manufacturers label ear piercing guns for use on ear lobes only (Association of Professional Piercers [APP], 2018). Infections from ear piercing gun procedures on the tongue or navel often result in serious complications. Due to widely varying regulations and underreporting, well documented data on ear piercing gun procedure complications are lacking. Nonetheless, infection and injury have been documented. When used on the high ear, piercing guns drive the blunt end of the earring through the cartilage, using sheer force to complete the piercing. Rather than creating a clean cut, the cartilage can be fractured around the piercing, which can lead to infection and a difficult, lengthy healing process (Lyons, Stephens, Wasson, DeZoysa, & Vlastarakos, 2012). In rare cases, infection from this type of injury can lead to choroiditis and the collapse of the upper ear, resulting in a difficult reconstruction process with varying success (Cicchetti, Skillman, & Gault, 2002; Margulis, Bauer, & Alizadeh, 2003). Keloid formation, or excessive scarring, has also been documented after high ear piercing infections using an ear piercing gun (Bashir, Afzal, Khan, & Abbas, 2011). In any piercing area, the posts of the jewelry used in ear piercing guns are often too short to accommodate the swelling that occurs after the procedure, pushing the stud up against the back of the ear. This occurrence can lead to cases of embedded earrings, increased pain, and infection. Jewelry that fits too closely to the skin prevents normal discharge from piercing sites to escape, creating a fluid barrier that traps bacteria against the skin (APP, 2018). Furthermore, the jewelry used in ear piercing guns is typically not high quality, implant‐grade metal suitable for body piercing and could contain common allergens such as nickel. In one study, more than 26 cases of embedded earrings were identified after using a spring‐loaded ear piercing gun (Cohen, Nussinovitch, & Straussberg, 1994). This issue is particularly worrisome for young children who often have their ear lobes pierced with ear piercing guns, since they might not be able to communicate that the earring has become embedded and parents might assume the jewelry is missing (Tiong, Sattler, & O’Sullivan, 2008). Justification The percentage of the U.S. population with piercings has grown steadily in recent decades, prompting a rapid expansion in piercing methods and locations (APP, 2018). The ear piercing gun is popular because it is easy to use. Its inherent design and the lack of training for employees, however, demands more regulation. While some states have begun to limit the locations on the body where ear piercing guns can be used, few states have standards that consider the increased likelihood of contamination from improper sterilization, procedures, or training. Ear piercing guns should be held to the same standards as all other piercing techniques and should be limited to use on the ear lobe. Streamlining sterilization regulations will allow for uniform inspections and improve consumer health. Ear piercing guns have been shown to cause more damage than the techniques typically used in professional piercing studios. Cases of shattered cartilage and keloid formation have been reported when ear piercing guns are used on the upper ear. Many mall kiosks or cosmetic stores are entirely prepared to use the ear piercing gun on any part of the ear, creating a greater risk for these types of injuries. Employees have also not hesitated to use the gun for cartilage piercings on children under 16 years (Jervis, Clifton, & Woolford, 2001). In contrast, the technique used by most professional piercers
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