Clinical Reference Systems: Pediatric Advisor 10.0

SYMPTOMS of INFECTION

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

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.

EXPECTED COURSE

With proper care, most mild earlobe infections will clear up in 1 to 2 weeks. Recurrences are common if you are 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.

PREVENTION

1. Prevention of infections when ears are first pierced
   • Do not pierce your ears if you have a tendency to bleed easily, form thick scars (keloids), or get staph skin infections.
   • Have your 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 your 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 your earrings may be changed as often as desired.

2. Prevention of later infections
   • Do not touch your 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 your earlobes and to provide an air space on both sides of each earlobe.
   • Polish or discard any posts with rough spots.
   • At bedtime, remove your earrings so that the channel is exposed to the air during the night.

3. Prevention of injury to the earlobe

   Dangling earrings can lead to a torn earlobe requiring plastic surgery. Do not wear dangling earrings during sports. Also take precautions while dancing, hair washing, or handling young children who might yank your earrings.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

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

CALL YOUR PHYSICIAN WITHIN 24 HOURS IF:

• Swelling or redness spreads beyond the pierced area.
• You develop a fever (over 100 degrees F, or 37.8 degrees C).
• The infection is not improving after 48 hours of treatment.
• You have other concerns or questions.