Dear Alice,

I was hoping to wear plugs. You know, the earrings...but do they hurt when you put them in?

Dear Reader,

Pain can result from any attempt to physically alter the body, but it can be exacerbated by infection or noninfectious damage that can result from body piercing and/or the stretching of a pre-existing piercing. Ear piercing results in bleeding during and after the procedure, and a large gauge piercing, also known as plugs, would be bloodier. Applying direct pressure to the piercing site can stop bleeding, and applying a cold pack can help reduce swelling and bruising. Ice can damage skin if placed directly on it — put a layer of clean fabric or cloth between a cold pack and your skin. Washing the piercing site for five minutes, three to four times a day with large amounts of warm water and any antibacterial soap can reduce the risk of infection. Keeping the piercing area elevated will reduce swelling. A nonprescription medicine, such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or naproxen, and aspirin, can help with the pain after piercing and during the stretching process.  

Stretching of body piercings has a long history as a ritual practice done for cultural, religious and traditional purposes. Today it is often done to reflect personal style. The ear is the most common site for body piercing, and one of the most commonly stretched piercings is the earlobe. The process of stretching an ear piercing, sometimes referred to as gauging, can be done in a few different ways and requires time and patience.

To insert plugs, the ear lobe must be stretched. One way to stretch the ear lobe is by piercing ears at a large gauge and immediately stretching them with a taper. Gauge refers to the size of jewelry — the smaller the gauge number, the larger the jewelry. A typical ear piercing is around a 18- or 20-gauge, while a 00-gauge is the largest size most earlobes can safely tolerate. During the stretching process, it’s best to go up a single gauge size at a time, to minimize the risk of tearing. A taper is an intermediate plug earring that facilitates the widening of an ear piercing. This is more traumatic for the ear, as it causes the skin to break, and more painful.

Another way is to pierce at a small gauge and stretch slowly over time after the ear piercing has healed (usually within six to eight weeks, though it’s recommended to wait longer to begin stretching). This can be done using tapers, tape wrapping, or with weights. For example, every so often (several weeks to several months), a tapered earring is pushed as far as possible without breaking the skin, until the desired gauge is reached, a plug is inserted and the skin heals. This process should not be particularly painful, and you may experience slight soreness, discomfort, or a burning sensation from the pressure. However, if the experience is very painful, this could mean the ear isn’t ready to be stretched again yet and you should wait longer.

Every kind of piercing has risks involved, and gauging has the following associated with it:

  • Infection could occur if piercing equipment is unsterilized, and later, if you don’t follow proper piercing care. Minor infections can progress into serious conditions if not treated, and may require topical or oral antibiotics. Make an appointment with a health care provider if you suspect infection.
  • Allergic reaction could occur if you are allergic to a metallic compound in any jewelry used during the piercing and stretching process, especially given the prolonged wearing of a taper or plug.
  • Scarring such as hypertrophic scarring and keloid formation is associated with gauging, and can be painful. They can require steroid treatment, surgery, or radiation to remove.
  • Traumatic tearing can occur. A simple ear lobe tear can be sutured under local anesthesia.
  • Permanence of the procedure should be considered, because after a certain point, gauging ears is permanent and would require surgery to fix.

The Association of Professional Piercers (APP) has great tips on what to look for as a potential piercee, and has informative brochures available on picking a piercer, suggested aftercare guidelines for body piercings, and body piercing troubleshooting for you and your healthcare professional. Visiting an APP certified piercer can help ensure that your ear piercing and stretching are performed safely.  

Happy gauging!


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