GENERAL PIERCING AFTERCARE

  There is much conflicting information given out in the media and by the piercing community about the methods used for piercing aftercare; most of which is good. However, there are also a lot of methods recommended for aftercare, which are incorrect and dangerous.  To find the safest methods to recommend to clients, many hours were spent going through medical journals and textbooks on wound care. All the following recommendations are based on the most up to date medical evidence available.

This information is the result of hundreds of hours of research on the best aftercare methods. Feel free to disseminate these instructions to your customers; you'll find a dramatic increase in healing time if you advise your customers to use this application method. However, please allow me the recognition of including my name if you publish my information. Failure to include the source of this information is infringement of Copyright, artistic theft, poor business ethics and bad Karma.

WOUND HEALING

The healing of a normal wound and the healing of a piercing is vastly different.  In the case of a normal wound the body merely has to repair and rejoin the damaged tissue, but with piercing, this process is complicated by the presence of a foreign object, the jewelry. The cells that form the scar tissue are mainly on the surface of the skin (epithelium), and therefore they must migrate from the surface into the wound to enable the formation of the scar tissue, this process is called “epithelialisation”. The body must build a tube of scar tissue to encapsulate the jewelry within the body, this tube is called a "Fistula". Piercings take longer to heal because it takes longer to create the Fistula and they are more prone to infection because the protective surface layer of the skin has been damaged, so there is no barrier to prevent the microorganisms invading the wound.

A wound goes through several stages of healing, the first stage being the inflammatory stage. During this stage, the body sends a variety of different cells into the wound, almost immediately the wound is inflicted. These cause blood to clot and seal of the jewelry from the body. This extra blood flow causes the distinctive redness of a healing piercing, this shouldn't be confused with infection. During this phase the wound will release exudates or crusting, this is a combination of fluid, dead tissue and white blood cells. This shouldn't be confused with pus or seen as a sign of infection.

The next stage is called the Reconstructive stage, and can take several weeks or even months, the process begins with in hours of the piercing, the cells move from the edge of the wound together until they join. Once they join they start to proliferate causing the growth of new tissue, this tissue doesn't have the strength of normal skin. After 3 weeks it only has 70-80% of the strength of normal skin. The cells that form the new tissue form a very thin layer that is easily damaged by movement or the use of incorrect aftercare products.  This is the most important healing phase during which you must care for the wound carefully.

The next and final stage is the Maturation phase. During this phase, the new-formed tissue develops, strengthens and eventually shrinks back to the normal size. The redness will gradually disappear and the scar tissue will diminish until the wound is fully healed.

AFTERCARE PRODUCTS

The majority of incorrect information disseminated to the public is in the area of aftercare. As the previous section shows, the most important factor in achieving a healed piercing, is in the use of proper aftercare products and procedures.  The aftercare product used must fulfill the following criteria: It must be antibacterial, preferably promote healing, be non-allergenic, be safe to use on wounds for a prolonged period and easy for customers to use. Firstly, we will list the safe products and methods of use; and then the unsafe products and the reason why they are unsafe.

SAFE AFTERCARE PRODUCTS

Chloroxylenol (PCMX) Soaps

According to the "Efficacy Data: MICs" sheet, Chloroxylenol is an antimicrobial antiseptic effective against both gram-positive and gram-negative bacteria, fungal and yeast microorganisms. They are used in soaps intended for frequent hand washing and wound care, making them appropriate for piercing aftercare. Unfortunately, these soaps are not yet widely available. At this time, mild soaps containing Chloroxylenol (PCMX) are emerging as the most appropriate product for piercing aftercare. Chloroxylenol has tested safe for use as long-term wound care and is more effective on a broader range of microorganisms than the other antiseptics.

  First Choice of Soaps

Satin brand, PCMX 0.8%

  Second Choice of Soaps

Provon brand, PCMX 0.3%

  Third Choice of Soaps

Triclosan based Antibacterial soaps:

Any soap used should be low-Ph, deodorant and moisturizer-free. Brand names include Liquid Dial, Almay Hypo-Care, Clearly Natural, and Soft-soap (contains aloe). In the UK and Australia, SAVLON wound wash (or Savlon soap), Physohex and Sapoderm are the most commonly used aftercare product, they contains Triclosan diluted to the right concentration for use on piercings (5%). Dial and most orange colored brands can be overly drying. Suggested are soaps that are low-pH, free of deodorants and moisturizers.

