Influencing cosmetic industry practice through sharing learning from a Pseudomonas aeruginosa ear piercing infections outbreak in the South West

Description of impact

In September 2023 a cluster of infections was linked to a tattoo and cosmetic
piercing studio in South West England. Ten clients experienced perichondritis
following upper ear cartilage piercings; seven required hospital admission and threerequired surgery. The source was traced to a contaminated water heating system within the studio.
UKHSA South West Health Protection Team convened a multi-agency incident
management team (IMT) to investigate. Using microbiological, epidemiological and environmental methods, the team confirmed a genetic match between clinical and environmental isolates through Variable Number Tandem Repeat (VNTR) profiling. This provided conclusive evidence of transmission from the water system to the
clients. The IMT worked with the business to implement infection prevention and control improvements, including replacement of the contaminated heater. Beyond resolving the outbreak, the team recognised an opportunity for broader impact: they developed new national guidance for the cosmetic piercing industry, delivered training to the Environmental Health workforce and published findings in scientific literature. This work has since shaped national surveillance priorities across the UK.

Impact date	6 Aug 2025
Category of impact	Health impacts