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Minor Localized Infection

When a piercing acts up, a common assumption is that infection (invasion and multiplication of disease-causing microorganisms that have a detrimental effect) is to blame. However, not everything that is wrong with a piercing is caused by pathogens. When piercings are performed and cared for according to accepted practice, infections are not prevalent; other complications, such as irritation, are far more common. However, when a piercing is infected, prompt care is required. If left untreated, it can worsen to become extremely dangerous and, in rare cases, life-threatening.

Many minor (or self-limiting) soft tissue infections resolve spontaneously or are successfully treated at home. If your condition is recent, mild, and you do not take steroids or have a chronic illness or other health condition, you can try the suggestions listed below for a few days. Numerous products are readily available in drugstores to treat minor skin infections. If your piercing is visible to the public, show it to a pharmacist. Ask for their suggestion on the best over-the-counter product, or whether they think you need to see a doctor. Note that if you suspect an infection in a piercing of the ear cartilage or nose, you should seek help right away.

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Identifying Minor Localized Infection
• Skin is pinkish or reddish, swollen, and warm to the touch 
• Localized tenderness, burning, and/or itching
• A small amount of pus 
• Swollen lymph nodes

You can have an infection even if you don’t have all of the symptoms above. Conversely, having several of them doesn’t guarantee that your piercing is infected. Some redness, swelling, and tenderness are normal in fresh piercings, especially during the first two weeks. You are susceptible to infection throughout the healing period. Once the wound has sealed and settled, it is unlikely to become infected unless the piercing experiences a flare-up or gets injured, and the tissue is open again.

What to Do for a Minor Localized Infection 
The following suggestions are for minor infections only:

  • Keep the area clean and wash the skin around the piercing daily with a mild fragrance-free soap, but don’t get it inside the channel. Rinse gently but thoroughly, and dry with fresh, disposable paper products.

  • Apply warm, moist compresses to stimulate circulation, encourage drainage, and relieve discomfort (see the information on warm compresses in “Running Cold and Hot,” page 236).

  • Apply topical over-the-counter antibiotic cream or gel (not ointment) according to package instructions. While this type of product is not suggested for routine aftercare, this is the time to use it. Topical antibiotics usually contain bacitracin, neomycin, or polymyxin B, individually or in combination, to fight different types of microorganisms. Combinations of these ingredients work against a broader spectrum of bacteria, but allergic reactions to neomycin are common. Stop using if you notice redness, itching, or skin eruptions, and consult your physician

See a doctor right away if you experience the following: 
•    Your symptoms last for more than a few days or markedly worsen.
•    You experience a fever, chills, nausea, vomiting, dizziness, or disorientation.
•    The piercing is very painful, swollen, has red streaks emanating from it, or there is a loss of function in the region.
•    You have copious pus discharge that is greenish, yellowish, or grayish.

For topical treatment of localized piercing infections, a cream or gel called Bactroban (mupirocin antibiotic, available only by prescription) is recognized as an effective medication for localized bacterial infections in piercings. A doctor who is unfamiliar with piercings may be unsure what to recommend, so you can inform them this is commonly prescribed. Never try to self-treat an infection with leftover antibiotic medication or someone else’s prescription.

Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.

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