The needles come in sterile, single-use packaging and are ready to use right out of the box. The sizes used most often run in the high 20 gauges, i.e. 25g or 27g which is like a slightly large acupuncture size. The image to the right here shows the effect of having birthday cake-sized candles stuck into the plastic caps on the ends of the needle tips and then lit. The warm candle wax adds sensation but does not burn the skin and the visual effect is very striking.When doing play piercing, protective nitrile or latex gloves should be worn. These minimize transmission of blood-born diseases and reduce the chance of introducing infectious agents. A “sharps” container is essential, as it refers to a medically-approved container for disposing of needles or any related hardware. These temporary piercings can be worn in the skin for just a few minutes, or for a few hours. Capping the points with small corks is recommended for extended wear. The needles can also be used like anchor points and string or yarn can be looped around the needles to form geometric patterns against the skin.
In a city like San Francisco, you will sometimes see play piercing done as performance art, especially in the fetish community. The pictures on the left came from a performance at a fetish-themed club event. The London performer Luci Fire sang a torch song while play piercings with candles were pierced and lit along her arms. This image shows her removing the needles herself and dropping them into a bottle. Sometimes you also see performances of flesh hook suspension. On occasion, piercing groups have staged large group hook rituals or Ball Dances (literally small balls or bells are sewn all over the participants). These can be anything from performance art to focused spiritual workings.Some roots of modern piercing rituals can be seen in rites performed by Hindu-based sects in Southeast Asia. The Tamil held kavandi rituals, where the dancers “wore” large frameworks to hold long metal spears which would be used to pierce the skin. Each frame would hold two dozen or more of these spears. More modern rituals are still conducted by these people and the custom has shifted from the kavandi to skin hooks. Participants now often have anywhere from a half dozen to two dozen metal hooks pierced into the skin of their backs and they pull against ropes held by friends who pull back, carefully controlling weight and tension. This ritual is done as a walking pilgrimage along a sacred route. Their religion believes in worship through or in the body and see these intense endurance rituals as offerings to their gods.
There are also records of Aztec culture and images showing tongue piercing, especially offerings made by members of nobility to gods on sacred holidays. They show the use of long cactus spines or ropes of thorns for the tongue piercing process, and often a ritual bowl was used to catch the blood. This too was seen as an offering to the gods.

