Adolescent Health Brief
Piercing and tattooing in patients with congenital heart disease: patient and physician perspectives

https://doi.org/10.1016/S1054-139X(98)00089-5Get rights and content

Abstract

Purpose: The frequency and safety of ear piercing and tattooing were assessed in a group of children, adolescents, and adults with congenital heart disease (CHD). Also, a group of physicians who care for adolescents and adults with CHD were surveyed for opinions and experiences regarding piercing and tattooing.

Methods: An eight-question survey was mailed to 445 patients (181 adults and 264 children) from one center. A different five-question survey was mailed to 176 physician members of the International Society of Adult Congenital Cardiac Disease.

Results: The patient survey was completed by 152 of 445 (34%) patients (mean age ± standard deviation 19.8 ± 16.2 years; range 0.25–67 years). Eighty-eight of 152 (58%) patients were female. Ear piercing occurred in 65 of 152 (43%) patients (mean age 12.4 ± 8.7 years; range 0.25–45 years). Prior to piercing, only 4 of 65 (6%) patients took antibiotics, but 15 of 65 (23%) had piercing-related infections. No patient had endocarditis. Infections occurred 1 week to 3 years after piercing. All were local skin infections. Tattoos were placed in 8 of 152 (5%) patients (median age 17.5 years; range 13–56 years). No antibiotic use or infections were reported in patients with tattoos. The physician survey was completed by 118 of 176 (67%) physicians. The majority of physicians did not approve of patients having piercing or tattooing performed. However, 60% of physicians believed that antibiotic prophylaxis is indicated for these procedures.

Conclusions: Despite the opinion of many physicians, most patients do not take antibiotic prophylaxis for piercing and tattooing. Patients apparently do not suffer serious sequelae. The efficacy of standard antibiotic regimes as applied to ear piercing and tattooing requires further study, since these procedures are increasingly popular in modern society.

Section snippets

Patient survey

An eight-question survey (written in English and Spanish) (available from author) was mailed to 445 patients (181 adults and 264 children) with congenital heart disease, followed at the Loyola University Medical Center, Maywood, Illinois. Completed questionnaires were returned via prestamped envelopes which were enclosed. All patients were selected from the active mailing lists of the Pediatric Cardiology and Adult Congenital Heart Clinic sections. No patients were excluded.

Physician survey

A five-item

Patient survey

Completed questionnaires were returned by 151 of 445 (34%) patients (mean age 19.8 ± 16.2 years; range 6 months to 67 years); 58% of participants were female. Ear piercing had been performed in 43% of participants (mean age 12.4 ± 8.7 years; range 3 months to 45 years). Tattoos had been placed on 5% of participants (median age 17.5 years; range 13–56 years). No participants had body piercing performed. Frequency of self-reported infection and frequency of antibiotic prophylaxis in patients who

Discussion

It is estimated that millions of people have been pierced or tattooed (3). These cosmetic procedures are considered to be safe with low risk of serious infection. However, many persons with pierced ears experience local skin reactions which necessitate antibiotic use, altering the type of metal worn (use of gold only), or allowing pierced holes to close spontaneously. All of these local skin reactions are not infectious. Metal allergy after ear piercing has been well documented in children (4).

References (5)

  • Ronge L. Pediatricians’ piercing insight can help teens get the point. AAP News...
  • A.S Dajani et al.

    Prevention of bacterial endocarditisRecommendations by the American Heart Association

    JAMA

    (1997)
There are more references available in the full text version of this article.

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