Body piercing studios in the high street are now almost as familiar as a certain ubiquitous hamburger chain. Sporting jewellery through navel, nose or nipple has become a very mainstream fashion statement. So it is only when a rare case such as that of 39-year-old Lesley Hovvells of Llanelli, south Wales who died of septicaemia following 118 piercings, hits the headlines that we are reminded of the medical dimension.
A verdict of misadventure was recorded on Hovvells at an inquest last week. Coroner William Owen said: "There is a considerable risk in body piercings unless hygiene is maintained. Miss Hovvells neglected these precautions and died as a direct result."
The hygiene practices of both the piercer and the pierced are absolutely crucial to prevent potentially fatal septicaemia or other infections, but as long as sensible precautions are taken, complications are unlikely to arise. Risks exist because of inconsistencies in current legislation. Cowboy piercers outside London can operate legally without a local authority licence - only London boroughs can license piercing premises after carrying out checks to ensure that they use sterile equipment and give clients proper advice about aftercare.
Anna Kai was one of the first female body piercers to move into what was, in the early 90s, a very male-dominated scene closely linked to tattooing. Now she runs one of the biggest body-piercing operations in the UK, the Manchester and Leeds Bodypiercing Company. She is worried about under-16s who are dedicated followers of fashion but have little awareness of the dangers.
"We always turn children away but there's a piercing business I know of which makes between £800 to £1,000 a week out of business we refuse to take on." Kai takes the medical aspect very seriously - she spent three years at medical school before gaining a qualification as a radiographer and paramedic.
"Apart from scrupulous hygiene there are two main things to be aware of - people fainting during or after a piercing, and bleeding," she says. Her customers have to fill out a very detailed medical form and she urges them to be frank about any medical condition, even if they don't consider it to be relevant.
"One person had psoriasis on her arm but didn't mention it when she came to have her navel pierced. She returned after the piercing saying she had developed psoriasis in her navel. She hadn't mentioned the condition because she'd never had it around the navel and didn't think the fact that she had it on her arm was relevant."
Sometimes medical conditions can reveal themselves for the first time during a piercing. "If someone faints we check their blood pressure for a while before letting them go. One man didn't recover very well and I suspected his blood sugar was low. We took him to hospital and he was diagnosed as having diabetes."
People who seek out piercing will often not own up to having conditions like HIV or Hepatitis C. "We treat everyone as if they have something very infectious, as that's the only way to be safe," says Kai.
Health issues are not always uppermost in the minds of those who seek out piercings. According to James Glover, a north London piercer who has 24 piercings, aesthetics are a major consideration: "For some people getting a new piercing is the same as getting a new outfit or a new hairdo. Having a piercing done can be slightly painful and there is a sense of having achieved something."
After its cult beginnings, piercing has been propelled into the mainstream. So sanitised has it become that even Barbie was set to add a nose stud to her fluffy pink wardrobe - toymakers Mattel dropped the plans only when parents voiced opposition.
Social psychologist Dr Martin Skinner believes that it has always been a way of controlling how the body looks. "Someone with a lot of body piercings takes the initiative in an encounter. A piercing is very in-your-face, it's almost like a wound. Someone with piercings does not look soft and sweet, you are forced to look at them on their terms."
While piercing is often seen as an expression of individuality he believes there is also an element of belonging to a club. He also argues that even those who have scores of piercings are not addicted to the practice but rather demonstrate the qualities of a collector. "It's a consumer thing, like acquiring a new car or a new pair of shoes."
But for some trendsetters the buzz has begun to pall. Slicing the tongue down the middle to create a forked effect and placing small Teflon beads under the skin to create a scaly appearance are the newest crazes. Kai and others say they want to wait and see what the medical implications of these latest forms are before deciding whether to add them to their repertoire. So it may be a while before models sashay down the catwalk with chopped tongues and beads from their dresses sewn into their skin.