Derbyshire would like to acknowledge Rotherham Children's Services for their agreement to use their work in forming the content of this chapter.
This guidance is new and was added to the procedures in December 2017.
Fashion trends have increased the body parts that are pierced. With this in mind, looked after children's requests to be pierced or tattooed need to be taken into consideration in light of current youth culture, but subject to appropriate safeguards contained within this policy.
Any request for consent to piercing (other than ear lobe) should be referred to the appropriate Manager (usually a Team Manager) and will be considered on a case-by-case basis exploring all issues and consulting parties with parental responsibility (PR) before a decision is reached. In complex situations, the relevant Head of Service (Localities) should be consulted. Consultation with the LAC Nurse should also form part of the investigation process as some medical conditions may contra indicate piercing.
Tattoo - The practice of making a design on the skin by pricking and staining, with the intention of leaving a permanent mark on the skin.
Body Piercing - Any facial, cosmetic or deep body piercing other than the ear lobe.
In practice piercing practitioners should not pierce a young person they believe to be under the age of 16 without the consent of an adult with Parental Responsibility.
Body piercing is also covered by Section 15 of the Local Government (Miscellaneous Provisions) Act 1982 as amended by the Local Government Act 2003, which gives a local authority power to regulate body piercing and to require practitioners to be registered with the local authority.
The legal age to give consent to a tattoo is eighteen years; it is an offence to tattoo anyone below eighteen years as set out in The Tattooing of Minors Act (1969). Staff should understand there are no circumstances whereby consent can be given for a tattoo for a young person below eighteen years of age.
The only exception to this is for tattoos performed for medical reasons by a qualified medical practitioner.
If a child or young person in care acquires a tattoo, the residential staff or foster carer should immediately notify their social worker. Issues and actions to be considered include:
Consent cannot be given to the piercing of breasts or genitalia. As the young person cannot legally consent the piercing practitioner would be committing an assault and may also be committing an indecent assault under The Sexual Offences Act (2003).
The piercing practitioner will not seek consent from a person with PR. In these circumstances the looked after children will consent themselves as legally there is no legislation to prevent them from doing so.
Tattooing or body piercing may be an integral part of either religious or cultural practices for some groups. The social worker should consult the line manager and contact relevant sources of cultural information to support the decision making process. Any issues should be dealt with sensitively and adults with parental responsibility should be consulted and kept informed of the decisions and the reasons for those decisions, as appropriate.
There are other body tinting processes, which can take place, such as eyebrows, eyelashes, cheeks, body tints etc. It is not deemed necessary to include these in this policy. However, if there are concerns from the parent or carer, or any other worker, the social worker should consider the views of the young person and adults with PR, and obtain further information using other professionals as appropriate.
Young and vulnerable children should not have any body part pierced even if parents consent unless there are genuine religious or cultural considerations. In these circumstances it should be referred to the appropriate Senior Manager for a decision on how to proceed. Religious and cultural sources should be consulted to support and inform any decision made.
If the young person or their parents are determined to proceed with the piercing the need for a child protection referral should be considered.
A looked after child may carry out a piercing without permission themselves or arrange for a friend to do so. In these circumstances a judgement should be made on the risks associated with the piercing and whether the piercing should be removed. The child's age and understanding should be assessed, the site that has been pierced and the circumstances in which the piercing was carried out. Then a decision should be made whether to leave the piercing in situ or remove it. Guidance on care of the piercing and risks around the piercing can be found within this policy and further guidance can be sought from the LAC Nurse.
Any piercing taking place should be in a long school holiday, as healing times for piercings vary. Schools will insist that the jewellery is either removed or covered for some school activities, the school will have their own policy on this.
Known allergies or medical conditions should be considered as they may adversely affect the health of the LAC when the ear is pierced:
Infection is the main risk of any piercing.
If hygiene standards are inadequate there is a risk of blood-borne diseases such as hepatitis (B and C) and HIV.
Bacterial infections, which left untreated, can develop into septicaemia or toxic shock syndrome.
Allergic reactions to jewellery, metals, antiseptics, soaps, creams and ointment can occur.
Body piercing also presents a risk of scarring and keloid formation (a type of oversized scar).
Tongue piercing can chip teeth and also carry a high risk of bacterial infection because of the bacteria present in the mouth; this can result in inflammation of the heart valves or tissues. The tongue is also very vascular so excessive bleeding can occur or the tongue can swell obstructing airways.
Responsible piercing practitioners will give verbal advice and provide written information on aftercare. Different piercings have different healing times and the practitioner should provide this information and any specific instructions on care of the area.
The jewellery can be removed and reinserted when healing has taken place so this should only be done as indicated.
If any problems such as redness, swelling or pain do not improve within 24 hours following piercing, advice should be sought from the GP.
The pierced area should be kept dry outside normal bathing and showering routines.
If the area requires bathing use gauze and cooled boiled water (for any discharge).
Hands should be washed thoroughly so the pierced area is only touched with clean hands.
Jewellery should be gently turned when the pierced area is wet.
The pierced area should not be closely covered or bandaged to allow free circulation of air.
Medical advice should be sought before removing a piercing from an infected site as it may be embedded.
Only valid for 48hrs