Gauged earrings

Dear Alice,

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

Dear Reader,

Looking to gauge the level of pain experienced with gauges? Pain could result from different kinds of attempts to physically alter the body, but it’s possible to be exacerbated by infection or by noninfectious damage that arises from piercing parts of the body or improperly stretching a pre-existing piercing. Ear piercing usually produces some bleeding during and after the procedure, and a large gauge piercing (for which the type of earring is called a plug) could potentially be bloodier, if done too soon or incorrectly. According to the Association of Professional Piercers (APP), properly stretching a piercing is more likely to cause slight discomfort than any pain. However, if you do experience painful bruising or swelling, applying ice or a cold pack may help. Keep in mind that it’s best to place a layer of clean fabric or cloth between a cold pack and your skin to reduce the risk of further damage. You can also keep the piercing area elevated to reduce swelling, and use an over-the-counter medicine, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, to help with any pain you might experience 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. Recently, it’s also been done to reflect personal style. The ear is the most common site for body piercing, and the earlobe is one of the most commonly stretched piercing sites. The process of stretching an ear piercing, sometimes referred to as gauging, may be done in a few different ways and might require time and patience to be done correctly.

The recommended strategy by the APP is to pierce the ear at a small gauge and stretch slowly over time after the piercing has healed (usually within six to eight weeks, though it’s recommended to wait longer to begin stretching). This may be done using tapers (intermediate sized earrings to help widen the gauge), 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, then a plug is inserted and the skin heals. This process usually isn’t particularly painful, though you may experience slight soreness, discomfort, or a burning sensation from the pressure. However, if the experience is painful, this could mean the ear isn’t ready to be stretched again yet and you might consider waiting longer.

Every kind of piercing has risks involved and gauging is no different! Keep in mind that stretching an existing, healed piercing is different than receiving a new piercing or stretching one that isn’t fully healed. Any of the following could happen during the gauging process:

  • Infection may occur if proper piercing aftercare, such as regular cleaning and avoidance of contact with the site, isn’t practiced. Minor infections may progress into serious conditions if not treated, and might require topical or oral antibiotics. You might consider making an appointment with a health care provider if you suspect an infection has occurred.
  • Bloodborne diseases, such as hepatitis C or human immunodeficiency virus (HIV), may result from unsterilized or improperly sterilized equipment, if a person already infected with one of these pathogens was recently pierced. Selecting a piercer who practices proper cleaning techniques, including the use of an autoclave, will help reduce risk of contracting these types of diseases. 
  • Allergic reaction could occur if you’re 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 may be painful. Scars may require steroid treatment, surgery, or radiation to remove. Stretching too quickly may cause scar tissue to build up, which decreases the flexibility of the piercing and could potentially limit the extent of the stretching in the future. Massage may help break up scar tissue if this becomes an issue. 
  • Tearing of the ear lobe may occur. Applying direct pressure to the piercing site may stop any bleeding, and a simple earlobe tear may be sutured (stitched) under local anesthesia. However, if proper piercing and stretching has occurred, the site won’t look torn. Remember, excessive tearing may result in loss of the piercing, so patience may help in preventing this type of injury. 
  • Permanence of the procedure might also be a personal consideration, since after a certain point, gauging ears is permanent and would require surgery to reverse. You may consider asking yourself what draws you to gauging. While gauges, like tattoos, are becoming more acceptable in the workplace, it may be worth it to consider if you're committed to these body modifications in the long term, considering the cost and time to reverse the decision.

The APP offers 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 health care providers. Keep in mind that in most states, formal training isn’t required to become a piercer, and body piercing artists are unlicensed. Learning how long your potential piercer has been piercing, what their educational background in piercing is, and how they keep that knowledge up to date can help you find someone who may be a right fit. You may also want to look at the location in which you get pierced, ensuring that it's clean and well lit. 

Here’s to less painful piercing and safer stretching!

Last updated Mar 08, 2019
Originally published Dec 21, 2012

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