A Letter to Improving Piercers

Through discussions with newer piercers and on the Body Modification Learning Forum, it has become very clear that there are a lot of piercers who know the services they are providing are substandard, and desperately want to get better. Wanting to improve the quality of your piercing is a good thing. Actually, this is a great thing, and perhaps the only way to stay relevant in the piercing industry. The fact that many of you still pursue a career in piercing when you know your shop, jewelry, and education are substandard; this is where a lot of your more experienced peers may start to lose patience with you. There are three basic areas a body piercer can improve his or her shop and skills. Health and safety, jewelry quality and education.

I will start with health and safety because this is our primary concern. Both piercer and client are at risk when minimum health and safety standards aren't met, and body piercing isn't worth damaging ones health over.  Health and safety “techniques” can be considered an educational advancement, so for our purposes, we will discuss health and safety equipment and facility standards.  There is a certain set of minimum equipment and facility standards I feel comfortable with. Anything below this, you should not offer body piercing.

1) Autoclave: Front loading, spore tested at least monthly, ideally weekly.
2) Ultrasonic: large enough to completely submerge tools, about 1⁄2 gallon.
3) Hand Washing Sink: In piercing room, used only for washing hands.
4) Sharps Container: locked, and wall mounted in your piercing studio.
5) Contaminated tool tray: totally separate from everything else in your piercing room.
6) Instrument Stand: Completely separate movable stand for piercing setups.
7) Piercing table: Disinfectable, comfortable, and sturdy.
8) Clean storage area in piercing studio: For clean supplies and storage of sterilized equipment and jewelry. This should never be contaminated with unclean gloves.
9) Clean-up Room: An area other than your piercing studio for the processing of contaminated tools.

If you cannot meet these standards, which are still below Association of Professional Piercers (APP) standards, then you should stop piercing at the facility until these standards can be met. What is nice is these equipment standards are relatively inexpensive, with the possible exception of a hand washing sink. Plumbing can be expensive.

Improving jewelry quality is a huge issue at a lot of otherwise adequate piercing shops.  If the Body Modification Learning Forum is any indication, many piercers consider it to be the biggest problem at their studio.  The problem with buying high quality internally threaded or threadless jewelry is seldom a lack of money. The problem is perspective.  Most piercing shop owners fail to understand how the sale of body jewelry benefits the shop. Below is a simple explanation of body jewelry sales (apologies for the math).

I like working with imaginary people as examples, so we'll invent two fictional piercers: Anne and Beth.
Piercer Anne charges $30 for a piercing with jewelry.
Piercer Beth charges $60 for a piercing with jewelry.
Anne, because her prices are cheaper, does a lot of piercings. Let's say Anne does 20 piercings a day, which results in $600 gross.
Beth does a lot fewer. She's twice as expensive and that has a negative consequence.  Her prices seem to chase some potential customers out of the shop. Let's say she does 12 piercings a day, which is $720 gross. ($120 more than Anne!)
But let's compare that $600 gross versus the $720 gross. I will give Piercer Anne the benefit of the doubt, and assume she goes through the same amount of supplies per piercing that Beth does. Let's say the cost for each piercing is $5 in supplies. Now let's assume the jewelry costs $5 wholesale for Anne and $10 wholesale for Beth. Anne nets $20 each piercing, or $400. Beth nets $45 each piercing or $540.
Beth did 8 fewer piercings and made $140 more dollars. While the initial shock of piercing less people seems terrifying, it ended up being significantly more profitable.
What's important to notice is that these numbers we are discussing above are happening in a “vacuum”. This isn't actually the way body piercing works.

