:

cepting o body piercings?

perienced in treating problem piercings?

ling to consult with a trusted expert body piercer, or seek other

ources or inormation about piercing?

or The Piercee:hen To see a docToru experience a problem that is beyond the scope o your piercer,

ollowing acts can assist you and your healthcare provider in

sion-making about the best care and treatment.

a doctor immediatelyi you have problems with your piercing and

perience severe redness, swelling, or pain rom the piercing

ve a large amount o discharge that is thick, green, yellow, or gray

d smells bad

ve red streaks coming rom rom the piercing site

e steroids or have a chronic illness or other health condition

ve symptoms that last or a week or get worse

perience ever, chills, nausea, vomiting, dizziness, or disorientation

or The Piercee ande medical ProFessional:

mPorTanT Piercing FacTsen piercings are properly perormed and cared or, complications

h as irritation or allergy are ar more common than inection.

en momentary removal o jewelry rom a piercing can result in rapid

sure o the channel, and make reinsertion difcult or impossible.

mply taking out the jewelry may not resolve the problem, and i an

ection is present, removal can lead to a more serious problem--the

mation o an abscess.

st piercing complications can be handled without the piercing being

t.

anging atercare and/or jewelry size, style, or material oten resolves

blems.


17/17

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Item Quantity Cost for Each TotalManuals NEW LOW PRICE! (get one of each for $25.00 )

Procedure Manual: Hard Copy/2005 Edition $20.00 + $4.95 s/h

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Brochures (domestic shipping included) ALL available in Spanish*; please indicate if Spanish desired. Fo

larger quantities discounts may be available.Picking Your Piercer $25.00/100

Body Piercing Aftercare Guidelines $25.00/100

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What is the APP? (call for cost of amount less than 100) $5.00/100

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Tshirts call for sizes/styles $20.00+; s/h 3.00/eaPhuket Vegetarian Festival DVD by Paul King - buy 1

get 2nd one off!

$20.00 plus $3.00 s/h

APP Mugs Black with logo and mission statement $7.50eaPublic Service Announcements on CD $5.00Stickers (call for availability)

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1.00 per sticker

THE PIERCING BIBLE- The Definitive Guide to SafeBody Piercing by Elayne Angel - Proceeds from thesesigned copiesgo directly to Elayne and the APP!

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