Ask the doctors: Ear piercings create open wounds susceptible to bacteria

Dear Doctor: My boyfriend let a friend of his pierce his earlobe and cartilage, and both places got infected. He says things will get better on their own, but I’m worried. What should he be doing?

Dear Reader: When you pierce your ear, whether it’s the soft and fleshy tissues of the lobe, or the thick and dense cartilage that makes up the outer ear, you’re creating an open wound. On top of that, you’re introducing a foreign object into the wound to keep it open until it heals from the inside. Earlobe piercings take from six weeks to two months to heal completely. Cartilage piercings take even longer.

Infection can occur when the site of the piercing isn’t cleaned thoroughly with an antiseptic beforehand. That means bacteria on the surface of the skin can be pushed into the wound, where they can multiply and fester. A needle that hasn’t been completely sterilized can also introduce bacteria into the subsequent wound. Touching an unhealed piercing with dirty hands can introduce bacteria, and failing to keep it clean and dry can lead to infection. So can wearing an earring that’s too tight, which puts stress and pressure on the wound and keeps it from healing properly.

The symptoms of an infected piercing can include warmth, tenderness, swelling, itching, burning and redness at the wound site, and a yellowish discharge that looks like pus. In more serious infections, the swelling can move beyond the immediate area of the piercing and begin to involve the rest of the ear. Because cartilage doesn’t have a lot of blood vessels, infections in that area are harder to treat than those in the earlobe.

Unfortunately, your boyfriend is wrong about infections resolving on their own. If the infection hasn’t progressed very far and is just some minor redness or swelling, he can care for it at home. Start by cleaning both sides of the piercing several times a day using a sterile saline solution. You can make one at home by mixing salt with distilled water. Don’t remove the earring. The wound has to stay open as it heals, otherwise bacteria may become trapped inside the piercing as the hole closes. Hands must be washed thoroughly every time before touching the site or the earring. Other than when rinsing the site, be sure to keep it dry. It’s important to continue this regimen of wound care until the piercing has healed completely.

If things don’t visibly improve in a few days, your boyfriend must seek treatment. If the infection grows or spreads, if there is fever along with the infection, if an abscess develops or if the earring becomes immobile or embedded in the skin, he needs to see a doctor.