Our hero, Beth, is using awesome jewelry. Internally threaded or threadless designs. This means Beth has a lot of beautiful gemstone options that Anne simply doesn't have access to. This means Beth's piercings are, for lack of a better term, “cuter”. This also means Beth benefits from increased word of mouth marketing. Because of the smaller, “blingier” gemstone options Beth carries, she is very seldom piercing with “basic” jewelry. Her $60 basic piercing fee usually increases to $70 or $80 or even more when her clients see Beth’s beautiful gemstone options. This increase in profit doesn't go directly into the bank, mind you. It turns into more education, a bigger jewelry selection, more up to date health and safety equipment, fancy tools like StatIMs and anodizers. Before long, Beth's shop is not only safer AND piercing with better jewelry, but also far busier than Anne's. Money begets more money and eventually Anne’s shop isn't “the competition”, Anne’s shop is a different kind of business altogether. Beth gets to say when someone stumbles into her shop, “I'm sorry we don't carry externally threaded barbells, but I think Anne might”.

If I seem like I'm belittling others for making this mistake, not true. I know from experience with gold jewelry. For years I said, “our customers can't afford it” and “it's too expensive to stock”. Then I realized that this is the same excuse I heard from people using substandard jewelry. I began ordering more and more gold. I took classes on selling gold. I networked with gold manufacturers. Sure enough, my shop started selling gold. A lot of gold. And that math that worked so well with internally vs externally threaded jewelry slapped me in the face. Buy a barbell wholesale at $15, sell it for $30; $15 profit. Buy one at $100 and sell it at $200? I shake my head at all the money I lost out on. Not because I'm greedy, but because it took me 10 years at the same shop before I was able to offer my employees health insurance. Now I can. This keeps my shop happy and healthy, and means my already experienced piercers are able to stay with me and gain still more experience and training.  The difference is, of course, not carrying gold was a bad idea. Carrying and piercing with poor quality jewelry isn’t just a bad idea, it’s bad ethics.  

It’s also nice to note: at my shop, clients now benefit from a better trained, happier staff and a larger jewelry selection. This wasn’t a selfish endeavor.  Everyone has benefited from slightly higher prices and markedly better jewelry quality.

There is no cheap way to jump into better jewelry quality, unfortunately. There are several companies besides Industrial Strength and Anatometal. Blue Mountain Steel, AC Steel, Intrinsic, Neometal, SM316 and several others make internally threaded, implant grade body jewelry that meets APP specifications. I'm sure there are several more I don't know about. Picking one style of jewelry (straight barbells, for instance) and working your way up from there may be your best option. Offering two price levels may work while you phase out your old stock may also be effective. It will seldom seem easy, but if you are consistent and intelligent, segueing from externally threaded jewelry to implant grade internally threaded jewelry can be done in less than a year’s time.
Finally, educational improvements are almost always available. Some of them are free, or nearly free. Shadowing an experienced piercer you've met through networking is a valuable exercise. An apprenticeship is a necessary step in becoming a piercer, and the value of a good apprenticeship cannot be understated.  That said, in many cases you learn the purported “one right way” to pierce. Seeing another experienced piercer work is often an eye opening experience. Attending a class like the Fakir Intensives (full disclosure, I am an instructor) was essential for my growth as a piercer, as I benefited tremendously from hands on training and supervised piercing. Of course, the APP conference is a spectacular resource that I strongly encourage you to pursue (again, full disclosure, I am a member, on the membership committee, as well as a roundtable facilitator at the conference and hopefully a speaker at future conferences). Regardless of what educational options you pursue, the more exposure you get to other piercers, the more you will find seemingly difficult problems have easier-than-expected solutions.

