Piercings and Polysporin

Antibiotic ointments like Polysporin (Neosporin, Bacitracin etc) can be beneficial for wound care and are useful with fresh piercings if used properly. If used improperly, problems can ensue. First, let's clear up a couple of dangerous myths.

Myth no. 1: Polysporin heals wounds.
This is absolute crap perpetrated by the marketing campaign we have seen recently (dubbed "Put on the Poly").

Polysporin will provide a protective barrier over a clean wound to help prevent bacteria from establishing themselves in the underlying tissues. Thus, during the initial healing period, the antibiotic ointment helps prevent problems in the wound caused by infection.

If the wound is not clean and/or bacteria have already insinuated themselves into the wound, the antibiotic ointment will have absolutely no benefit. Don't bother to Put on the Poly if the wound is already infected.

Assuming the wound is clean and healing has progressed properly (with no infection), after a couple of days the body has provided a layer of granulation tissue over the surface of the wound which will be very effective at preventing bacterial intrusion. Once this has happened, the ointment is completely unnecessary.

Myth no. 2: Polysporin is bad for piercings.
The origins of this myth are veiled in obscurity, but it is being perpetrated by a huge internet following. The following continues to grow because so many unqualified people repeat it based on the understanding that so many have already chosen to follow it. Unfortunately expertise is not a democratic bandwagon, and numbers to not translate to truth.

The perpetrators of this myth point to several things to back up their preposterous stand:

Polysporin should not be used on puncture wounds.
True, but piercings are not 'puncture wounds' in the sense intended.

In a medical or first aid environment, puncture or penetrating wounds are injuries cause by a penetrating object and include everything from a splinter to a bullet wound. The concern is typically not the extent of the wound, but rather what has been left in the wound. If the object is fragile (glass, wood) a piece may have broken off to remain in the wound. If the object penetrated clothing, some cloth may remain, and any bacteria on the clothing may now be growing in the wound. Pseudomonas infections are common with penetrating wounds which occur in a gymnasium. The object itself may be contaminated. Rusty nails are commonly covered in soil bacteria, and clostridium spores (like C. tetani) may find a home in the wound.

These wounds cannot be allowed to close without thorough cleaning, and if the skin heals over the wound, the wound may suppurate and the infection could be life threatening. Polysporin is not suitable because it cannot be applied to the entire wound, only to the opening. These wounds need to be irrigated, and a systemic antibiotic (oral or injected) is usually used for prophylaxis.

Polysporin prevents air from getting to the tissue. The wound can't breathe.
Bunk! The cells of the body don't 'breathe'. Their oxygen is provided by the red blood cells, and diffuses from the inside. Antibiotic ointment does not interfere with that exchange of gases.

Piercings, as with any cosmetic or medical procedure, are expected to be free of contamination by bacteria. The methods used by piercers should take into account the chain of contamination, and the client should be protected from any undesirable bacteria or viruses which may have been brought into the shop by others. Admittedly, this relies on the skill of the piercer, which each client should assess before agreeing to be pierced.

The interior surface of a fresh piercing will benefit from a thin layer of antibiotic ointment like Polysporin. It can act as a lubricant, making the passage of the needle and the insertion of the jewelry less uncomfortable. It will also serve to protect the freshly injured tissues from being compromised by bacterial invasion.

This thin layer of antibiotic ointment can be re-applied every time the piercing is cleaned over the first 2 to 3 days if the jewelry is easily moved, as with a ring or long barbell. If the jewelry is fitted, movement of the jewelry is not recommended, and getting the antibiotic ointment into the piercing is not possible. In such cases, do not try to use the ointment. Regardless, use of the ointment should not be continued any longer than three days. When the ointment is applied, any excess visible outside of the piercing should be removed.

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