nipple piercing healing

I received this message from a woman concerned about discharge and crusting from her nipple (areola) piercing:

Hi Elayne, I had contacted you a little while ago regarding my nipple piercings. Its taken me a bit to remember too get photos/get decent ones.

To remind you, I have had my nipples pierced since I was 18, so going on 4 years. They are in areola (as shown in the first picture) not nipple. they get crusty just about everyday if I'm lucky its only every couple days, and when moved/lightly pinched to clean the crust off and avoid it going back into the piercing in the process a whiteish creamy liquid comes out. (Shown as best as I could manage in the second picture)

Other possibly pertinent info, I have never had children or been pregnant so the chances of it being a breast milk like substance is very low, especially considering its not even in nipple. My jewelry is and has always been stainless surgical steel. I do not change it ever, I clean it every shower. Do not wear acrylic balls. My gynecologist had been consulted because she had areloa piercing, she said its normal that it happened to her for ten years. Only stopping when she took them out after having children.

I think that's it, I hope it helps...and I mean I have no pain or irritation. It only mildly smells like plugs do once in a blue moon if its really oozing so it makes me think its normal? Please help! End my 4 year span of thinking I'm crazy haha

And also thank you so very much for being willing to help.

I performed a consultation for a woman whose new nipple piercings were placed very deeply:

Dear Elayne,

I recently got both of my nipples pierced. I worry that they were pierced too deep. I have puffy nipples that aren't hard very often so I suppose they need to be pierced deeper than normal. My left one has been giving me a lot of trouble but the right is fine. I feel like the top of the left one tries to bury into my piercing. I'm not sure if it's too deep, the bar is too short, or if the balls are irritating me. I plan on changing to PFTE once it has healed.

I've provided some photos for you to look. I'd like to not remove them as I paid nearly $80 for the piercings but if they appear detrimental to my nipples I would take them out.  

Thank you,

S

My reply:

Hi S.

The piercings do appear to be deeper than they had to be. I have marked one of the photos with arrows showing where the entry and exit should have been located on that side. 

I don't know that price should be your key deciding factor on whether to keep the piercings and make the effort required to heal them since they are not optimally placed. There's a chance the piercer may be willing to redo them (if you trust him or her to do so) in the more traditional placement (in the natural crease that defines the tip of the nipple from the base--where I marked the image).

I received a message from a woman who was experiencing unusual discharge from a healed nipple piercing: 

Hello Elayne.

I had my nipples pierced when I was 18, took them out when I was 22.  I am now 32, my left nipple when pinched has a creamy white (normal) discharge like an ear, but my right nipple has a thin watery brown discharge.  I had no infection when I removed the jewelry, but its been 10 years and I still get a little brownish discharge sometimes.  There is no pain, no swelling, no extra sensitivity.  I clean the area daily, have a very healthy lifestyle, and was curious if there is anything I can do to stop it without going on antibiotics?

Thanks,

M

My reply:

M,

Have you ever tried a regimen of 2-3 daily saline soaks for 2 weeks or so? Sometimes that will dry up/clear up discharge issues with abandoned piercings.

Feel free to send a clear, close up photo or two if you like. That isn't something I have heard about or seen in my career. 

The coloration and consistency of the discharge don't seem consistent with infection, so you probably don't need antibiotics.

My "better safe than sorry" suggestion would be that you pay a visit to a piercing-friendly physician for input and advice.

Please keep me posted!

Dear Elayne,

Thanks for your response.  I have been using saline twice a day for the last week, and it has gone away almost completely.  Thanks so much for your help, I have been trying to get this to go away for 10 years.

Thanks again,

M

I recieved a message from a woman who was concerned about the odor of her healed nipple piercings:

I am a female that has a nipple piercing from a reliable professional piercer who you recommend.

