This product is designed to pierce the ear with the universal ear piercing instrument. They are packaged by the pair on plastic mounts and sterilized. Any product that pierces the skin is required by the AMA (AMERICAN MEDICAL ASSOCIATION) to be sterilized. Wearing gloves is not considered sterilization. Your hands cannot be sterilized. Any product that only touches the skin should be sanitized. The instrument is spring loaded and pierces the ear in a 10th of a second once the trigger is pulled. THE BLACK UNIVERSAL EAR PIERCING INSTRUMENT IS REQUIRED TO PIERCE THE EAR. The studs/styles used to pierce the ear are made out of surgical stainless steel (same material as a surgical instrument), which is also an AMA requirement. If the piercing stud is gold, it is 24 ct. gold that is electro- plated over the surgical steel. Electro-plating is a process where the gold is attached to the surgical steel with an electrical current in water. The bond is very strong and the gold should stay on for at least a year or longer. 24 ct. gold is the only gold that is pure and does contain nickel. Nickel is an alloy (Copper, iron, etc. are other examples) that is used to harden pure gold and metals. People have varying degrees of sensitivities to nickel and thus the 24 ct. (no nickel) should prevent sensitivities on a newly pierced ear. This training stud should be worn for 3-4 weeks without removal. At that time it should be replaced with a similar material (no nickel) earring. This replacement earring (can be interchanged) should be worn day and night for the following 4 months. The total healing time for a newly pierced ear is about 5-6 months. Very important, the replacement earrings for the 4 month period should be at least 14 ct. gold or higher. The advantage of using the Universal system is the cost. They generally range in the price range of $3 to $8 (Sally's Beauty Supply). THE RETAIL PRICE TO CHARGE THE EAR WITH THIS SYSTEM IS $20-$30./br/brSize: Mini. Each pair individually packaged with all 12 pair together on a flat sheet. 12 Pair Mini Gold Stud April Birthstones in Bezel setting. April. Surgical Steel Ear Studs./br/brGTIN: 796433441335 048675120418. Best Sellers Rank: See Top 100 in Beauty & Personal Care. : B00197VEVC. Manufacturer: Studex. UPC: 796433441335 048675120418. Product Dimensions: 0.25 x 0.08 x 0.45 inches 3 Ounces. Is Discontinued By Manufacturer: No.