Medical disclaimer
This guide is informational and does not replace personal medical advice. Autoimmune diseases vary widely in severity, treatment, and complications. Discuss piercings with your rheumatologist or specialist before booking. Your specific condition, current medications, and disease activity may require different guidance than the general principles below.
Autoimmune disease and piercings, the balance
Autoimmune diseases (lupus, rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriatic arthritis, ankylosing spondylitis, multiple sclerosis, Type 1 diabetes, autoimmune thyroid disease, and many others) all involve the immune system attacking the body's own tissues. They affect piercings in different ways depending on the specific condition and its treatment, but share common themes worth understanding before making a piercing decision.
This guide covers autoimmune diseases generally, with focus on the shared considerations. Specific conditions are highlighted where they warrant particular attention. The overall principle: many people with autoimmune disease get piercings successfully by timing them well, choosing appropriate studios, and working with their specialists. Some situations do warrant postponing or reconsidering.
How autoimmune disease affects piercings
The immune dysregulation itself
Autoimmune diseases involve immune system dysregulation, which affects wound healing in complex ways. In some periods (remission, well-controlled disease), immune function is close to normal and piercings heal well. In active disease periods, altered immune function can slow healing, increase inflammation, or trigger localised flares at the piercing site.
Medication effects
Most autoimmune medications affect immune function directly, which affects piercing healing.
• Corticosteroids (prednisolone and similar) slow wound healing significantly at higher doses
• Traditional DMARDs (methotrexate, sulfasalazine, hydroxychloroquine) mildly affect healing
• Biologics (adalimumab, etanercept, infliximab, rituximab, and others) significantly affect immune function and healing
• Small molecule inhibitors (tofacitinib, upadacitinib) similarly affect healing
• The higher the immunosuppression, the more the piercing decision needs careful consideration
Increased risk of complications
• Infection risk is elevated when immune function is suppressed
• Wound healing complications (delayed healing, hypertrophic scarring) may be more common
• Some conditions have specific risks (e.g. keloid tendency in some ethnic groups with autoimmune conditions)
• Piercings can occasionally trigger disease flares in susceptible individuals, though this is not well-characterised in research
Timing, the most important factor
For autoimmune disease, timing the piercing well is probably the single most important factor for good outcomes.
Get pierced during remission or stable disease
• Confirmed remission or long-term stable disease is the best time
• HRT, MRI, or other disease activity measures within your specialist's targets
• Medication regimen stable, not recently changed
• No recent flares in the last 3 to 6 months
• Life circumstances stable, not currently undergoing major stress
Avoid piercings during
• Active flare or increased disease activity
• Recent medication changes where you do not yet know how you respond
• Recent high-dose steroid courses (wait at least 2 weeks after steroid taper)
• Recent biologic dose recently changed or new biologic started
• Active infection anywhere in your body
• Recently ill or recovering from surgery or major medical event
• Any period your specialist considers unstable
Working with your specialist
The conversation to have
Before booking a piercing with autoimmune disease, discuss with your rheumatologist or specialist. Cover: current disease activity, your current medication regimen and any planned changes, your history of flares and what triggers them, your history of infections while on current medications, any piercing complications you have had before, and their view on timing. Some specialists will actively support the decision. Some will recommend waiting for a specific milestone (medication stability, longer remission). Some may raise concerns you had not considered. Take their guidance seriously and do not shop for a doctor who says yes.
