I have, errm......six holes in my ears.
1st set was done with a sanitised needle at a gold jewellery
shop.
2nd and 3rd was done with those guns. Faster, quicker
& in one swift motion, insert in the surgical
steel earstuds at the same time.
They will wipe your earlopes with antiseptic wipes, so
there isnt really a issue with cleaniness. If you like, can
request they wipe the metal bits of the gun before they apply
it onto your ears.
BTW, there is some fengshui issues about piercing ears, my
sister disapproved my ear piercing because metal goes thru wood.
(which is my birth year signs.)
And red colour gems burns wood. So you might want to
consider those fengshui thingy when piercing ears.