What is a keloid?

The natural response of the body to a traumatized tissue is the scar. The wound healing process has three different phases: the first is the inflammatory phase, the second - the proliferative phase or the granulation phase and the third is the remodeling phase or the maturation phase. When there is an imbalance between anabolic and catabolic phases of the scar formation, the result is the appearance of a pathologic scar. Two types of excessive scars are described: hypertrophic scar and keloid, as a result of an aberrant healing process. The difference between the two entities is a hot topic in the medical literature. 

Epidemiology of Keloid scar

The keloid scar was observed to occur in individuals of all races, but more frequently in the darkly pigmented individuals (6% to 16% in African populations). It is about 15 times greater in dark skin individuals than in whites. Higher incidence was observed during puberty and pregnancy, periods with hyperactivity of the pituitary gland.

The keloid scar has a genetic predisposition and an autosomal dominant inheritance pattern was demonstrated.

What is a keloid on the ear?

An ear keloid is a type of fibrous scar tissue that forms after an injury. Unlike other types of raised scars, an ear keloid extends beyond the original injured area. They can form anywhere on your ear, including earlobes, cartilage or behind your ears. Most people who have ear keloids develop them after getting their ears pierced.

Characteristic of Keloid scar

  • May appear after months
  • Grows beyond the boundaries of the initial wound
  • Rarely improves, usually develops with time
  • Raised, firm, pruritic, painful
  • Do not spontaneously regress
  • Occurs on the ear lobe, sternal notch, shoulders, upper back, back of the neck, cheeks
  • Associated with dark skin

Treatment options for ear keloids

  • Surgical excision
  • Intralesional injection of corticosteroids
  • Compressive therapy
  • Radiotherapy
  • Laser therapy
  • Cryosurgery
  • Therapy with antitumor or immunosuppressive agents
  • Combinations of these methods. 

To Conclude

The aesthetic considerations of ear keloid are serious, especially in young patients. Numerous management strategies have been proposed for ear keloid treatment but none of these is ideal. Better results are obtained using various combinations of the therapies mentioned above than in monotherapy.