If you poke needles straight down into the skin—that is, perpendicular to the skin surface, you run the risk of poking organs such as the lungs, heart, intestines, liver, and spleen. This is especially true with longer needles. Stick to the simple technique of pinching the skin unless you have studied human anatomy. If you want to be a great piercer, take a college course in anatomy and physiology.
I especially do not advocate poking needles straight into the breast tissue of female-bodied people. (Imagine the breast as a birthday cake with candles). There are structures in the female breast that are more susceptible to infection; placing puncture wounds deep into the breast increases the risk of infection. It is my opinion that women who are breast-feeding are at an even higher risk.
Always dispose of your needles in a puncture-proof plastic container. Many people just use commercially manufactured “sharps” containers, but some local ordinances allow for disposal of needles in regular trash. Please check your local laws concerning needle disposal. Many public dungeons often have specific containers for disposal of bloody materials such as paper towels and gloves.
HOW THE BODY REACTS TO PIERCING
Bottoms can react in different ways to piercing. Those who enjoy piercing will welcome the sensation and be receptive to it. Some may get very still, while others may thrash about. It is best to talk to your bottom and discuss how he may react. Remember that piercing is unlike some other SM activities in that a fear of needles is a common phobia. Let’s face it: most of our first experiences with needles were in a medical office—not the best introduction to piercing and needles. With a person who has never been pierced before, always prepare for the worst, but be open to everything. You cannot always predict how someone’s body will react to needles.
One evening my wife, Katie, and I were having sex in our home dungeon. Katie and I had been together for about four years at the time and I had yet to place needles in her nipples. This seemed like a great time to address that oversight. By this point Katie was really hating me—at anything I did she screamed “No!” and fought back in anger. I should add that Katie and I are very experienced at what we do. She often protests during our scenes—it’s part of how we do BDSM. As I inserted a single needle into each nipple, you would have thought I was cutting a limb off. If she had not been rendered immobile, I think she would have run out of the house naked.
So what size needles did I put in her nipples? It may surprise you to know that I used 25-gauge ⅝-inch needles. Keep in mind that Katie has no problems with needles in general—I have poked her hundreds of times, but her nipples are borderline hypersensitive. When I proposed marriage to her, she was suspended from six 8-gauge hooks in her back. So why did she have such a violent reaction to these tiny, tiny things in her nipples? The answer is context, location, and pain theory. When it comes to needle work, size really does not matter, nor does the number of needles you place.
There is a theory called “wind-up” that pertains to pain and the body’s response to pain. Wind-up pain results from the constant bombardment of the neurons in the spinal cord. Pain becomes amplified and the body develops opioid tolerance: opioid painkillers are no longer effective. If pain goes untreated during surgery, for example, wind-up can occur, causing the patient to wake up with increased sensitivity to pain. Additionally, the body’s own natural responses to pain no longer work. All that adrenaline and those endorphins go right out the door. This may be an “aha” moment for some of you.
Taking this into account, I knew that I did not have to place harpoons into Katie’s nipples to get the sexual satisfaction I wanted. This understanding about the body’s response to pain enabled me to avoid the potential complications of greater trauma or damage caused by larger-gauge needles in such a small target. Yeah, I did fuck her one more time after the needles were in place, but I held her for a long time after it was over—she was in a rather fragile emotional state.
THE RISKS
When you puncture someone’s skin, you must be aware of the potential dangers. If you slide a needle into someone, then accidentally poke yourself as it comes out the other side, you can be exposed to their blood. The most common potentially infectious body fluids are: blood, preseminal fluid (precum), semen, vaginal secretions, and any fluid in which blood can be seen (for example, bloody saliva after brushing teeth). Exposure can be defined as an incident when the potentially infectious blood or body fluids of one person come in contact with the blood or body fluids of another. If these fluids come into contact with cuts or sores, hangnails, needle sticks, or mucous membranes, there is the potential for exposure. Mucous membranes are those linings or cavities of the human body that are exposed to air: the linings of the digestive tract and the mouth, respiratory tract and nose, conjunctiva of the eyes, and the genitourinary tract, including the urethra. Contact of potentially infectious body fluids with intact skin does not constitute exposure.
The bloodborne pathogens that are of greatest concern are the hepatitis B and C viruses (HBV and HCV) and Human Immunodeficiency Virus (HIV). Blood contains the highest concentrations of HBV, HCV, and HIV, thus contact with blood poses the highest risk of transmission.
Based on 2005 statistics, the known risk for becoming infected with HIV after a percutaneous exposure (needle stick) to blood containing HIV is approximately 0.3 percent—that is, 1 out of 300 exposures will result in seroconversion. The rate for hepatitis B-positive seroconversion in a nonimmunized host is 6 to 24 percent and for exposure to hepatitis C, 1 to 10 percent.
When contracted, hepatitis attacks the liver and can result in lifelong illness. Liver cancer, failure of the liver, permanent scarring of the liver called cirrhosis, and death can occur after a person has become infected with HBV or HCV.
A carrier is an individual who is infected by the virus and has not recovered fully from infection. They may harbor the virus for the rest of their life without any signs or symptoms of infection. The only way to know if you are infected with HBV or HCV is to get a blood test.
A virus needs a host such as a human to live in. Many viruses do not survive long outside the human body. HCV can stay alive in a drop of blood for up to four days. HBV is a rather strong “bug” that can live in a drop of blood for about a week. Hepatitis B and C are easier to acquire than HIV for this reason.
There is an HBV vaccine available. It consists of a series of three injections given over a six-month period. I recommend that all persons involved in BDSM activities get the series.
HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). It is a rather weak virus compared to HBV, in that it is easily destroyed outside the human body. HIV is less contagious than HBV or HCV because there are lower concentrations of HIV in a drop of blood. However, there is still a serious risk of transmission. The stage of infection affects the concentrations of the virus in body fluids—the more advanced the illness, the higher the concentration of the virus. Currently there is no approved HIV vaccine.
Should an exposure occur, remain calm. If you stick yourself with a needle that has been used on another person, or are otherwise exposed, immediate treatment is essential.