Keloids on ear: definition, causes and possible treatments

Ear keloids: firm, rubbery, fibrous nodule

Keloids are skin abnormalities that resemble scars but are larger in size. Ear keloids, in particular, are quite common and often develop as a result of piercings or earrings. They are characterised by excessive swelling of the ear. To understand more about keloids, it is important to explore why they form, the underlying causes, and how to effectively treat and manage them.

What is a keloid?

Keloids are fibrotic lesions that occur on the skin as a result of an abnormal healing response to various types of injuries, such as

trauma
abrasions
surgical incisions
burns
piercings
earrings.

These lesions form due to a disruption in the control mechanisms that regulate the balance between tissue repair and regeneration. Unlike regular scars, keloids grow excessively from the initial wound site, extending well beyond its boundaries, and they do not regress naturally over time. They can develop within a year of the injury, particularly in cases of second-intention wounds (where the wound edges cannot be closed together due to the risk of infection or significant tissue loss), especially if they take more than 3 weeks to heal. Factors such as

prolonged inflammation
infection
burns
inadequate wound closure
repeated piercings or trauma

can also contribute to keloid formation.

What do ear keloids look like?

To gain insight into the appearance of keloids, it is worth exploring the origin of their name, which is derived from their distinctive shape. The term "keloid" was coined in 1806 by dermatologist Jean Louis Alibert due to the resemblance of certain keloids to crab claws. Keloids manifest as excessive swelling of the earlobe, which becomes shiny and devoid of hair. While keloids do not typically cause pain or result in hearing loss, they can have a significant impact on one's self-esteem and social interactions.

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What causes a keloid on my ear?

The primary causes of ear keloids, characterized by excessive swelling of the earlobe, are typically associated with prolonged inflammation, infection, or chronic inflammation resulting from piercings.

Keloids from piercings

Keloids commonly occur at piercing sites when the body tries to repair the hole by producing collagen, but this process gets disrupted. The exact reasons for keloid formation are not fully understood, but some researchers propose that it could be due to inflammation caused by contact between the metal components of earrings and the earlobe. Neglecting proper piercing care can worsen keloid development, although they can sometimes form regardless of meticulous care. It's important not to squeeze or manipulate keloids like pimples, as it can damage the skin and make them worse. If a keloid forms around a piercing, it's advisable to consult a healthcare professional. They may suggest removing the earring and using a pressure earring or keeping it in place until a physical examination can be conducted.

Who is more likely to get keloids?

Keloids can affect anyone, but certain individuals are more prone to developing them than others. Generally, women have a higher susceptibility compared to men. Additionally, studies indicate that individuals of Hispanic, African, and Asian descent have an increased predisposition to keloid formation, in addition to factors such as personal susceptibility and family history. Furthermore, keloids tend to occur more frequently in individuals between the ages of 10 and 30.

Does melanin cause keloids?

In recent years, a study has revealed a connection between the concentration of melanin and the collagen density within keloid tissue. This finding aligns with the observation that keloids are more commonly found in individuals of African, Hispanic, and Asian descent. Ongoing research is being conducted to gain a deeper understanding of this specific relationship and its implications.

What are the symptoms of an ear keloid?

Some keloids are associated with symptoms such as pain, itching or burning sensation around the scar. In some cases, they may cause discomfort, pain to the touch or even hypersensitivity at the site where they developed.

Step 1: slow development

Typically, keloids have a gradual onset and may take anywhere from 3 to 12 months to develop. In the case of ear keloids, they often begin as raised scars that appear pink, red, or purple due to their rich blood supply. They can assume various shapes, such as round or oval. Initially, keloids are raised scars, and the skin appears smooth, hairless, and translucent.

Step 2: the growth

Keloids exhibit slow growth, causing the skin to stretch and elevate beyond the boundaries of the original lesion. The colour often transitions to pink, and the texture becomes thick and rubbery. When touched, keloids have a combination of soft and firm characteristics. Over time, the affected skin may darken compared to the surrounding skin, while the absence of hair or sweat glands persists.

Step 3: pain, itch, or burning

During the formation of keloids, individuals may experience itching in the affected area, along with potential pain, burning sensations, and reduced sensitivity. These symptoms arise due to the growth of the skin, which is sensitive, somewhat inflamed, and less elastic compared to the surrounding skin. Itching is typically mild initially but can intensify and become persistent, leading to a temptation to scratch, which can exacerbate the condition. At this stage, chamomile extract can offer relief. It is a traditional remedy known for its soothing properties and can help alleviate discomfort in the affected area, preventing further aggravation.

