Ear Piercings and Kids: What You Need to Know

What should you consider before getting your child’s ears (or anything else) pierced? We get straight to the, er, point.
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Not too long ago, my 4-year-old daughter studied me intently. Then she cocked her head, cleared her throat, and said, “Mommy, can you take me to a place where someone can put holes in my ears? I want to wear earrings like you.”

This innocent question from my jewelry-loving daughter sent me on a quest for information. How do I make sure she gets pierced safely? And what I can I do to ensure she won’t end up with slightly uneven piercings like mine?

The American Academy of Pediatrics released its first-ever report on tattooing, piercing and scarification in adolescents and young adults in the fall of 2017. The pediatrician and piercing professional I spoke with echoed much of the same advice found in the report. Here’s what parents should know.

You’re on Your Own

Unlike tattoo parlors, there are no safety regulations or inspections for piercing facilities in North or South Carolina. That doesn’t mean it isn’t safe to get a piercing done here, but it does mean that the burden is on the consumer to make an informed decision about the facility and the expertise of the person doing the piercing.

Whether you have your child’s ears pierced at the mall, the pediatrician’s office or at a piercing shop, it’s important to keep in mind that any piercing is a cosmetic procedure, says Dr. Rhonda Patt, a pediatrician with Charlotte Pediatric Clinic and past president of the Charlotte Pediatric Society.

As with any procedure, there can be risks. “The skin is a part of the body’s immune system. Any time this barrier becomes disrupted, bacteria may be introduced into deeper tissues, leading to infection,” Patt says.

What about babies?

For infants, whose immune systems are just getting started, it can take longer for piercings to heal. It also is important to consider the immune system, especially for younger children and for children with autoimmune disorders or allergies.

“Your immune system is what heals a piercing,” says Cindy Goode, manager and head piercer at SADU Body Modifications, located in the Plaza Midwood area of Charlotte.

Fledgling immune systems are one reason piercers at SADU prefer to wait until a child is at least 5 years old, a more conservative benchmark than the American Academy of Pediatric’s recommendation to hold off piercing a child’s ears until he or she is at least 6 months old.

“Most people who pierce ears also require that a child or infant has had at least her initial hepatitis B and tetanus vaccinations prior to piercing,” Patt says. She also suggests that parents carefully consider the jewelry they select.

“Because earrings are small and children are very oral, a loose earring can be a choking hazard.” Best options: screwback earrings or earrings with notches to keep the back in place.

Top Priority: Cleanliness

Experts agree that clean, sterilized equipment is key to the process, and this is where the method of piercing can come into question. Piercing guns, while convenient, have some downsides. Some European countries and U.S. states have banned the use of piercing guns, noting that surgical needles are sharper, more precise and more sterile.

According to the American Academy of Pediatrics, most piercing guns, even those that are loaded with single-use cartridges, aren’t sterilized between procedures. The Association of Professional Piercers considers piercing guns to be unsafe because although they can be disinfected, they cannot be sterilized in a medically recognized way. Most professional piercers use an autoclave — a heated, pressurized container — to sterilize equipment. The difference? Disinfection reduces the number of microorganisms on an object; sterilization kills them all. This is no small issue when you consider the Centers for Disease Control and Prevention reports that new hepatitis C virus infections nearly tripled from 2010 to 2015, reaching a 15-year peak.

“Professional piercers do not use piercing guns,” says Goode, who prefers single-use, hollow-point, tri-beveled surgical needles for her piercings. “[Piercing guns] cause a lot of trauma to the tissue; it often leads to impaction. [Piercing guns] can’t be autoclave-sterilized. Everything we use is single-use, from the markers that we mark the earlobes with, to the needle, to the jewelry.”

Goode recommends that parents seek out an experienced piercer who has had ongoing training and an understanding of basic anatomy.

“Ask for documentation. Look at portfolios. Make sure the piercer is comfortable with children and talking to children,” she says.

One of the most common complications of piercings is to develop keloids, a type of raised, fibrous scar tissue that can form in response to a trauma such as a piercing.

“Keloid formation tends to run in families,” Patt says. “If there is a family history of keloid formation, then this should be discussed with your child’s doctor prior to piercing.”

Consent and Other Considerations

Once a child reaches age 5, he or she is usually able to understand giving consent to the procedure and the after-care commitment of getting a piercing, Goode says, however she recommends waiting until a child is about 8 or 9 years old for ear piercings. At this stage in life, she says, the changes in a person’s body aren’t as rapid and there’s less of a chance that a piercing will move around on the earlobe — a situation she often has to fix.

For older children who might be interested in more advanced piercings, it’s important to check your child’s school policy on visible piercings, especially if they participate in sports. Goode suggests waiting until at least age 10 for a second earlobe piercing; 13 for a cartilage piercing; age 14 for nostrils, lips and navels; age 15 for a tragus; and 17 or 18 for an industrial piercing. These piercings are “a bit more intense on the pain scale,” she says, and they take longer to heal. A navel piercing can take up to nine months to heal.

Finally, don’t forget about some of the ramifications of a new piercing, warns Goode. Fresh piercings can’t go in the pool, which means late spring or early summer might not be the best time of year to make an appointment.

Materials Matter

“This generation has more sensitivities and allergies than the last. So it’s very important for the jewelry to be high quality,” says Goode, who uses implant-grade materials for her clients, preferably titanium. “That’s the same thing that would be use for a knee replacement. It’s biocompatible, it’s hypoallergenic, and it’s a lot easier for the body to heal that way.”

Patt recommends gold posts and suggests parents avoid plated earrings, which can wear away, exposing allergy-inducing nickel beneath.

A piercing professional should give you all the information you need about caring for your piercing — and many piercing shops, including SADU, recommend coming back for a checkup after 30 days.


Aleigh Acerni was inspired to write this story after her 4-year-old asked if she could “find someone who puts holes in people’s ears” because she wants to wear earrings—just like her mommy.