Say 'aah': Out comes the tongue - and a stainless steel stud

The cold and flu season knows no age limits, and though infants and toddlers seem to bear the brunt of wintertime illness, teens are not immune. My 17-year-old patient was the season's most recent casualty, and she sat on the exam table looking miserable and complaining of a severe sore throat.

I listened to her lungs, checked her ears, felt for swollen neck glands, then did the standard "stick out your tongue and say aah" part of the exam so I could decide if a strep test was needed. Out came the tongue, and with it a piercing, quivering stainless steel stud.

Now, I try to be open-minded when dealing with teenagers (if my own kids are reading this, this does not apply to you!) but I have to admit, tongue studs always catch me a little off-guard. Even when prompted by parents, I try not to express any opinion about body piercings once they are already in place. At the same time, I do occasionally have to evaluate and treat complications from such body art.

Physician Lester Mayers and his colleagues recorded a 51 percent prevalence of body piercing in their population of New York college students. Piercing was noted in 60 percent of young women (excluding earlobe piercing) and 42 percent of young men, with one to five body sites pierced per student. With these numbers in hand, the researchers suggest that body piercing is no longer unusual, but can actually be considered "mainstream" for this age group.

Dr. Mayers' team found that the incidence of medical complications following body piercing reached 17 percent in their student population. Complications included bacterial infections (especially in pierced navels), bleeding and trauma to the tissue.

Body piercing is relatively quick, but it is still an invasive surgical procedure. It should therefore go without saying that once a young person decides to pierce a body surface, the piercing should only be performed by an individual who practices good hand washing, sterile technique, and universal blood and body fluid precautions.

Post-piercing healing time will vary depending on the chosen body site. In her 2005 American Family Physician review article, Dr. Donna Meltzer reports that tongues take an average of three to six weeks to heal, with nipples requiring two to four months and navels up to nine months to fully heal following body piercing.

Dr. Meltzer notes that a low infection rate follows tongue piercing, but a high incidence of tooth chipping occurs due to traumatic contact with metallic tongue barbells. Nipple piercing can be complicated by infection and abscess formation, and jewelry or scar tissue can, at times, interfere with successful breast-feeding. As noted earlier, pierced navels tend to have higher rates of infection and longer healing times, likely due to the constant chafing and resultant skin breakdown caused by tight clothing.

Regardless of the intended body piercing location, to help avoid unfortunate allergic skin reactions, nickel-sensitive persons are advised to carefully select studs, barbells, earrings and backings to make sure that all metals are nickel-free.

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.