It happens to all of us. Father Time makes an uninvited appearance on our doorstep, and we realize we aren't quite ready to play host. For some it is a random Monday morning, a yawn and stretch in front of the mirror as the shower water heats for our everyday ritual of prepping for the office, followed by the open-mouthed reaction to the skin that settles after the yawn. Oh no. Are thosecrow's feet?

For many of my friends, it's the realization that the next 5 weekends are booked with weddings and baby showers, with the implication that everyone has settled down and grown up-- that days of reckless youth are over. A co-worker of mine said she realized youth had slipped out the back door when she spent the day before Halloween sewing a cape for her son's Harry Potter costume while baking cookies for her daughter's kindergarten Halloween parade. "When did this happen?" She laughed. "Somewhere along the line I became a responsible adult, and now I only have photos of Spring Breaks gone by to prove that once I was a teen without a care in the world."

For me it happened early, right after I shook hands with the college Dean and walked away with a well-deserved diploma, ready for a "real" job that offered a 401K plan and goo dental benefits. Suddenly I realized I would never have homework assignments or final exams, and it was time to trade in glitter eye shadow for eye cream with SPF. Unsure about whether or not I wanted to be an actual 'adult,' I investigated ways to rebel against my disappearing 20s. A tattoo was out of the question, because I knew someday I'd rather have portable photos of an irresponsible youth, rather than an indelible, unavoidable reminder. Besides, I couldn't handle having a needle break skin over and over while I waited for a design to appear. I could only handle a needle piercing my skin for about one second. So that's what I sought.

I got my ears pierced in the local mall when I was 13, and never thought about adding another hole until my second-coming rebellion. I decided to get my nose pierced, as I'd seen women with nose piercings that looked gritty, independent, yet still totally feminine and pretty. An eyebrow piercing was too far out for me, and just the THOUGHT of a needle near my belly button made me pale and peaked.

I was young enough to act on impulse, but mature enough to know that if impetuous could equal infection, I better do some research. "Body piercing has become extremely popular in the past decade," says Creo Bettencourt, former "head piercer" at Body Shots in San Francisco, "which means hygiene rules have come a long way. Still, it's important to investigate a piercing studio before going through with it." In order to be bejeweled without risking health, Bettencourt offers the following guidelines:

• Have a dialogue with the person performing the puncture.
  "Most piercers take their job very seriously, and are well-educated on the process and the rules of maintaining a healthy, clean, pierced site." Look for certification, ask plenty of questions, and never feel like anything is a "given." ASK about sterile needles, LOOK for proper waste vessels for used needles, and make sure surgical gloves are worn. If the piercer cares about taking steps to protect his/her own health, chances are they'll care about yours. You should be asked to sign paperwork that indicates all risks have been explained, and should seek a practitioner that asks for ID and refuses to pierce minors without their parental consent.

• Educate yourself on the different healing times of different body parts.
  Scar tissue forms quite easily in the ear lobe, as lobes don't contain dense tissue and heal quickly. Areas with high cartilage content such as the helix of the ear have little blood supply and healing is slower and can be accompanied by infection and even disfigurement.

  Navel piercings require the longest healing time, which can range anywhere from 6 9 months. Though a belly ring seems like an easy answer to the not so daring who want to feel rebellious, one should be extremely careful about making the decision to pierce the navel. You must be willing to wear loose clothing, as tight garments can cause friction and increase chances of developing infection. Furthermore, it's more difficult to keep sweat and moisture away from the navel area, and a dry area is essential in keeping yourself free of the 'dark, damp, wet' phrase that's a real estate requirement for bacteria.

• Know the Risks
  With any invasion of the body, needle or otherwise, puncturing the skin and entering the bloodstream, you subject yourself to the possibility of infection.

  Health risks include infections and allergic reactions, and could even include hepatitis B, and potentially HIV transmission. Again, investigate your piercing studio thoroughly. Irritations are more likely to occur if sebaceous glands are located at the piercing site, and temporary infections can be relieved with proper follow-up. However, if piercing equipment is not clean, you are at risk for picking up infections from the customer before you. If a teen hasn't had a vaccination, even Tetanus can be a risk.

