REMOVAL OF A BODY PIERCING Indications Infection Allergic reaction Persistent bleeding Edema Keloid formation Complications Infection Procedure Traditionally, a typical earring consisted of a stud and a backing However, there are now many types of piercing jewelry Labret studs and Barbell studs consist of a straight bar with a ball threaded onto one or both ends, respectively A captive bead ring is a ring that holds a single ball in place by tension A bead ring is different in that it has one ball that is fixed and one that is removable To remove a stud, hold the bar with forceps and unscrew the ball To remove a captive bead ring, use two sets of forceps (or other tool) to hold onto the ring on either side of the ball and release the tension that holds it in place which will then dislodge it To remove a bead ring, simply unscrew the removable ball If the piercing is near the mouth or nose, use extra caution to avoid aspiration A portion of the jewelry may be imbedded in the soft tissues and not easily available This may require an incision to expose the necessary portions, in which case, consider pharmacologic anxiolysis or analgesia prior to the procedure (see Chapter 129 Procedural Sedation ) The application of anesthetic cream may be of value in anesthetizing the superficial epidermis but may be inadequate anesthesia for a deeply embedded piercing Distraction techniques and the use of child life may also help to reduce anxiety and pain Immediately prior to beginning the procedure, position the child to maximize access to the area Have an assistant stabilize the patient at the site of the procedure and restrain as necessary Cleanse the area thoroughly and use aseptic technique Infiltrate the area of the piercing with local anesthetic (lidocaine 1%) injection Consider a field block or nerve block if appropriate In the case of a traditional stud earring with backing that is embedded in an earlobe, use your non-dominant hand to gently apply pressure to the anterior aspect of the earlobe to force the earring back through or close to the opening on the posterior aspect of the earlobe It may be necessary to apply