I have fairly large nipples and he used a large gage post for my piercing.  I experienced many months of bloody leakage that finally healed.  My piercing is over 2 years old, but now I have a daily discharge of white fluid that has an odor.  I want to have an attractive piercing that isn’t stinky.  Could I schedule a consultation to review my situation and possible options?  Do I need to just remove my piercing?  Can I exchange it for another gage?  Can I change it out for a different piece of jewelry?  I love having my nipple pierced and how it feels, but the drainage is really a bother.  I hope you can advise me on my options.

Thanks.

Thanks for your message. If you've had your piercing for over 2 years and the discharge is smelly, I believe I know what you need. An appointment with me is not required. You're welcome to change your jewelry, but that is not required and is unlikely to have any effect on this particular situation.

The excerpt below is from my book, The Piercing Bible--The Definitive Guide to Safe Body Piercing, and it explains the issue:

Sebum is a substance from your oil glands that collects in healed piercing channels. It is a naturally occurring product of the body, containing fat, keratin (a fibrous protein), and cellular material. The purpose of sebum is to protect your skin and hair, keep it moisturized, and to inhibit the growth of microorganisms on the skin. People sometimes mistake it for pus, but it is more solid and cheeselike and has a distinctive rotten odor that reflects the dead cellular debris it contains. 

I received a message from a woman who wondered if her water consumption could affect the healing process:

OMG! Let me start off by saying that I'm so excited that you have an advice column sort of thing. I have had your book for years, and I've always wanted to ask you questions. Anywho I've had my nipple piercing done for about 6 months. It still crusts up, and I know that it has not completely healed. It used to have previous issues until I had my piercer change the barbell to a longer one. I still use salt water soaks every time it gets irritated, but I've noticed that as I've been drinking a lot of water it has stopped crusting up as much. Is this because I'm in the final stages of healing or the amount of water I've been drinking? 

Thanks again.

My response:

Thanks for your message. I haven't ever heard of increased water consumption being responsible for a major healing effect. That said, being hydrated is important for overall health and well being, so it couldn't hurt to continue drinking a lot of water.

And, you may find (as described in my book) that you will have ups and downs over time. You may have stopped crusting now, and whether you drink a lot of water or not, you may have more secretion once again. Don't be surprised by that cycle.

I received a message from a piercee who was concerned about her nipple piercing, which appeared to be migrating:

Hey. 

I had both nipples done back in August. The one had to be removed about 3 months later because of rejection and now I think the other is doing the same. 

I have been under a lot of stress but I'm just not sure. It's not in the same place anymore.

My reply:

Yes, sorry-that does appear to be migration.

Did you use the same jewelry the first time? 

I noticed your jewelry appears to have a matte finish and that can cause problems, especially in a new/healing piercing. Initial jewelry should have a super-smooth, high polish mirror finish for safety. It is unclear whether the ring would have been wide enough for optimal safety when the piercing was new. The part of a ring that passes through the tissue should be relatively straight.

You should probably go ahead and remove that ring now to avoid further tissue damage.

I received a message from a woman who was concerned about the placement of her nipple piercing:

Hi, 

I had my nipple pierced a few days ago and it seems to me that the piercing is wrongly situated. It goes through my areolas, and not my nipple. I'm wondering how dangerous this is because I like it. I'm sending you a picture.

My Reply:

Hello,

I'm sorry to say this but I considered asking if your piercer was blind. I've never seen a more poorly placed nipple piercing on anatomy that is so perfectly suited.

You really should go and ask for your money back and remove the jewelry. That is not where your nipple should be pierced. And the bar is dangerously short. 

I marked with arrows where it should have been placed at the base of your nipple.

I received a message and photo from a woman who was concerned about her nipple piercing:

Hey,
I've attached a picture of my nipple piercing. Ive had it for roughly about 3 months.

A bump has appeared and sometimes puss/blood leaks out of it. I think this is because I became less strict with salt soaking it daily, because I assumed it healed already. Do you have any ideas for getting rid of this bump and do you know if this is just simply and infection or is it worse e.g. Migration/Rejection.

My reply:

Nipple piercings can take 6-9 months or so to heal on women, so you will need to keep up with aftercare, including saline soaks, for some time. The excerpt below is from my book: