It is nine years since Pauline Clarke wrote The Eye of the Needle, about the then largely fetishistic art of body piercing. Pauline owns and manages a shop in Nuneaton, Warwickshire, which sells every kind of decoration for every conceivable kind of piercing in every conceivable part of the body. Her mail-order business serves the piercing enthusiast searching for adornments for everything from eyebrows to genitals. The shop, Piercing World, is increasingly popular and will soon be installing a state-of-the-art piercing studio.
Nuneaton is not exactly a stronghold of the avant-garde, but then body piercing is no longer the preserve of the rebellious and the marginal. A practice adopted in the 1960s by a group of gay men for private pleasure, and subsequently taken up by punks, goths, grungies and dedicated explorers of body expression, has hit the high streets of middle England and is being adopted by young people at an increasingly earlier age.
Navel piercing among young women is almost as popular as ear piercing, and it is possible to get your nose done in the most respectable of department stores.
As the girl-gang culture promoted by the Spice Girls becomes popular among an ever younger age group, the repercussions of Melanie B's pierced tongue are being felt in schools. Only recently, Mizz magazine, a popular read among 13-year-olds, hailed piercing as the "coolest thing since Brit pop".
Rachel Totten is headteacher of Whitby Community College, in north Yorkshire. Since a piercing studio opened in town, she has had four or five Year 11 pupils with pierced eyebrows and between 10 and 15 with pierced noses, while PE staff have become aware of a rise in navel piercings. Some sixth-formers, she says, have been pierced "copiously".
"For some it's an act of bravado, a challenge," Ms Totten says. "For others, it goes with a very individualistic style of dressing; but for many it's just fashion, it's conventional - and their parents do it as well."
Supermodel Naomi Campbell has her belly button pierced; Stella Tennant parades her bejewelled and sometimes chained piercings in ears, nose, lip, chin, mouth and nipples on the international fashion stage. Jean-Paul Gaultier has incorporated the practice into his designs. Fashion has always been effective in taking outrageous ideas and making them part of mainstream culture.
Traditions of body decoration, such as tattooing in Japan and piercing among peoples in places such as South America, Polynesia, India, and New Guinea, have increasingly been appropriated by the West. Images from the pages of National Geographic magazine or from picture books such as The Decorated Skin - A World Survey of Body Art (Thames and Hudson) have been transformed by the catwalk and so find their way into the everyday.
Pauline Clarke is 59. She has 30 piercings as well as an intricate floral tattoo running the breadth of her back and chest. Into her shop come mothers and daughters, fathers and sons, of all ages and income brackets, looking to enhance their multiple piercings through ears, eyebrows, lips and nose with bolts and rings of varying weights, sizes and thicknesses. Piercing, Pauline believes, is part of an atavistic desire to adorn the body that has been long suppressed but is now accepted in the West. Much has changed in the last nine years.
Helen Baker Alder, head of fine art in the faculty of art and design at the University of Northumbria, Newcastle upon Tyne, says that the multiple piercings worn by many of her students represent a "host of signifiers". She explains: "Some of it's about gender and gay issues, but for others its about travelling and ethnicity. It's really rather sweet and child-like, not at all militant."
At York College of Further and Higher Education, one group of 19-year-old fashion students have all had their navels pierced. Exposed midriffs are de rigueur among the fashion-conscious and part of youth club culture. "I think it's just really pretty, really sexy," says Joanna Oak. Grant Pattison is 18 and studies sculpture. He has several nose rings. "It's good that different ways of decorating and expressing yourself are becoming acceptable. It makes life more interesting," he says.
Pauline Clarke received a phone call recently from a teacher in the south of England. "The school had discovered a boy with a genital piercing and this teacher decided pupils should do a project about the whole subject of body piercing. They were going to make a video about it," says Pauline.
Genital piercing might be a minority pursuit, but, over the past 12 months, schools that have tolerated girls wearing studs in their ears have seen an increase in the number of girls - and boys - sporting a much wider range of facial and bodily adornment.
Frank Vigon, headteacher of Turton High School in Bolton, one of the country's top academically achieving comprehensives, has noticed tell-tale holes in the faces of his under-16s, even though it is not allowed. Only in the sixth form, where jewellery has crept in, are there girls with bejewelled noses, eyebrows, and navels, a few boys with pierced eyebrows, and one with a ring through his nose. He says: "In my school it's very much a middle-class thing. They don't think it's rebellious; they are really very conservative. They think it looks fashionable, and they like the decoration."
Mr Vigon sees it as part of the eclecticism of modern fashion. "I've got boys in my school with brylcreemed hair like their grandfathers in the 1930s, with piercings straight out of the National Geographic, expressing a desire for a Home and Away style of school uniform, which is discouraged. It's a very confusing picture."