The "Triclosan Mic sheet" reviewing antimicrobial efficacy is available from decon laboratories inc., (800) 332-6647, (610) 520-0610 http://www.deconlabs.com/deconlab/dcn03s.htm

USE: Work soap up into lather and apply to the piercing, massage the piercing gently to work soap into the wound. Leave on for 1-2 minutes then wash off, being careful to remove all soap from the wound.  It should be used after going swimming in the ocean or public pools.

Lavender Oil:

 Lavender oil possesses unique healing properties. It has good antiseptic, bactericidal, fungicidal, and anti-inflammatory and cicatrising (wound-healing) properties.  It is a powerful immuno-stimulant, by encouraging a rich flow of blood to the wound, it promotes faster healing.  It is gentle on the wound, doesn't sting, and is a mild anesthetic providing some degree of reduced discomfort relief.

Lavender oil is one of the few essential oils which may applied neat to the skin, it's non-toxic, non-sensitizing and non-irritating. It has very low toxicity levels and may be used safely on all types of cuts and wounds. It may be applied neat, or diluted with water. (See separate article)

USE:  Apply 1-2 drops (no more!) every second day after a shower to promote healing. Let the Lavender oil soak the piercing and remove any excess with a tissue, excessive use of Lavender oil may result in skin irritation.  Continue to apply a drop or two of lavender oil once a week after the piercing is healed to lubricate it or the wound can become tight and dry.  (see more at bottom of this page)

Salt Water

Salt water: The safest thing to use on wounds, it helps remove any accumulated exudate (crusting) and irrigates the wound accelerating the healing process. It also helps to dry out the wound, which promotes healing.

USE:  Make some salt water by dissolving Sea salt or rock salt (not table salts) in warm water, or use Saline solution (available at any chemist). Soak facial piercings for 2-3 minutes using a cotton wool ball soaked in salt water, soak nipple and navel piercings by putting the salt water in small glass or medicine cup. Make sure to wash the piercing with fresh water afterwards to remove salt from the wound.

Tea Tree Oil:

 A natural product that is a very effective antiseptic and fungicidal agent.   Pure tea tree oil can cause burns to the skin if left on for a period of time, and can damage the delicate tissue of the newly forming wound. Anecdotal evidence suggests that tea tree oil promotes wound healing, however scientific tests show no proof of this.

USE: It's best used in a foaming glycerin base or diluted form in the shower, and it should be washed of after use. (5% in a base solution is most effective).

Benzocaine:

 Cepacaine: Mouthwash: active ingredient, for use in healing tongue piercing during first week, local anaesthetic action reduces the reduced discomfort.

Biotene, TECH 2000, and Oral-B brands:

Are suggested over mouthwashes such as Listerine, which has a high alcohol content. Mouthwashes are not intended to be used as often as typically used for piercing aftercare. Mouthwashes with a high alcohol content quickly dry out the tongue's protective mucous layer. If you use an alcohol-based mouthwash dilute 50% with preferably distilled, bottled water. After using any mouthwash rinse with water to reduce mouthwash residues and dryness.

A white discoloration of the tongue indicates that the mouthwash is being over used. When over used the mouthwash dries out the mucous layer of the tongue, upsets the pH and depletes the healthy and necessary bacteria of the mouth. Depletion of healthy bacteria can result in thrush (Candida Albicans), a fungal infection indicated by a white carpet like layer on the tongue. Medications for treating thrush are only available with a doctor's prescription. In some cases the condition of the mouth can be restored if frequency of use is reduced. Some people have successfully treated minor thrush by rinsing with warm salt water containing a few drops of tea tree oil, said to be fungicidal.

Biotene

http://www.laclede.com/biotene.html

TECH 2000, Care-Tech Laboratories, 1-800-325-9681, (314) 772-4610

http://www.caretechlabs.com

UNSAFE AFTERCARE PRODUCTS - Do not use!!!

Alcohols:

 Ex. Alcohol wipes, Hibiclens, Hibitane. Alcohols are irritant and toxic to the tissue cells forming in the wound and are therefore totally unsuitable for the aftercare of piercings. Products that contain alcohol like Chlorhexidine solutions i.e. Hibiclens, Hibitane etc. should therefore be avoided even if they are diluted. Triclosan based antibacterial soaps are far safer and more effective.