  That said, Professor Norman Noah, an epidemiologist at the London School of Hygiene and Tropical Medicine, and the Communicable Disease Surveillance Center, says that equipment is now so safe that danger from blood-borne viruses (HIV, Hepatitis B and C) is virtually non-existent.

  Major metropolitan cities have piercing studios nearly every city block, and as the piercing trend is ever-popular, studios go the extra mile to gain and secure business, aiming to bring in new business via word of mouth. Therefore, the chances of running into a clinic stuck in the dark ages, with horror movie fodder like rusty needles or used piercing wire are slim to none. Still, an education on the risks and right questions to ask are your best defense against ending up needing triple antibiotic ointments or a trip to the doctor.

• Clean with the proper products
  "Alcohol is far too drying," warns Bettencourt, "so we recommend a simple cleansing with an antibacterial soap and a spray of Bactine." You can overdo the healing process by covering the area with thick antibiotic ointments. Instead, wash with sudsy, warm water, and rotate the jewelry two to three times a day. More than that, however, is unnecessary. "Some people think they are helping the healing process when the really are hindering it," warns Bettencourt, "especially with navel piercings. Resist the temptation to play with it or turn the jewelry without lubrication provided by antibacterial soapy water."

• Wear "safe" jewelry
  A friend of mine had a single silver hoop with a sapphire in it, part of a set from her late Grandmother. With just one of these, she decided to pierce her navel to be able to wear the nostalgic jewelry at all times. Fortunately, the staff at Puncture in Los Angeles nipped that idea before nipping her skin. Apparently you CANNOT insert "live metals" into most piercing sites, especially the nose, navel, or lip. As sterling can and will tarnish, you seriously risk site infection from the metal's activity.

  Instead, choose jewelry sold at the piercing studio, as they're sure to sell inert and non-toxic metals. Your best bet is surgical stainless steel, which won't corrode, or 14K gold, niobium, or titanium such as Blomdahl.

If you can keep the above in your hip pocket and still feel the urge to go for it, you can proceed without worrying that the trend is barbaric or unhealthy. If your son or daughter insists on adding a hole to their bodies, investigate a studio with him or her, to assure yourself that the locale is clean, and that you can have a good rapport with the technician (who should detail follow-up maintenance and proper after-care/cleaning BEFORE your child even selects the jewelry). After all, a piercing IS removable, for that family photo or cousin Jean's big wedding. A dragon tattoo that snakes around the forearms and neck, is not.

I enjoyed my nose piercing for two full years before deciding I'd outgrown the fun. As far as I know, Zara Phillips, Princess Anne's teenage daughter, has had no problems with the metal stud she sports in her tongue. "Scary Spice", Spice Girl Mel B, has her tongue pierced, and supermodel Gisele Bundchen has been flashing a navel piercing on catwalks all over the world. In 1997, a Miss America contestant sported a belly ring as shiny and polished as her toothy smile.

And it isn't really a new practice, if you think about it. In the 1800s, aristocratic French and English women wore specially designed bodices to flaunt nipple piercings, and Roman centurions pierced their nipples to demonstrate valor.

So if you, or someone you know, has something to "demonstrate," or crows feet to rebel against, a piercing is not a terrible idea. Just keep my friend Molly's words in mind as you pursue: "I thought a belly piercing would be so sexy, I went out and did it, and then cried for four hours straight. Keeping it clean wasn't a problem, but I walked with a hunched posture to protect it, and wore these muumuus to keep fabric from rubbing it or irritating it. After 6 weeks, surrounded by bottles of Bactine and brochures on wound-cleaning procedures, I thought, 'Wait, wasn't this supposed to make me feel sexy?' So I removed the piercing and went out and got a new haircut instead."

The bottom line is this: go with whatever inspires you to make you feel better about your looks, conservatism, age, or style, and know that all it takes is a little research and a dedication to after-care to maintain the new you.

Katie Wright
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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