Few heads were prepared to discuss the issue of body piercing among pupils; it remains a taboo subject for managers who do not wish their schools to be associated with the practice. Most said they did not allow any piercing jewellery to be worn on safety grounds, and that it simply wasn't an issue in their school . This is a surprising and worrying attitude, given the popularity of piercing among the young and the related risks of infection.
Those heads who did talk were concerned about health issues. Ms Totten was horrified when two of her pupils returned from a school residential trip having pierced their own eyebrows. Although she makes it clear that pupils should not have piercings, she does try to counsel them about the risks. "We've had real problems in the last 12 months. Some of our girls have had infections from belly-button piercings. Because they are concealed under belts or waist bands they tend to get knocked or pulled. It's also hard to keep nose piercings clean.
"I think there is a problem with young kids doing something to their bodies that can leave scarring when they are so unclear about what kind of person they are, but above all they are risking their health and we have to deal with that."
Joanna Oak, at York, pierced her own lip after she'd had "a fair bit" to drink. "I stuck a pin through with lots of ice, TCP and Savlon," she says. Grant Pattison saw a do-it-yourself lip piercing performed on a friend. "He decided he wanted his lip done when he was out in a pub, so this guy stubbed a cigarette out on his lip and stuck a safety pin through."
It costs about Pounds 20 in a reputable studio to have a piercing with a basic, appropriate jewel, so some young people inevitably do it themselves. Responsible practitioners are reluctant to perform body piercings on minors as legally it can constitute assault.
Norman Noah, professor of public health and epidemiology at King's College, London, says that young people who pierce each other are "playing with fire", putting themselves at risk of contracting Hepatitis B and C or even Aids. Hepatitis B, which can be fatal, is highly infectious and resistant to treatment. "You don't even have to pierce the skin. Breaking a few skin scales would be enough," Professor Noah says.
However, the choice of piercer and nature of the aftercare can be just as crucial in reducing infection. Simon Fraser, a jeweller, says that the last four or five years have been "absolute mayhem". He says: "A lot of people are going into piercing just to make money. There are some very good piercers about, but there are a lot of cowboys."
The Department of Health is currently circulating a consultation document to tighten up the laws concerning body piercing. Although tattooists and ear piercers have to register with, and are inspected by, the local authority, body piercers are not regulated in this way and there is nothing to prevent anybody setting up in practice.
Dr Richard Staoghton, a dermatologist at Charing Cross Hospital in central London, says there is a real risk of septicaemia from body piercings, especially if they are done "under less than ideal conditions or cared for inappropriately" and have become infected. "Appalling scarring" can also occur.
Some people are susceptible to keloid scarring, whether there is an infection or not. "A keloid is a big, matted hard lump that can be very disfiguring and there is no knowing whether somebody is prone to these or not. It is more common than you would think," says Dr Staoghton.
The cartilaginous part of the ear above the lobe, says Professor Noah, can become "unbelievably disfigured" if infected. Twenty per cent of all people, warns Dr Staoghton, are allergic to bright metals such as nickel.
Professor Noah has updated his department's Guide to Hygienic Skin Piercing, which has been sanctioned by the Department of Health, to include new forms of body piercing in an effort to reduce the dangers of Hepatitis B, Hepatitis C and transmission of Aids to piercer and piercee.
These guidelines have been adopted by the Piercing Association UK, a body of professional piercers headed by Pauline Clarke, which has become increasingly concerned by the rising incidence of infection among young people.
"I do think teachers should try to talk to pupils," she says, "to take an interest, but advise them that they might be better to do this when they are older. If kids are going to have it done anyway, they should be educated about the health implications so they know whether proper procedures are being followed."
The King's College guidelines
* Administration of local anaesthetic injections other than by medically qualified practitioners is illegal. If performed incorrectly it can be extremely dangerous.
* Disposable syringe and needle in pre- sterilised packets should be used. They must not be used on another person.
* All surgical instruments in contact with broken skin and all jewellery to be used for piercing should be put through a benchtop steam steriliser first.
* A "no-touch" technique should be used as much as possible to reduce the risk of skin and soft tissue infections. Disposable rubber gloves should be worn.
* The piercer should have a licence from the local authority to carry out piercings on suit able premises. The piercer should be dressed in clean clothing and hands should be kept thoroughly clean.
* Jewellery should be of top-grade surgical steel or high-carat gold.
* Once inserted, the jewellery and pierced area should be kept dry and touched as little as possible. Disinfectant (out-of-date disinfectant can harbour organisms) and antibiotic creams should not be used without advice from a qualified doctor. In this respect bottles of disinfectant fluid supplied by ear piercers can constitute an extra hazard.
* A pierced navel should be kept clean and dry and covered by loose clothing. Belts are not advisable.