Benzalkonium Chloride & Benzethonium Chloride Solutions:

 (Containing 0.12% Benzalkonium chloride or 0.13% Benzethonium-chloride). Bactine Earcare, Germinol, Germitol, Pierced Ear Care Solution No More Ouchies, or Sensitive Ears Solution and other solutions of benzelkonium or benzalthonium-chloride (usually available at stores that perform ear piercing). Can cause sensitivity and prolonged use often causes overly dry or flaking skin. Some products contain isopropyl alcohol that is very irritating. Some Bactine and No More Ouchies contain lidocaine to which many people are sensitive and can cause allergic reactions.

Chlorhexidine Gluconate Solutions:

Include AC 2000, Bacticlens, Hibiclens, Hibiscrub, Hibitane, Savlon, Spectro Gram 2.

Solutions vary in concentration from 2 to 4%. Product inserts for all solutions state intended use only for handwashing and pre-surgical skin antisepsis. Not suitable for piercings as these solutions contain alcohol, which is toxic to the cells that form scar tissue. It also causes irritation and delayed healing. Even in a diluted form it still can cause problems. Triclosan and PCMX based antibacterial solutions are far safer and effective.

References:

Hibiscrub, http://home.intekom.com/pharm/zeneca/hibscrub.html

Savlon, http://home.intekom.com/pharm/pharmedica/savlnsol.html

Spectro Gram 2, http://www.rxmed.com/monographs/spectro2.html

Hydrogen Peroxide:

In solution 3%: Provides mechanical cleansing and some debridement of wounds by effervescent action, however, it can cause ulceration of newly formed tissue, and can create Granulomas. It is toxic to fibroblasts, which are vital for wound healing, and therefore should never be used as an aftercare solution for piercings because of the damage it causes the wound even in it’s diluted form.

PerOxyl and Gly-Oxide:

 Oral cleansing antiseptics contain peroxide or carbamide peroxide may be detrimental towards healing when used for an extended period of time. Use of these products in addition to antiseptic mouthwash is unnecessary. Additionally, the US Food and Drug Administration has declared "oral wound healing agents [including] allantoin and carbamide peroxide in anhydrous glycerin" as "unacceptable" because these products have not been found to be safe and/or effective for treatment of oral wounds; these products have effectively been recalled. See "FDA Medical Bulletin, January 1996, Volume 26 Number 1" at http://www.fda.gov

Iodine Compounds:

 Examples: Iodine (tincture of Iodine, weak iodine solution) Iodophors (Betadine, Betaisodina, Braunol, Braunosan H, Disadine DP, Disphex, Efadine, Inadine, Isodine, Proviodine, Traumasept, Videne), Betadine soaps and skin cleansers, and povidone-iodine based liquid soap (Clearly Natural brand).

Iodine solutions have a broad spectrum effectiveness when used on intact skin or relatively clean wounds, but it is toxic to fibroblasts (cells which form scar tissue) in normal dilutions, and has questionable effectiveness in infected wounds. Long-term use of Betadine/ Povidone-Iodine solutions can induce insensitivity to the product as well as allergy.  Long-term use has also been known to cause growing skin cells to lyse (over-saturate and rupture) and can result in allergic reactions.

Methylated Spirits:

 Too strong to be used as an aftercare solution, can lead to inflammation of the wound, and increase the healing phase.

Ointments:

Examples: Vitamin E, Aloe Vera, Betadine ointments, Antibiotic ointments i.e. Neosporin, Neomycin, Polymixin-B, Bacitracin Zinc, etc.

Ointments should not be used as they limit air circulation to the piercing, and they can cause Granulomas. Antibiotic ointments should only be used if recommended by a physician. Some people experience allergic side effects that can lead to anaphylactic shock, which is potentially fatal.

Antibiotic tablets:

 A piercing will not heal any faster if you are taking antibiotics. It’s not an infection, it’s a wound. Using antibiotics can actually hamper healing because it depletes your body’s natural immune system. The wrongful administration and over prescription of antibiotics has resulted in antibiotic resistant strains of bacteria appearing and using antibiotics as an anti-infective increases the chance of catching an antibiotic resistant strain of bacteria i.e. staphylococcus Aureus.

