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Ear Keloid

What Are Ear Keloids?

Keloids are overgrowths of scar tissue caused by trauma to your skin. They’re common after ear piercings and can form on any part of the ear, to the lower earlobe or along the more cartilage portion of your ear. When we get an ear piercing, there is a small trauma to the piercing site that normally should heal with scar tissue.  Sometimes your wound healing abilities goes into hyper-drive and your body makes too much scar tissue, leading to hypertrophic or keloid scars. From a cellular level, there is increased collagen synthesis and decreased collagen breakdown, resulting in raised scar tissue that extends beyond the original margins of the wound. This causes a bump or small mass that’s larger than the original piercing, after on both the front and back of the ear. In some people, they experience keloid scarring as a result of removing their ear piercing or after an infection.

Ear keloids affect people of different races and is a challenging problem to treat. There are different types of non-surgical and surgical treatment options, with variable effectiveness and risk of recurrence. The most common non-surgical therapy is intralesional corticosteroid injections (injected into keloid scar) to help shrink it, relieve symptoms, and make it softer. Injections are performed every four to six weeks until the keloid improves.  According to the American Academy of Dermatology, about 50 to 80 percent of keloids shrink after treatment with injections. Keloids that have minimal response to steroid injections can be excised followed by postoperative intralesional corticosteroid injections and pressure therapy.

What To Expect During The Procedure

Ear keloid surgery is performed under local anesthetic, and while you may feel some movement and light pressure on your ears, you should not be in any discomfort while the surgery is carried out.  Depending on the size and location of the keloid, it may be possible to remove the entire keloid (extralesional excision). If closure of skin is not possible without tension, the firm keloid will be “cored out” from the surrounding keloid skin (intralesional excision), which will be used as skin flaps for closure of the wound. The ear incisions will be closed using dissolvable sutures at the back of the earlobe and non-absorbable sutures on the front of the ear. The non-absorbable sutures will need to be removed at 7 days. Polysporin and a dressing will be placed immediately after the procedure.

What to Expect During the Recovery Period

Patients should keep their incisions dry for 24 hours. There may be some minimal bleeding from the incision for the first few days, so we advise placing a towel over your pillow. Pressure can be applied if there is some bleeding.  Swelling and some mild discomfort is normal after the procedure, and Tylenol or Advil can be taken.  A thin layer of polysporin should be placed over the incision every day until the sutures from the front of the ear are removed. Heavy exercise should be avoided until the sutures are removed.  The incisions will be red after the sutures are removed. Swelling and redness of the incision will continue to fade. After 2 weeks, it is important to receive corticosteroid injections to the scar to help avoid keloid scar recurrence.   Scar massage is recommended at 2-3 weeks to help soften the scar tissue. Scar tape or gel can also be used, with the window of opportunity being 1-6 weeks to improve the scar. We also highly recommend pressure therapy, either with a clip or screw on earring to the lobule of the ear, or having a custom Earpress Pressure Device made, especially if the cartilage is involved.   Please visit