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Piercing Ears Early Lowers Risk of Keloids

Doing it before age 11 better, new study finds

MONDAY, May 2, 2005 (HealthDay News) -- Ear piercing is seen by many young girls -- and some boys -- as a rite of passage, an outward sign that they're starting to grow up.

So, they beg for their parents' permission, but they're often told to wait until they're teenagers.

Now, a small study in the May issue of Pediatrics may help them convince their parents that sooner is better than later.

Ear piercing done before the age of 11 might actually be better for health and cosmetic reasons, said study author Dr. Joshua E. Lane, an assistant professor at Mercer University School of Medicine in Macon, Ga. He conducted the research while at the Medical College of Georgia in Augusta.

In a survey, those who had ear piercings done at age 11 or older were much more likely to develop keloids -- unsightly scar-like growths that occur at a site of an injury -- than those who had the piercing done before when they were younger.

With co-researchers Jennifer Waller and Dr. Loretta S. Davis, both of Georgia college, Lane surveyed 32 patients, including 27 women and five men, who were, on average, 24 years old when they were seen. About 85 percent of the participants were black, and keloids are more common in blacks, Lane noted. And 56 percent had a family history of keloids; it's known that these run in families.

Lane found that 80 percent of those who had their ears pierced at age 11 or after developed keloids, but only 23.5 percent of those who had their ears pierced before age 11 did.

Further dividing the age categories, Lane and his co-researchers found that 83.3 percent of those who had their first piercing between 11 and 18 years got keloids, compared to 66.7 percent of those who had been at least 19, 25 percent of those whose ears had been pierced in infancy and 22.2 percent of those who had been between the ages of 1 and 10.

In all, 50 percent of the participants developed a keloid after their first piercing. Twenty developed a keloid after a second piercing.

It's not known why those who got their ears pierced when they were younger weren't as likely to get keloids, Lane said. But he suspects that somehow children are more susceptible after puberty.

"That's yet to be studied," he added. "Our study did not address that at all."

Keloids are usually firm, flesh-colored and sometimes painful. They are commonly found on the ear lobes, back, arms and chest, usually after an injury or trauma, according to the American Academy of Dermatology.

A keloid is different than an ordinary scar, Lane explained: "When you have a scar there is a hyperproliferation of tissue, but it remains within the boundary of the cut. A keloid kind of goes crazy. It's a growth that extends beyond the original insult."

Treatment options include topical medicines such as corticosteroids, medicines known as immune modulators, cortisone injections, laser treatments, freezing treatments, surgery, radiation therapy or combinations, according to Lane and the academy.

Keloids are difficult to treat and have a tendency to come back, sometimes even larger than the original one, Lane added.

A pediatrician who frequently deals with ear-piercing issues among his patients called the study very interesting.

"It's a small number," said Dr. Dennis Woo, chairman of the department of pediatrics at Santa Monica UCLA Medical Center. Even so, he added, the results may cause him to reconsider some of his standard advice about ear piercing.

Generally, Woo said he advises parents to wait until a child is older, allowing the child to participate in the decision, perhaps as a preteen or teen.

"Based on this study, I probably will mention, there is some suggestion it's better to have it done in early childhood," he said.

"Usually I discourage piercing [very] young, especially in the first six months," he said, unless there are strong cultural inclinations to pierce early.

When infants' ears are pierced, he said, he is concerned that there could be infection or that the infants will grab ring-type earrings and cause tears.

Based on the study, Lane said that those with a family history of keloids should consider not having their ears pierced at all.

"But if there is a history, and you want to pierce, do it early," he said. "The key is prevention."

More information

To learn more about keloids, visit the National Library of Medicine.

SOURCES: Joshua E. Lane, M.D., assistant clinical professor, medicine, Mercer University School of Medicine, Macon, Ga., MOHS micrographic surgery fellow, Dermatologic Surgery Specialists, Macon, Ga.; Dennis Woo, M.D., chairman, department of pediatrics, Santa Monica UCLA Medical Center, Santa Monica, Calif., and assistant clinical professor, UCLA David Geffen School of Medicine, Los Angeles; May 2005 Pediatrics
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