Lavender Oil, The Most Effective Wound Healing Agent

HISTORY

Lavender has been used for medicinal purposes since antiquity, and is mentioned in the Ancient Greek "Materia Medica" by Dioscorides in the 1st century AD. The famous Roman physician Galen (AD 129-199) also mentioned it.  However, it wasn't until WW1 that it's use for wound treatment became widely adopted.  In 1915 the French Dr. Menciere used lavender oil for the treatment of war wounds, due to it's remarkable healing properties.  His contemporary, Dr. Jean Valnet commented on it's antiseptic and cicatrizing (wound healing) properties, he noted that the antiseptic power of lavender oil exceeded that of phenol, cresol, and guiaicol, and that it's vapour destroyed pneumococcus and haemolytic streptococcus in 12-24 hours.

But it was the French perfumer, Rene-Maurice Gattefosse (1881-1950) who did the most to promote the use of lavender oil for wound healing. Gattefosse became fascinated by the use by the French peasants of essential oils for their healing properties, this empirical evidence was scientifically validated when Gattefosse burnt his hands in a laboratory explosion.  He instinctively plunged his hands into the nearest liquid which happened to be lavender oil, he found that the lavender oil provided immediate relief, so he applied it to the wound while it was healing. He was amazed to discover that the wound healed in a very short period of time, and that there was no scarring.  This experience led to him devoting more of his time to exploring the medicinal uses of essential oils.

In 1932 he published a paper in the Journal "Parfum modern" on the antiseptic use of lavender, and in 1937 he published his two main works, "Aromatherapie" and "Antiseptiques Essentiales".  These books had a profound effect on the European medical establishment, and it's from Gattefosse that the term Aromatherapy originated.  In his works he cited numerous cases of the therapeutic properties of lavender oil, he concluded:

"In all cases the following is noted: rapid disappearance of pus; decrease in the number of bacteria; powerful stimulation of healing; recovery in a very short time. It is as though the physiological matter receives an added dynamism causing the pathological phenomena to abate immediately".

In his works he also cites evidence of it’s healing powers by other physicians.

"Infected sore on the posterior side of the instep, dating back 18 days. All the usual methods had been tried: dry and wet dressings, ointments and powders. One application of lavender. Twenty-four hours later, the sore was dry and healed." Dr Marchand's observations in "Aromatherapy" R.M. Gattefosse p. 90

"I grabbed the lavender oil and poured it over the wound. Without reduced discomfort of any description, I promise you that I stood and watched the gaping hole close before my eyes.... By evening I had a small scar that looked rather like a wrinkle, and the following morning even the wrinkle had disappeared."

"Miraculous Healing" M. Dambach-Sinclair, "International Journal of Aromatherapy" 3.4, p. 32 1991

PROPERTIES

As already stated Lavender oil possesses unique healing properties, it has good antiseptic, bactericidal, fungicidal, anti-inflammatory and cicatrizing (wound-healing) properties.  It is a powerful immune-stimulant, encouraging a rich flow of blood to the wound.  It is gentle on the wound, doesn't sting, and is a mild anesthetic providing some degree of reduced discomfort relief.

Lavender oil is one of the few essential oils which may applied neat to the skin. It’s non-toxic, non-sensitizing and non-irritating in most cases. It has very low toxicity levels and may be used safely on all types of cuts and wounds. It may be applied neat, or diluted with water.

Some people may experience allergic reactions to Lavender Oil. The symptoms are itchiness, redness and vesicles or small red lumps around the area, which will in extreme cases give of histamine fluid, An almost clear or very pale yellow fluid, which dries to form a light yellow crust on the flesh. Warn customers of the (small) possibility of developing a reaction, but in our opinion the highly effective healing properties of Lavender oil are far more important than the very small chance of an allergic reaction.

APPLICATION METHOD

We advocate the use of Lavender Oil to all our customers and include the following instructions for its use in all our aftercare literature.

The best application method for lavender oil is by diluting two drops in a hot salty water solution. Wash a clean glass with household disinfectant, rinse and clean under hot water, fill the glass one third full with boiling water, add one half teaspoon of Rock or Sea Salt, stir until dissolved. Don't use ordinary table salt or Epsom salts, as they will aggravate the piercing.

Add two drops of pure essential Lavender Oil to the hot slightly salty water, wait until the water is the temperature of a hot bath (being careful not to scald yourself!). Place the glass and solution over the piercing and lie back for 10-15 minutes and allow the solution to soak. Wash the area carefully afterwards with fresh water, failure to wash the salt of may lead to irritation, dry the area thoroughly with clean lint-free toilet or tissue paper. Don't use towels or cloths as they harbor bacteria.