Step 4: different color

Over time, keloids undergo changes in both colour and shape. They initially start as raised scars with a pink, red, or purple hue, primarily influenced by the high vascularity in the area. As they progress, keloids transform into raised scars with a smooth surface. The colour gradually darkens over time, compared to the surrounding skin of the affected individual.

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How do you get rid of a keloid on your ear?

Keloids are typically non-malignant in nature, but many patients seek specific interventions to enhance their aesthetics. The interventions employed vary depending on the location of the keloid. Generally, it is challenging to prevent their occurrence except by avoiding unnecessary surgeries, particularly cosmetic procedures, or piercings for individuals prone to keloids. Over time, various pharmacological treatments have been developed to help reduce the size and thickness of keloids.

At-home treatment

When dealing with keloids, it is advisable to consult a specialist for appropriate treatment. Early identification and intervention are key. In some cases, certain treatments can be utilized at the first signs of keloid development. This may include the application of creams containing vitamin E and antioxidants, as well as the use of chamomile extract, which is known for its soothing properties and effectiveness against itching and burning sensations on the skin.

Surgical removal

Surgically removing a keloid, whether from the ear or any other body part, is generally considered counterproductive. As we've discussed, keloid formation is often influenced by individual predisposition, and surgical removal can potentially lead to the development of new, larger scars, rendering the removal ineffective and possibly exacerbating the condition. Typically, surgical treatment for keloids is pursued only after exhausting other therapeutic approaches, and it involves complete excision, always taking into account the high risk of recurrence.

Corticosteroids

Corticosteroids is a commonly employed treatment for keloids. Cortisone injections are administered once a month directly into the keloid to reduce swelling and make it less prominent. This approach is particularly suitable for treating keloids in the ears. The procedure is generally tolerable in terms of discomfort and considered safe, with noticeable improvements. After several treatment sessions, the keloid typically becomes flatter and less noticeable. However, it is important to note that despite these benefits, there is a significant risk of keloid recurrence.

Cryosurgery

Cryotherapy is another treatment alternative to reduce the size of keloids. It involves freezing the affected area using liquid nitrogen. However, it is important to note that cryotherapy has a limitation, which is the potential occurrence of hypopigmentation. This refers to a loss of skin pigmentation and progressive lightening of the skin tone in the treated area.

Laser treatment

Laser treatment is a commonly employed treatment method for reducing the appearance of keloids. The laser works by flattening the affected area, making the swelling less noticeable over time. This treatment is considered effective, safe, and generally painless. However, multiple sessions are typically required to achieve satisfactory results.

Radiation treatments

Radiotherapy treatment can be utilized to flatten or minimize the visibility of keloids. It often yields positive outcomes; however, it is not always recommended due to potential long-term side effects, including the risk of skin neoplasms (abnormal tissue growth). Therefore, the decision to pursue radiotherapy as a treatment option for keloids should be carefully evaluated, weighing the benefits against the potential risks.

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Frequently asked questions about keloids

Do keloids hurt?

Keloids typically do not hurt, but they can occasionally trigger symptoms such as itching and localized discomfort. Generally, the impact of keloids is more psychological than physical, leading to a decreased quality of life for individuals who may feel compelled to hide the affected area, avoid explaining the condition to others, or even avoid eye contact. Itching and pain associated with keloids are commonly experienced during the formation phase.

Can a keloid turn into cancer?

No, keloids cannot transform into tumours. Keloids are considered hypertrophic scars that develop when the skin undergoes trauma and elevates beyond the skin's surface. They are benign in nature and can be effectively reduced through the treatment options mentioned earlier, following consultation with a specialist.

Can you pop an ear keloid?

No, a keloid cannot be popped like a pimple, as it is a different type of skin condition. However, there are various methods to reduce the size and prominence of a keloid after consulting with a medical professional. These may include treatments such as injections, cortisone therapy, or other approaches aimed at minimising the raised appearance of the keloid.

Do ear keloids go away on their own?

No, keloids do not spontaneously disappear or naturally flatten and diminish over time, as is the case with hypertrophic scars. To effectively reduce the appearance of a keloid, medical intervention is necessary. They can identify and recommend the most suitable treatment options for addressing keloids.

Are ear keloids contagious?

No, keloid scars are not contagious. They arise solely from alterations in the normal wound healing process and are not transmissible from person to person. While there may be a familial predisposition to their development, keloids should not be considered contagious in any way.

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Keloid on ear