Women once got their ears pierced simply to wear a wider variety of jewelry.

But these days, more and more women and men are getting other parts of their bodies pierced -- from eyebrows and noses to navels, tongues, and genitals -- as a popular form of personal, cultural, or artistic expression.

By one U.S. estimate, 49% of women and 19% of men aged 18 to 50 had piercings in their earlobes in 2004. And 21% of women and 8% of men had piercings in other places.

When done by a trained professional, body piercing is fairly safe overall. The most common problem is infection, affecting up to 20% of all piercings, according to a new review by dermatologists at Northwestern University Feinberg School of Medicine in the American Journal of Clinical Dermatology.

Most often the bacterial infections are at the piercing site. Other complications may include bleeding, allergic reactions, skin tearing, or scarring.

In the review, the researchers described some of the main health risks from body piercings and how to prevent them.

To stay safe, the paper describes these points to consider before getting your body pierced.

1. Know your infection risk: If you currently have an infection or an open wound, it's a good idea to put off the piercing until you are healthy. Risk of infection is higher -- especially if the piercer is poorly trained and working in an unsterile environment or using unclean equipment -- or if the wound doesn't heal properly.
2. Be aware of medical issues: If you have health problems, such as poorly controlled diabetes or other conditions that weaken your immune system, your chances of infection are higher and piercing is riskier.
3. Factor in lifestyle. A nose ring when you're 20 may look cool, but it may not be so hip or accepted at 30 in some workplaces. If you're planning to remove piercings frequently to conceal them at work or from your family, this may increase your chances of infection. It may also lengthen healing time of newly pierced skin. If you play a contact sport and your piercings are in an area where they might rip or the jewelry can snag on clothing, this may injure the skin.
4. Recognize healing tendencies. Some people may be prone to scarring that may be raised, or thick, and form what are called keloids. Piercing may not be a good idea for keloid-formers. Healing times vary depending on the site pierced, with navels, nipples, and genitals among the slowest to heal.
5. Consider your anatomy. Not all skin surfaces are well designed for a desired piercing. For example, a belly button with a distinct ridge is easiest for a navel piercing. Tongues with a short frenum (the fold on the bottom of the tongue), known as "tongue tie," are not good candidates.
6. Find a trained professional. Most body piercings are done in tattoo and piercing parlors; earlobe piercings may be done in jewelry or departments stores. "Qualified practitioners have a good understanding of the physiology and anatomy of the body part to be pierced," write the Northwestern researchers. They should also use sterilized tools and follow safety precautions for dealing with bloodand controlling infections.
7. Share your health history. Piercing professionals should obtain a medical history, including allergies,heart disease, diabetes, and asthma so your health risks are known. Medications taken should be discussed. To limit bleeding, it's recommended to avoid aspirin for a week before piercing and other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen) for at least a day before getting pierced and for seven days afterward.
8. Ensure proper materials are used. Nickel-free rings, pins, and studs should be inserted to reduce the risk of allergic reactions and infections. Jewelry that's too small or thin or of poor quality can move from its initial placement, known as migration, or be rejected by the body.
9. Follow care instructions. Find out how long the wound typically takes to heal and how to keep it clean afterward. Know the possible side effects from the piercing, such as pain or swelling, and what to do to minimize them.

SOURCES:Holbrook, J. American Journal of Clinical Dermatology, February 2012.News release, Northwestern University.Association of Professional Piercers web site.

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