High Ear piercing

Dr. K S Prasanna, Dermatologist, Institute of Applied Dermatology, Uliathadka, Kasaragod

Ear piercing is the creation of an opening in a part of the external Ear for the insertion of Jewellery. The ear has an External and an inner ear. The external Ear has an upper part (cartilage covered with skin) and a soft lower part (lobule). The outer upper part of the ear is elastic and is covered with skin. It is not supplied with blood vessels, and it tends to get infected more often than the lobule.

High Ear piercing (upper cartilage part) is common now and it is rarely done under local anesthesia. It is nothing but piercing through the cartilage of the upper third of the outer Ear. It is done either by professionals or by nonprofessionals. There are two methods of ear piercing; 1.  Gushing a gun or 2. A Needle.

The use of a gun for high piercing carries an additional risk of Perichondritis (type of infection). This is because the gun applies a shear force to the perichondrium which may slip off the cartilage. Avascular cartilage may then become necrotic.

Before high Ear piercing, think completely about it. If you are in dilemma, consider waiting for some time. Before piercing consider the following safety precautions: -

1. Who does the piercing? - Go to a reputed piercing center where employees are properly trained.
2. Regular requirements and licensing standards vary from state to state.
3. Make sure that the piercer washes his/her hands and wears a fresh pair of disposable gloves for piercing
4. Does the piercer use proper equipment? -Some people use guns for high ear piercing. But reusable piercing guns can`t be properly sterilized and can damage ear tissue due to infection. So, it is better to use a fresh, sterile, disposable needle to create a hole and then insert a piece of jewelry into it.

How to take care of high ear piercing?

1. The skin around a new piercing might be swollen, red and tender for a few days. It might bleed slightly. If the swelling, redness, and bleeding last longer than a few days, contact your doctor. Prompt treatment can help to prevent infection.
2. Clean the site twice a day with soap and water. Be sure to wash your hands before cleaning the piercing site.
3. Avoid swimming
4. Do not fiddle with the piercings
5. Most piercings heal within about six weeks, but some might take several months or longer to heal. To maintain the piercing hole, leave the jewelry in place even at night, to help the hole from closing. 

There are some risks of high ear piercing. They are,

• Allergic reaction-some piercing jewelry pieces are made of Nickel, which rarely can cause an allergic reaction.
• Skin infection- This might cause redness, pain, swelling, or pus-like discharge.
• Keloid- In a small number of people, piercing can lead to scar and raised areas (bumps) caused by an overgrowth of scar tissue called Keloid. As the wound heals, fibrous scar tissue starts to replace the old skin tissue. Sometimes the body produces too much scar tissue, leading to keloid. Sometimes Keloid appears quickly, but usually, they appear within several months of piercing.
• Jewelry can get caught and can be torn out accidentally, which requires stitching and other repairs.
• Rarely earring can get embedded which needs minor surgical intervention.
• Pyogenic granuloma—It is red-colored growth near or around the pierced hole.
• Very rarely infection of Ear cartilage (Perichondritis) can occur. Staphylococcus and Pseudomonas are the most common bacteria which cause this infection. The use of guns for high-piercing cartilage presents an additional risk of perichondritis.

Do you really need high ear piercing?

Early ear piercing is very important because

• To reduce the pain and to gain the maximum co-operation of the child since the tissue of the ear is still soft.
• Quick healing occurs in early age, which prevents complications.