Thinking of getting your child's ears pierced? Here are answers to common questions about this rite of passage.

child with ears pierced
Credit: Blend Images/Veer

What is an appropriate age to get my child's ears pierced?

Experts agree that this is a very personal decision, but some do warn of potential risks in piercing your daughter's ears too early. "Any time you puncture the skin, you open up the opportunity for infection, and because infants still have developing immune systems, I encourage parents to wait until their child is at least 6 months old to get her ears pierced," says Wendy Sue Swanson, M.D., a Parents advisor and a pediatrician at Seattle Children's Hospital. On the flip side, if you want your child to make her own decision about ear piercing, it's best to wait until she's around 10 or so to have that discussion. The older the child, the more likely she'll be able to take responsibility for keeping her ears and her new studs clean.

How can I make the experience less painful for her?

Ask your doctor to prescribe a topical numbing cream with lidocaine derivatives that can help anesthetize the earlobes. Layer a thick coat of the cream onto the lobes 30 to 60 minutes before the piercing. Experts also say that applying ice 15 to 30 minutes before the piercing might help numb the pain receptors. If you do this, you might consider covering your child's ears with plastic wrap or a similar substance, as the ice can cause discomfort if applied directly to the earlobe. These interventions won't completely diminish the pain, though. "When your daughter gets her ears pierced, it will be somewhat painful," Dr. Swanson says. Talk to your child about the piercing in the same way you would talk about an injection at the doctor's office -- reduce her anxiety by saying it's a quick procedure and encourage her to breathe deeply.

When choosing earrings, which metal is best?

Surgical stainless steel earrings and posts can be your best bet -- especially because this metal doesn't contain nickel or any alloys that might cause an allergic reaction. Nickel and cobalt allergies are extremely common, so experts recommend avoiding earrings that contain these metals. Some kids may even be sensitive to white gold, as it can often contain nickel, says Bruce A. Brod, M.D., clinical associate professor of dermatology at the University of Pennsylvania Health System. Besides surgical stainless steel, the safest options include platinum, titanium, and 14K gold. The key when choosing earrings is to ask which metals were used -- and talk to your doctor about what might be safest.

How should I choose a piercing place?

First, ask if your dermatologist or pediatrician does piercings. Many don't, but it's worth inquiring since they'll use sterile equipment and follow basic safety procedures. If that's not an option, ask your doctor where she recommends that you go and check in with trusted friends to see where they took their children to get their ears pierced. Once you determine a piercing location, make sure the technician has had at least a year's experience doing several piercings each day. Most important, says Lisa Garner, M.D., a dermatologist in Garland, Texas, check that the technician follows basic safety protocol: Make sure she has washed her hands or used antibacterial hand gel, put on new gloves, cleaned your daughter's earlobes with an alcohol pad, and taken an individual sterile ear piercer out of its previously unopened packaging in front of you for each ear.

What kind of post-piercing care should I follow?

After the ears are pierced, avoid infection by always keeping your daughter's earrings clean. Wash your hands with a mild soap and then clean the front and back of the earrings twice a day by using a cotton ball or pad that's been dipped with a little rubbing alcohol, hydrogen peroxide, or cleaning solution provided by the piercing locale. Allow the pierced hole to maintain its shape by gently rotating the earrings and sliding them back and forth a few times. Make sure the earring is not too tight. Do not remove the first pair of earrings until at least six weeks have passed -- if you do, the hole will immediately start to close. After six weeks, remove the initial pair of earrings and replace them with another, but make sure your daughter wears earrings continuously for six months so that the holes will become permanent.

What are the signs of infection?

Redness, swelling, or drainage, or any pain, itching, or tenderness are signs you should contact your doctor to determine if it's an infection or a possible allergy, says Jenny Murase, M.D., assistant clinical professor of dermatology at the University of California, San Francisco. If it's an allergy to the metal, choosing new posts will likely solve the problem. If it's an infection, your doctor will prescribe antibiotics to treat it. If there is a reaction, remove the earrings right away and wait at least six months or longer before you consider getting the ears pierced again. Keep in mind that keloid tissue (a thick scar tissue) is more likely to develop when there's an infection or allergic reaction. "Repeatedly traumatizing the area greatly increases the chances that a person will develop keloids," Dr. Murase says.

Are there any other safety measures I should consider?

"When getting your daughter's ears pierced, avoid piercing the cartilage -- doing so carries a much higher risk of infection and keloid formation," Dr. Brod says. When your little one is changing her clothes or brushing her hair, make sure she doesn't irritate her newly pierced ears. Put her hair back with a headband or up in a ponytail. Try to keep hairspray, shampoo, perfumes, and similar products away from the earrings.

Will my child have to avoid certain sports or activities after getting her ears pierced?

Some experts say no; others warn that children should be extra careful, especially during the first two weeks after a piercing when the wound site is more prone to infection. Dr. Garner suggests avoiding swimming in a lake or ocean, which might contain unknown bacteria, for those two weeks. As for sports, horseback riding and softball requires a helmet, which might rub against the ear. It's ideal to take earrings out before the sport, but if your child is playing during the first six months after piercing, consider putting small bandages over the earrings to protect them. Or, before you pierce your daughter's ears, check with her team coach to see if earrings are allowed -- if they are not, you might have to wait until the season is over.

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