By John Ward, MD

The points to consider when dealing with a piercing in the active person depend on the location and the timing of the piercing. The term "active person" can reflect a multitude of people, but for the sake of simplicity it will represent the individual who participates in athletic activities.

To begin, let us look at the navel. Much of the following information can apply to other piercings, but the navel is notorious for delayed healing. The key decision with a navel piercing will be the jewelry selection. There is a tendency within piercing circles to suggest only "ring" jewelry. Many piercees are frequently told that only a ring can initially be placed in a navel piercing. However, in an athletic person, particularly one who does sit-ups, the use of a ring can lead to irritation and delayed healing. The constant squeezing of the abdomen against the ring will cause increased friction inside the piercing -- leading to excessive scar tissue. The solution to this situation is the curved barbell. The half-circle design allows less tension at the edges of the piercing tube -- decreasing excess scar tissue.

So, when evaluating an unpierced client, the initial interview is important. If the person is inclined towards athletics, then the appropriate jewelry is the curved barbell.

If the active person already has a ring and is having friction problems, then jewelry exchange to a curved barbell is needed. This should be considered even if the piercing is relatively new. In addition, since there may be excessive granulation tissue (reddish tissue not covered by skin) at the edges, the following local care can be considered. For the first twenty-four hours after the exchange, several applications of a 3 % (hypertonic) saline solution can be used, and then switched to a normal saline solution. The first solution will help to shrink the tissues by withdrawing fluid out of the cells and the interstitial space. However, beware that prolonged use of the 3 % solution will destroy the healing tissue by pulling all the fluid out of the cells -- and thus killing them.

The following situation frequently arises in the person with a healed piercing. Remember that a healed piercing exists when crusting at the edges no longer occurs. Usually, the person will complain about pain that has previously not been present. This can indicate several scenarios:

• An increase in activity that causes friction within the piercing, or
• An actual tear in a healed piercing.

These situations can be remedied by decreasing the activity level (resting the piercing) and by starting local care with saline solution and antibacterial soap. The problem should resolve in one to two weeks.