Piercing and tattooing in patients with congenital heart disease: Patient and physician perspectives

Purpose: The frequency and safety of ear piercing and tattooing were assess ed in a group of children, adolescents, and adults with congenital heart di sease (CHD). Also, a group of physicians who care for adolescents and adult s with CHD were surveyed for opinions and experiences regarding piercing an d tattooing. Methods: An eight-question survey was mailed to 445 patients (181 adults an d 264 children) from one center. A different five-question sun ey was maile d to 176 physician members of the International Society of Adult Congenital Cardiac Disease. Results: The patient survey was completed by 152 of 445 (34%) patients (mea n age +/- standard deviation 19.8 +/- 16.2 years; range 0.25-67 years). Eig hty-eight of 152 (58%) patients were female. Ear piercing occurred in 65 of 152 (43%) patients (mean age 12.4 +/- 8.7 years; range 0.25-45 years). Pri or to piercing, only 4 of 65 (6%) patients took antibiotics, but 15 of 65 ( 23%) had piercing-related infections. No patient had endocarditis. Infectio ns occurred 1 week to 3 years after piercing. All were local skin infection s. Tattoos were placed in 8 of 152 (5%) patients (median age 17.5 years; ra nge 13-56 years). No antibiotic use or infections were reported in patients with tattoos. The physician survey was completed by 118 of 176 (67%) physi cians. The majority of physicians did not approve of patients having pierci ng or tattooing performed. However, 60% of physicians believed that antibio tic prophylaxis is indicated for these procedures. Conclusions: Despite the opinion of many physicians, most patients do not t ake antibiotic prophylaxis for piercing and tattooing. Patients apparently do not suffer serious sequelae. The efficacy of standard antibiotic regimes as applied to ear piercing and tattooing requires further study, since the se procedures are increasingly popular in modern society. (C) Society for A dolescent Medicine, 1999.