With body jewelry being sold everywhere from fine jewelry stores to gas stations, it can be hard to separate the true gems from the worthless junk. It's important to realize that no government agency certifies or regulates body jewelry. So, how do you make sure you're getting a good deal, both for your wallet and the health of your piercing?
Outlets that care only sell sterilized, ready to wear jewelry. Because you're putting body jewelry in an enclosed space, it's important that it be sterilized even if it's going into a healed piercing. A small number of germs can easily multiply and cause problems. There's nothing you can do at home to sterilize jewelry. It takes high pressure steam at high temperatures for an extended period to accomplish this. Boiling isn’t enough, and chemicals can damage your jewelry or leave toxic residues. Used or previously worn jewelry should also be completely avoided as even the most effective sterilizers can't remove someone else's germs. Make sure returns are not accepted and no one is allowed to try on jewelry.
Jewelry for everyday wear should be implant-grade. Materials that meet standards for human implant have been tested and proven safe for you body, especially for extended periods. Manufacturers are also held to higher standards for purity when they make implant materials. While this is most important for new, unhealed piercings, even healed piercings will benefit from implant grade materials. These materials are the least likely to cause allergic reactions or inflammation in the short term. They are least likely to cause long term damage, like damage to nerve endings and blood vessels around the piercing, or damage to internal organs. Beware of generic terms like "hypoallergenic" or "surgical steel" since these terms have no real definition. Also look out for misleading advice like vendors who brag about "grade 23" titanium, which is aircraft/industrial grade, not implant grade. High quality gold (14k or 18k) has had a long history of use inside the body, and may be ok for you. The problem is manufacturers are required to say what else is mixed in, so stay alert for signs of an allergic reaction. It's safe to stick with titanium (ASTM F136 or F67), glass, or implant-grade silicone or Makralon. Read an article from Brian Skellie about the differences between implant-grade titanium and other standards.
Treat other materials as costume jewelry. There are plenty of beautiful materials that may be ok for you to wear for short periods (usually up to 8 hours) but may cause problems. This includes silver, or more traditional/ethnic materials like woods, water buffalo horn, bone, or stone (like for larger ear piercings). These materials shouldn't be worn in the shower or when you're sweating either, as this can damage the jewelry or lead to more serious reactions with your skin. It's also possible that you may be allergic to these materials and simply cannot wear them.
Gemstones should be set with true bezel or prong settings. In these settings the metal of the jewelry securely holds the gem in place. Inferior jewelry has glued on gems. The adhesives can soften at body temperature and/or over time, letting the gems simply fall off.
Use quality synthetic or genuine gemstones. There are now high quality lab-grown (synthetic) gems that mimic or even exceed the color, brilliance, and shine of natural gems. And genuine gemstones are always great. However, foil-backed crystals are another issue. These substitutes rely on a foil backing behind a less brilliant material like glass to produce their sparkle. The problem is the foil can tarnish over time leading to black or discolored gems, or simply wear away. Another issue is that many of the foils used contain lead.
Jewelry should be polished mirror smooth. Not only does this give you the best looking jewelry, it keeps your piercing healthy. Jewelry that isn't properly polished has microscopic roughness that can pick at and callus your piercing over time. This can cause inflammation, toughness, and de-sensitivity. It can also cause significantly longer healing times and more scar tissue if improperly polished jewelry is worn in unhealed piercings.
Stick to nickel-free jewelry. This advice is obvious if you have a nickel allergy, especially since this is one of the most common metal allergies, But even if you don't, nickel bearing alloys can cause damage such as tougher scar tissue and damage to nerve endings and blood vessels surrounding the piercing. The longer you wear jewelry containing nickel, the more damage occurs. This is a big reason that the entire European Union restricted the use of nickel years ago. Many sites will give misleading information about nickel content in their jewelry, especially when it comes to different types of steel.
Don't wear acrylic. The price point may seem appealing, but there are several downsides. Acrylic cannot be sterilized as it melts and cannot be chemically disinfected because it absorbs the chemicals. The material contains known carcinogenic chemicals and is rated as a "slightly toxic" chemical on its MSDS. It chemically breaks down and cracks and crazes at body temperatures. This causes an increased release of irritating chemicals. It also means bacteria can start to grow in the cracks. Acrylic is also a very brittle material and can simply crack or break.