Tattoo, Piercing And Breast Implantation Infections

16th European Congress of Clinical Microbiology and Infectious Diseases

Nice, France - In the USA, Canada, Australia and Northern Europe, between 8 and 13% of the population has tattoos and/or piercings, Jean-Baptiste Guiard-Schmid of the Paris Rothschild Hospital reported during the 16th European Congress of Clinical Microbiology and Infectious Disease (ECCMID). The congress, which is organized by the European Society of Clinical Microbiology and Infectious Disease (ESCMID), is currently underway in Nice and ends today.

In the USA alone, according to figures gathered in 2000, some 7 to 20 million Americans have tattoos, Guiard-Schmid said. Those with tattoos and piercings spanned various age and socio-economic groups. While piercings are more commonly found among teenagers; tattoos appear to be more popular with adults between the ages of 18 and 30. Other more extreme body modifications (scarification, foreign body implants, branding) are performed by a limited number of practitioners.

The main health complications associated with piercing and tattooing include infections, pathologic healing, allergic reactions, tissue damages, bleeding and odonto-stomatologic lesions.

Local bacterial infections are rare after tattooing but develop frequently from piercings, although they are usually minor. Between 10 to 20% of piercings are associated with local benign bacterial infection, according to the results of the few available studies on the topic. Typical symptoms of a local bacterial infection are redness, swelling, fever and pain. The main pathogens causing local infections, e.g. suppuration or abscesses, are Staphylococcus aureus, group A streptococcus and Pseudomonas spp. Impetigo has also been identified and is caused by Streptococcus pyogenes.

These infections may become chronic and lead to local pyogenic granuloma (also called botryomycoma). Bacterial infections occurring as a result of piercing rarely spread and rarely lead to severe or life-threatening infections. Erysipelas and cellulitis have been observed with S. aureus and S. pyogenes aetiology. Anecdotal case reports of leprosy, tuberculosis, syphilis, chancroid and tetanus have also been published in recent years.

The use of unsterilized needles, needle bars and tubes, forceps, jewelery, scalpels, dermographs and contaminated pigments can result in blood-borne infections, such as hepatitis B, C and HIV infection. HBV and HCV transmission have been well documented in cases reported about Dutch piercing shops in 1997 and in London tattooist shops during the late seventies. Similarly acute hepatitis C apparently originated from tattooing in an Australian prison population in 2001.

These viral infections may be asymptomatic in their early phases and therefore rarely diagnosed. Thus, their relationship to body modifications is not always realized. Piercing and tattooing are identified as risk factors for viral hepatitis in more than 20 epidemiological studies currently available. But debate continues among some authors who think that it is difficult to distinguish body modifications from other risk factors (use of intravenous drugs, incarceration, etc.) in the studied populations. Even if hepatitis B and C virus transmission rates are very low, the number of body modifications performed each year probably accounts for a significant number of hepatitis cases. Fortunately, the HBV vaccination should prevent at least half of these cases. HIV transmission has been documented by a case reported in 1997. The patient had been contaminated in a period of 3 months during which he underwent six piercings in different parts of his body, performed in different piercing shops in Europe and the USA. There were no biomolecular data on HIV strains in this report. The theoretical risk is probably very low since HIV is a fragile virus. However, piercing of genitals may be a risk factor for HIV infection, according to some authors. Piercers and tattooists generally work without medical supervision, and techniques are often passed on from one piercer or tattooist to another directly. Even though they have become very common, body modifications still exist within a context of "epidemiological silence". However, they have a significant impact on public health and concern all health care professionals, ranging from general practitioners to emergency units. Regulations on body modifications are heterogeneous, especially in Europe.

People seeking cosmetic breast surgery must be aware of the risk of infection. In fact, 2.5% of prostheses result in infection. This should be taken into consideration by those facing a mastectomy and wanting to reconstruct their breasts, Didier Pittet of the University of Geneva reported at the ECCMID.

Breast implants have to be divided into two categories: augmentation and reconstruction. In all the cases some adverse effects could occur: infections, wound dehiscence, capsular contracture, implant rupture, etc. But infection rates are 10-fold higher in breast reconstruction than in aesthetic implants.

Major predisposing and risk factors include pre-existing scarring, radiation therapy, simultaneous mastectomy or lymph node dissection. The origin of infection can be a contaminated implant, contaminated saline within the implant, contamination of the saline implant (some implants need to be filled by the surgeon during the intervention), contaminated surgical environment, seeding of the implant by remote infection.