Studio choice for autoimmune clients
• APP membership or equivalent certification, more important than usual
• Experience with autoimmune clients specifically, ask directly
• Willingness to postpone if you arrive during a flare
• Absolute cleanliness standards on inspection
• Autoclave sterilisation confirmed in the studio
• Willingness to work with your specialist's guidance
• Reasonable pricing that supports quality (avoid budget studios that may cut corners on sterilisation)
Piercing position considerations
Positions that work for most autoimmune clients
• Lobe piercings, fastest healing, lowest complication risk
• Some ear cartilage positions during confirmed stable disease
• Simple straightforward positions rather than complex or high-risk placements
Positions to reconsider
• Navel piercings, longer healing time and higher complication risk generally
• Nipple piercings, longer healing and infection risk considerations
• Complex ear cartilage combinations, more surface for complications
• Surface piercings and dermals, higher rejection and complication rates that worsen with impaired healing
Discuss with specialist
• Genital piercings during autoimmune disease, specific risks that warrant specialist input
• Oral piercings if you have Crohn's, ulcerative colitis, or other gastrointestinal autoimmune disease
• Any piercing near active disease sites
Aftercare with autoimmune disease
• Standard sterile saline rinses twice daily, same foundation as any piercing
• More frequent monitoring than a healthy person, notice changes earlier
• Photograph weekly for slow-change comparison
• Report any concerns to both your piercer and your specialist
• Do not stop autoimmune medication for piercing without your specialist's guidance
• Consider whether the piercing site is near any topical medications you use for your condition
• If your medication is prone to causing dry skin or thin skin (common with corticosteroids and some other treatments), your piercing may be more fragile initially
Specific autoimmune conditions
Lupus (SLE)
• Skin involvement varies significantly, if lupus affects your skin actively avoid piercing that area
• Photosensitivity means sun exposure during healing needs extra attention
• Kidney and other organ involvement warrants discussion with specialist about timing
Rheumatoid arthritis
• Well-controlled RA with stable medication is generally compatible with piercings
• Joint deformity around ear piercings does not typically affect the piercing itself
• Biologic timing matters, discuss with rheumatologist about optimal timing around biologic doses
Inflammatory bowel disease (Crohn's, ulcerative colitis)
• Oral piercings warrant caution, discuss with gastroenterologist
• Skin manifestations (pyoderma gangrenosum, erythema nodosum) at piercing site absolutely rule out piercing that area
• Systemic effects of active disease affect healing generally
Psoriatic arthritis and psoriasis
• Do not pierce through active psoriatic plaques
• Koebner phenomenon (skin trauma triggering new psoriatic lesions) means piercing sites can develop psoriasis, factor into decision
• Well-controlled psoriasis in areas away from piercing site is generally compatible
Autoimmune thyroid disease
• Generally compatible with piercings when thyroid function is well-controlled
• Thyroid antibodies present alone (without dysfunction) do not typically affect piercings
Shop the look
• Implant-grade titanium starter pieces
Internal links
• Piercings and medical conditions, complete guide
• Eczema, psoriasis and piercings
• Piercings with a weakened immune system
• Metal allergies beyond nickel
Frequently Asked Questions
Can I get a piercing if I have an autoimmune disease?
Often yes, during periods of stable disease or confirmed remission. Autoimmune diseases affect piercing healing in complex ways, but many people get piercings successfully by timing them well, choosing appropriate studios, and working with their specialists. Active disease periods, recent medication changes, and unstable phases warrant postponing. Discuss with your rheumatologist or specialist before booking.
Are biologics compatible with getting a piercing?
Biologics significantly affect immune function and wound healing. Piercings during active biologic therapy are riskier but not always ruled out. Discuss specifically with your rheumatologist about the optimal timing around biologic doses (some patients do better piercing at specific points in the dosing cycle) and whether your current biologic regimen is compatible with the risk profile you accept. Some biologics have more significant effects than others.
Should I stop my autoimmune medication before getting a piercing?
No, do not stop autoimmune medication for piercing without your specialist's explicit guidance. Stopping medication can trigger flares that are worse than any piercing-related risk. If timing around medication is a genuine consideration, discuss with your specialist for a proper plan. The piercing decision should adapt to your medication needs, not the other way around.
Can piercings cause my autoimmune disease to flare?
Occasionally, though this is not well characterised in research. Piercings involve tissue injury and immune response, both of which can theoretically trigger flares in susceptible individuals. In practice, most people with well-controlled autoimmune disease do not experience flares from piercings. If you have a history of flares triggered by minor injuries, illness, or immune challenges, discuss with your specialist before booking. Postpone if a flare would be particularly damaging (e.g. before an important life event).
What if I have psoriasis, can I still get pierced?
Yes, in areas away from active psoriatic plaques and during controlled disease. Do not pierce through psoriatic lesions. Consider the Koebner phenomenon, where skin trauma can trigger new psoriatic lesions at the trauma site, this means piercing sites can develop psoriasis. Factor this into your decision, especially if you have a history of Koebner responses. Well-controlled psoriasis in areas away from the piercing site is generally compatible.
Can I get a piercing with rheumatoid arthritis?
Yes for most people with well-controlled RA. Stable medication regimen and disease activity in your specialist's targets are the main requirements. Timing around biologic doses can matter, discuss with your rheumatologist. Joint deformity around ear piercings does not typically affect the piercing itself. Traditional DMARDs (methotrexate, sulfasalazine, hydroxychloroquine) mildly affect healing but do not usually rule out piercings.
How do I know if my autoimmune disease is stable enough for a piercing?
Your specialist is the best judge of this. Generally consider stability to mean: no flares in the last 3 to 6 months, stable medication regimen not recently changed, disease activity measures within your specialist's targets, no recent hospitalisations or major medical events, and life circumstances stable without major current stressors. Get your specialist's specific view, they know your disease pattern better than any general guide can.