Keloid Scars from Ear Piercing: How They Are Removed by an Aesthetics Doctor

Dr Chin Yee Choong
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"Dedicated to the ethical practice of Aesthetic Medicine"

Ear piercings create small wounds on our ears. Like any wound, our skin forms scar tissues around it as part of the healing process. Usually, the scar formation following ear piercing is minimal, but in pre-disposed individuals, abnormal scars form.

Keloids are one such dreaded scar. Keloid scars are formed when our skin overproduces scar tissues. In fact, they can grow to a size larger than the original wound.

They are characterised by firm and rubbery lumps that occur at the ear-piercing site [1]. Their colours can range from light pink to dark brown. Often, you may feel an itchy or painful sensation around the site.

Treatment methods for keloid scars

It is important to treat ear keloids, as they may grow larger over time. If the keloid is small, you may consider intralesional steroid injections and pressure ear clips.

Otherwise, you may consider debulking procedures ⁠like surgical excision or CO2 laser treatment. Keloids, however, are difficult to treat as recurrence is common.

Intralesional steroid injections

intralesional-steroid-injections

The injection is given to the affected area, beneath the skin. The benefits of a steroid injection are a reduction in keloid size and a lessening in associated pain and itching. The keloid will also become softer. However, there may be a risk of hypopigmentation. 

ProsComplicationsDuration of procedureDowntime
  • Penetrates the thickened skin
  • Reduces the chance of surface skin thinning
  • Delivers high concentration to the infected site.

Immediate:

  • Pain and bleeding
  • Bruising
  • Infection

Delayed:

  • Hypopigmentation
  • Skin depression

 

 10-15 minutesNil

 

Contraindication [2]:

Intralesional steroids should not be used if there is active skin infection ongoing. Patients who have a steroid allergy, which is rare, cannot undergo this treatment.

Pressure ear clips

pressure-ear-clips

Treatment with pressure ear clips has been around for decades, and it remains one of the least invasive treatments for ear keloids [3].

The pressure from the clips reduces blood flow, in turn slowing the rate of keloid recurrence. They can be used after a treatment to prevent recurrence or used to treat small keloids.

However, applying an inadequate amount of pressure can cause complications. Hence, it is important to understand from your doctor the effectiveness and the success of the pressure ear clips he/she provides.

ProsComplicationsDuration of procedureDowntime
  • Least invasive
  • Discomfort at the start.
  • Does not look attractive.
  • Ulceration, leading to prolonged treatment.
To be worn at least 12 hours dailyNil

Surgical excision

surgical-excision

This procedure removes keloids using a surgical cutting blade followed by stitching up the wound. While removal is effective, the recurrence rate is high if performed as a single procedure.

To prevent recurrences, intralesional steroid injections are given to the surgical site after the wound. [4]. Several intralesional steroid injections are usually needed every 3 to 4 weeks. The continued use of pressure ear clips also helps to reduce recurrences.

ProComplicationsDuration of procedureDowntime
  • Maximum immediate reduction of keloid bulk
  • Poor healing
  • Infection
  • Recurrence
30-60 minutes7-10 days

CO2 laser treatment

co-laser-for-keloids-100

The CO2 laser removes the keloid by cutting through it with high precision while stopping bleeding at the same time [5]. The wound created after the keloid debulking takes 4 to 6 weeks to heal. To reduce the recurrence of the keloid, post-laser intralesional steroid injections are recommended [6]

3 to 4 weekly injections are recommended for half a year. The continued use of pressure ear clips also helps reduce recurrences.

ProsComplications  [7]Duration of procedureDowntime
  • Able to debulk larger keloids with minimal bleeding.
  • Infection
  • Pigmentation
  • Scarring
  • Redness, swelling and itching
    • Redness may persist for months
30-60 minutes3-6 weeks

 


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Dr Chin Yee Choong is a medical director at DermClear Aesthetic & Laser Clinic. His area of practice is in the beauty aesthetics fields of dermatology and aesthetic medicine. In addition, he has had more than 12 years of experience in thread lifts and fillers. He also regularly travels to keep himself well-informed of the newest treatments available.

Would you like to ask any related health questions?

Read more from Dr Chin Yee Choong in his Q&A here.


Read more: 8 Dermatologist Clinics in Singapore for Your Skin Concerns (2020)


References:

1. The Children’s Hospital of Philadelphia. Ear Keloids | Children’s Hospital of Philadelphia. Chop.edu. Published July 30, 2014. Accessed December 17, 2019.

2. Intralesional steroid injection | DermNet NZ. Dermnetnz.org. Published 2019. Accessed December 17, 2019.

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