Usually infections occur during the first month after implantation (on average between 10-12 days) and cause fever, rapidly evolving pain, marked breast erythema. The only way to deal with such effects is the surgical removal of the implants.

http://www.escmid.org

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Hazards Of Tongue Piercing

Body piercing is popular today in the United States and other western societies. One common type of body piercing is tongue piercing, which involves placing a "barbell"-type stud through the tongue. But wearing a tongue stud puts people at risk for chipped teeth, recessed gums, and nerve damage, warns the Academy of General Dentistry (AGD).
However, most people don't realize that getting an oral piercing also places them at risk for developing a fatal infection or, in some cases, a mini-tongue, according to a report in the January/February 2006 issue of General Dentistry, the AGD's clinical, peer-reviewed journal.

In the report, a young woman's pierced tongue developed a large, round lump adjacent to the piercing. The lump, which she called her "second tongue," didn't hurt, nor was it infected, but it was growing. This mass was determined to be a scar tissue formation. Improvement was noted after oral hygiene was increased (frequent use of mouthwash and hydrogen peroxide mouthwash) and the tongue stud was replaced with a shorter shaft.

"Keep the wound clean. Make sure the bar is short so food and bacteria won't enter the site," advises Ellis Neiburger, DDS, lead author of the study. "Replace the metal barbell heads with plastic ones."

The number of adults between ages 21 and 31 who have their tongue pierced continues to increase, notes Melvin K. Pierson, DDS, FAGD, AGD spokesperson, despite his efforts to educate his patients about the dangers.

Although this article cited an extreme case, there are some very common dangers associated with tongue piercing. Unclean piercing equipment can cause other infections, such as bloodborne hepatitis. Also, if a patient is not instructed to avoid touching the piercing, they might spread infections with their own fingers.

"I see a lot of damage caused by piercing---tooth fractures, tooth chips. Patients don't see the relation between them and piercing, which weakens the tooth. The damage is almost always in the pre-molars, the middle teeth, almost parallel to the piercing," says Dr. Pierson. "The best way to prevent damage is to not get your tongue pierced."

"I don't recommend piercing," says Dr. Pierson. "Because of the risks associated with this unregulated procedure, if someone is considering an oral piercing, he or she should discuss it with their medical or dental professional."

Hazards of tongue piercing:
# Infection due to unsterile instruments.
# Pierced blood vessel or artery.
# Development of scar tissue.
# Tooth fractures and chips.

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The Academy of General Dentistry is a non-profit organization of more than 35,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patient's oral health needs. Learn more about AGD member dentists or find more information on dental health topics at http://www.agd.org/consumer

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Health Risks of Tattooing and Ear or Body Piercing

Tattooing and ear/body piercing are increasingly popular among Canadians. These procedures, however, may increase the risk of contracting a number of serious blood-borne diseases.

Background

Tattoos and ear/body piercings are very popular, especially among those aged 18 to 22. Between 73 and 83 percent of women in the U.S. have had their ears pierced. An American university survey in 2001 found that 51 percent of students had piercings and 23 percent had tattoos. U.S. studies show that the number of women with tattoos quadrupled between 1960 and 1980. The number of tattooing and piercing shops in Canada has increased dramatically in the last few years.

Health Risks of Tattooing and Ear/Body Piercing

Skin and mucous membranes in the mouth and nose protect you from many infections. Both tattooing and ear/body piercing procedures involve piercing the skin or mucous membrane with a needle or other sharp instrument.

Unless the needles are new, sterilized for each treatment and properly handled by the practitioner, instruments can be contaminated with the infected blood or bodily fluids of another person.

You may also have bacteria or viruses present on your skin that can enter your body and cause infection when your skin is pierced. Practitioners who do the tattooing and piercing are also at risk of becoming infected through accidental cuts and punctures.

It is possible to transmit viral infections such as hepatitis B, hepatitis C, Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and herpes through tattooing and piercing, as well as bacterial skin infections such as Streptococcus and Staphylococcus.

Minimizing your Risk

The best protection against disease and infection is to carefully choose where you obtain your tattoo or piercing. Here is a list of conditions on which to base your decision:

-- The work area is clean and brightly lit.

-- The shop uses instruments that are easily cleaned and sterilized, such as stainless steel.

-- Tattooing is done with sterile needles in a tattoo machine that has been wiped with alcohol after each use and covered with new disposable plastic.

-- Ear piercing is done with a sterile needle or a gun that has a disposable sterile cartridge to holds the studs.

-- Tattoo and piercing needles are new and sterile for each treatment. They should never be reused.