I applaud your desire to make improvements to your shop, regardless of what form that improvement takes. Tirelessly pursuing excellence is the mark of an ethical piercer. Still, it seems the question pops up regularly, “Well what if I don't have money for that right now”? This is where the nice guy stuff kind of ends. If you don't have the money to do something right, do not do it. I consider implant grade, internally threaded or threadless jewelry a minimum standard. I consider the equipment and environmental criteria listed above to be a minimum standard. I consider a decent apprenticeship, some piercing education, and BBP and First Aid classes to be a minimum standard. All told, I think you can start a shop like that for under $50,000, but probably not much less than $35,000. If you don't have that small amount of money, you are not in a position to open a business. That's not a bad thing, though! Doing something else, waiting until you are in a financial position to do things the right way: this is going to prevent expensive, unnecessary growing pains. Talk to your peers, the ones who successfully grew out of bad standards and into good ones and ask them: “Would you do it the same way over again?” The answer will almost always be a resounding no. I also urge you to consider the piercing industry and culture and how much it benefits from you pursuing things the right way from day one. Every poor piercing, every negative experience, these are all knocks to our industry. After years of working so hard, don't be surprised if those of us with a bit more experience feel like you owe us more. You do. 

A Letter To Improving Piercers by Jeffrey Saunders is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jefsaunders.com.

