Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version

Description

Signs of an infection of a pierced ear are tenderness, a yellow discharge, redness, and some swelling.

1. Causes of infection

   The most common causes of infection are piercing the ears with unsterile equipment, inserting unsterile posts, or frequently touching the earlobes with dirty hands.

   Another frequent cause is earrings that are too tight either because the post is too short (the thickness of earlobes varies) or the clasp is closed too tightly. Tight earrings don't allow air to enter the channel through the earlobe. Also, the pressure from tight earrings reduces blood flow to the earlobe and makes it more vulnerable to infection.

   Some inexpensive earrings have rough areas on the posts that scratch the channel and can result in infection. Inserting the post at the wrong angle also can scratch the channel, so a mirror should be used until insertion becomes second nature. Posts containing nickel can also cause an itchy, allergic reaction.

2. Expected course

   With proper care, most mild earlobe infections will clear up in 1 to 2 weeks. Recurrences are common if the youngster is not conscientious in ear and earring care.

Home Care for Mild Pierced-Ear Infections

Remove the earring and post three times a day. Cleanse them with rubbing alcohol. Clean both sides of the earlobe with rubbing alcohol. Apply bacitracin ointment (a nonprescription item) to the post and reinsert it. Continue the antibiotic ointment for 2 days beyond the time the infection seems cleared. Carefully review and follow all the recommendations on preventing infections given below.

Prevention

1. Recommended age for pierced ears

   Pierced earrings should not be worn until a child is old enough (usually older than 4 years) to know not to fidget with them (which can lead to infections) or take them out and put them in her mouth (which can lead to swallowing or choking on them). Ideally, the ears should not be pierced until a child can play an active part in the decision (usually past age 8).

2. Prevention of infections when ears are first pierced
   • Do not pierce your child's ears if she has a tendency to bleed easily, form thick scars (keloids), or get staph skin infections.
   • Have your child's earlobes pierced by someone who is experienced and understands sterile technique. Piercing by someone inexperienced can result in infections or a cosmetically poor result.
   • The initial posts should be 14-carat gold or stainless steel.
   • Do not remove the posts for 6 weeks.
   • Apply the earring clasp loosely to allow for swelling.
   • After washing the hands and cleaning both sides of the earlobes with rubbing alcohol, turn the posts approximately three rotations. Do this twice a day.
   • By the end of 6 weeks, the lining of the channels should be healed and earrings may be changed as often as desired.

3. Prevention of later infections
   • Remind your child not to touch the earrings except when inserting or removing them. Fingers are often dirty and can contaminate the area.
   • Clean earrings, posts, and earlobes with rubbing alcohol before each insertion.
   • Apply the clasps loosely to prevent any pressure on the earlobes and to provide an air space on both sides of each earlobe.
   • Polish or discard any posts with rough spots.
   • At bedtime, remove the earrings so that the channel is exposed to the air during the night.

4. Prevention of injury to the earlobe

   Remind your youngster that dangling earrings can lead to a torn earlobe requiring plastic surgery. Such earrings should not be worn during sports. Your child should also take precautions while dancing, hair washing, or handling young children who might yank the earrings.

Call Your Child's Physician Immediately If:

• The earring clasp becomes embedded in the earlobe and can't be removed.

Call Your Child's Physician Within 24 Hours If:

• Swelling or redness spreads beyond the pierced area.
• Your child develops a fever (over 100ƒF, or 37.8ƒC).
• The infection is not improving after 48 hours of treatment.
• You have other concerns or questions.