-- Those performing the procedure have clean working habits, including washing their hands before and after procedures, after handling contaminated items, before opening and handling sterile supplies, and before putting on and after removing their gloves.

-- Practitioners wear medical gloves during the procedures.

-- The shop has a "clean zone" and a "dirty zone." The procedure should be done in the clean zone where only sterilized packages and clean equipment are kept and used. The dirty zone is the contaminated area where there is a washing sink and holding basin for disinfecting implements.

-- Work surfaces are made of smooth and non-porous materials.

-- All surfaces are cleaned with a solution of bleach and water.

-- The shop has a sterilizing machine, preferably a steam sterilizer, and test strips are used to indicate whether the machine is operating correctly.

-- Waste is disposed of properly, with blood-contaminated waste placed in plastic bags and tied before being added to the regular waste.

-- Sharp implements used to pierce the skin are put into puncture-resistant containers.

-- Oral and written instructions are given to clients for personal care after the procedure.

You can minimize your own risk of infection by taking these precautions:

-- Choose a good professional practitioner who has been trained.

-- Ask the practitioner if she or he follows the Infection Control Guidelines for tattooing and ear/body piercing.

-- Never tattoo or pierce skin that has a cut or break, pimples, warts, or other abnormalities.

-- Make sure the practitioner disinfects the skin area using a skin antiseptic before the procedure.

-- Wash your hands thoroughly before you apply lotions or ointments to the tattooed or pierced area after the procedure or when rotating the jewelry, as directed by the practitioner. If you are concerned that the tattoo or piercing is infected, contact your doctor or local health unit.

-- Hepatitis B vaccine will help protect you from hepatitis B, but there is no vaccine for hepatitis C or HIV.

Health Canada's Role

Working in partnership with the provincial and territorial governments, Health Canada has created Infection Control Guidelines for tattooing and ear/body piercing. These guidelines were developed for practitioners of tattooing and ear/body piercing by representatives from industry, health services, and Health Canada's Centre for Infectious Disease Prevention and Control.

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Body Piercing Rant

Body Piercing Rant

Body piercing has become so common that it’s not even unusual to meet a person who has several piercings. I wonder where and when this trend started. Personally, I believe that teens in particular may opt to get pierced because of peer pressure, or because they want to seem “cool” and accepted by certain people at school. However, pressure from others can make a person do things impulsively that they might regret later.


I think that the media has a lot to do with why teens want to get pierced. Just about every “teen” channel you click on, whether it’s B.E.T., VH1, or MTV, there’s a show where members of the cast are sporting some sort of body piercing. Just as the media shows us that being a size “2″, having perfect skin and long, flowing hair is the ideal look, I believe that the media also tries to persuade teens that piercing every inch of their body is beautiful as well.

I remember when I was an incoming seventh grader; none of the girls or boys had piercings. Now, lots of my friends have at least one piercing in their eyebrow, tongue, nose or someplace else on their body. I’m not saying that it’s a completely bad decision for someone to get pierced; it’s their body! However, people should take a moment to stop and think about how a piercing will affect their appearance. Having certain types of piercings can even limit their job opportunities. All I’m saying is that teens should make an informed decision about body piercing before getting pierced, rather than letting the media or peer pressure influence them.

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Tattoos in High School

Tattoos in High School

Lately I’ve noticed that getting a tattoo has become a popular trend among teens in high school. Do you agree? Many teens have been getting tattoos, (most without parental consent), just so others think they’re cool or to fit in.
I’m not against people getting tattoos, but if someone is going to get a tattoo it makes sense to get a design that’s meaningful. For example, getting a tattoo of your mothers name would make more sense than getting a tattoo of your partners name. In many cases, the relationship with a partner won’t last, but your mother will always be your mother.


Many people that get tattoos don’t know the possible consequences. For example; some young teens don’t get their tattoos done by a licensed tattoo artist. This usually means that they go to someone’s house or a shop that isn’t clean or safe. They figure that the person injecting the ink knows what they are doing. The truth is that although getting a tattoo by an unlicensed tattoo artist may be cheaper, it can also be very dangerous. If the tattoo artist doesn’t sterilize the tools, you’re at risk of getting hepatitis and/or HIV.

It’s also important to think about your future and the type of career you might want to pursue. If you are positive that you want a tattoo, think about the type you want to get and where on your body you want to get it, so that you won’t be sorry later. What I’m trying to say is that getting a tattoo is a serious decision so you should think it through before making a quick decision to run off to a tattoo parlor. The bottom line is that you should never get a tattoo because you feel pressured or because you want to fit in. If you do decide you want to get a tattoo, go to a licensed professional.

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