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Evaluating New Products

As body piercers, we share the common experience of having been interrupted midway through our (hopefully) well-considered aftercare instruction by our client’s friend, sibling, or family member who declares: “Just use ‘Product X’, it worked for me.”  There’s a problem, though: We know Product X.  We have checked it out.  Not only has the bulk of the industry agreed that Product X is inappropriate for piercing aftercare, but the Product X website says you shouldn’t use it on body piercings.  None of this matters to the person who has successfully healed a piercing with Product X:  “Well, it worked for me.”
This is a problematic perspective, because an individual’s personal experience is powerful “evidence” to that individual. Explaining to them that they healed in spite of, not because of, a particular product is an uphill, and often losing battle. The problem is, personal experience is flawed. Our brains are wired to make the most of positive results and the least of negative results. When piercers try to evaluate a product, we can't help but "like" or "dislike" it ahead of time, usually based on marketing or who introduced us to the product to begin with. This skews our perception of the results we see to the side we want. There are a ton of cognitive biases at work when we attempt to evaluate a new product, but when we try something out, we are bound to have our assumptions prove correct.  This is a cognitive bias called the confirmation bias “the tendency to search for or interpret information in a way that confirms one's preconceptions” (1). This is exactly why so many studies are “blind” or “double blind”. Scientists try to eliminate biases like experimenter's bias and confirmation bias.
Most body piercings will heal because people’s bodies are built to heal wounds. Before the advent of modern medicine, we healed regularly through prayer and quackery. Before the advent of prayer and quackery, we simply healed like any other animal heals. A body piercing isn't a difficult wound to heal considering homo sapiens sapiens had to hunt dangerous animals, get injured in the process, and heal to survive.
Recently, a new aftercare product was discussed on the popular Body Modification Learning Forum.  I was pleased to see the lion’s share of my colleagues approach the new product skeptically.  “Is it FDA approved?” “May I see a Material Safety Data Sheet?” “What evidence do you have that this product is better than what is currently available on the market?” were all questions discussed with representatives for the product.  My peers wanted evidence that the product worked.  The representative for the product suggested that we try it, and see if it worked first hand.
This got me thinking about the idea of first hand experience and how flawed it is. 
How does one evaluate something like an aftercare product? A skin prep? A hard surface disinfectant?
The short answer is this: you don't.
The long answer is this: you can't.
Evaluating a product like an aftercare product requires money. The kind of money, regrettably, piercers tend not to have. It takes scientists. Control groups. Blind studies. Clinical evaluations. Large amounts of data. Peers to review that data. A piercer cannot do this.
An example: a piercer suggests to her clients that they clean their piercings with a new soap on the market, for our purposes we will call this fictional soap Placeboderm. The makers of Placeboderm have marketed heavily to the piercing community, boasting the health benefits and germ killing abilities of their product. Our fictional piercer buys into the hype, and suggests this new soap to her clients.
After one month, and 100 piercings later, our piercer is loving Placeboderm! Piercings seem to be healing better! Fewer problems! Her clients like the packaging and the smell of the soap. All is well, exactly as she had hoped.
Here is the problem: our piercer doesn't have all the data. Our piercer never asked for clinical studies on how effective Placeboderm is on injuries similar to body piercings  (a draining puncture wound, for instance). Had she asked, she would have gotten more marketing but no studies.  Again, paying scientists to accurately evaluate a new product is expensive, and if we as piercers do not demand it, it won’t be done.
Our piercer was never in position to really evaluate her new aftercare. She never saw the piercings that didn't heal well when using the soap. The clients with the worst reactions didn't follow up, got frustrated and removed their piercings, or went to other shops and got different aftercare. Even then, our piercer only did 100 piercings. For this intellectual exercise, let's assume Placeboderm actually is bad for healing piercings. It prevents 2% more of the population from healing well than the aftercare laid out in the APP “Suggested Care for Body Piercings” pamphlet.  Let's also assume, 90% of piercings would heal with the APP aftercare. Our fictional piercer would have to keep amazing records, get honest follow up, and be able to accurately assess what problems were caused by soap versus everything else, and still only 2 of the 100 clients she pierced would heal worse than the APP aftercare. I don't think our piercer has the capacity to discover this minute difference in aftercare issues. I don't think I do either. Even if the opposite is true, and Placeboderm is a fantastic improvement on the standard APP aftercare pamphlet, our piercer doesn't have the resources to really establish if a new soap is the basis for this improvement or not.
Not to mention, that these piercings weren't pairs. Our fictional piercer didn't do 100 sets of ear lobes, with identical jewelry, using soap on one side and then using APP aftercare on the other.
Add to that how small the sample size is... well you can see where this is going.
Chemicals for hard surface disinfection, skin prep, and aftercare simply cannot be evaluated by body piercers. We need the help of scientists and doctors, as well as government oversight. Does this mean that piercers will have a tough time innovating industry specific products? Absolutely. Is this a problem? No. 
We need to see this as it is: a blessing. There are some hoops that are really tough to jump through, and those hoops are tough to jump through for a reason. When I use a hard surface disinfectant on my instrument stand, my client is (unknowingly) happy that this disinfectant was government approved, tested for several months or years by the company who made it, and slowly adopted by a skeptical medical industry, followed by the piercing industry.  We consistently strive for legitimacy:  jumping through the right hoops, taking our time, and waiting for evidence only lends to our legitimacy.
Piercers understand that there are aspects of their job that they cannot evaluate. The best example of this is autoclave sterilization. We use sterilization indicators, sterilization integrators and regular spore tests to double and triple check the efficacy of our sterilizers. We accept that we cannot “like” the way our sterilizer works, we need scientists and engineers to provide us tools that can allow us to trust the way our sterilizer works.
As of late, I read a lot of piercers talking about how they “like” certain chemicals. I've been guilty of saying things like that myself. What we actually mean is we trust certain chemicals. This is an important distinction. Trust needs to be earned. When a new product is introduced, it is always best to be skeptical: make every product earn your trust. 
Step one, get approved for the use intended for your chemical by the government agency your particular product is regulated by. There are, indeed, products that do not require government approval.  When a product tries to “side step” FDA approval, for example getting a product approved as a soap when the people making it intend it to be used as a skin prep... this should draw our strongest skepticism, not our best apologetics.  
Step two, publish studies about your product.  Ideally, have published studies comparing your product to other products that compete with it. An example of this would be a peer reviewed study of the healing of a specific kind of wound with several different aftercare treatments.  
Step three, market your product. 
It really is that easy, yet all too often, we settle for step three alone.  
It's after these criteria have been met that we piercers can discuss what we “like” or “don't like”. We need to be able to discuss and debate the merits of certain products, and without the evidence to back up an argument, we truly are just making noise.  When piercers are skeptical of products, it is body piercing at its best.  We should demand data.  We should demand rigorous science.  Over time, this will actually ease the introduction of industry specific products, as we will have proven to the companies that want to sell us something that we need more than marketing, more than appeals to our biases, and more than popular spokes people for our industry to embrace their product.