Ear Piercing Complications: Comparing Cartilage and Soft Tissue Piercings in a Large Survey Cohort

OBJECTIVES: To compare complication and removal rates between cartilage and lobule ear piercings in a large adult population. METHODS: An anonymous electronic survey was distributed to all individuals with a University of Iowa email address. Respondents reported demographic characteristics, piercing site, age at piercing, technique, personnel, and specific complications. Multivariate logistic regression evaluated complication and removal rates between cartilage and lobule sites. RESULTS: Data were analyzed on 9016 ear piercings from 3270 respondents, including 6275 (69.6%) lobule piercings and 2741 (30.4%) auricular cartilage piercings. Complications were reported in 40.2% of cartilage piercings versus 25.4% of lobule piercings (odds ratio [OR] 1.98, p < 0.0001). Infection occurred in 30.3% of cartilage piercings versus 23.8% of lobule piercings (OR 1.39, p < 0.0001). Additionally, cartilage site and presence of any complication each independently predicted piercing removal (OR 1.62, p < 0.0001; OR 12.82, p < 0.0001). CONCLUSION: Cartilage piercings carried significantly greater odds of complication and removal compared to lobule piercings. These findings underscore the importance of thorough counseling and informed consent, especially when piercing through auricular cartilage.