A keloid is a firm, raised overgrowth of scar tissue that extends beyond the original wound. The earlobe is one of the most common places for keloids, usually after piercing. They are harmless, but they can be itchy, tender and noticeable, and they tend to come back unless treated carefully.
Keloid or hypertrophic scar?
A hypertrophic scar is raised but stays within the boundary of the original wound and often improves over time. A keloid grows beyond the wound, can keep enlarging for months or years, and rarely settles on its own. A small bump at a new piercing may also be a piercing bump or infection rather than a keloid, so it is worth having it assessed.
Why do keloids form?
Keloids are caused by an overactive healing response in which too much collagen is produced. You are more likely to develop them if:
- you have a family history of keloids
- you have darker skin
- you are between your teens and your thirties
- you have had a keloid before
Treatment options
- Steroid injections: injected into the keloid every few weeks to flatten and soften it. Often the first treatment for small keloids.
- Surgical removal: the keloid is carefully cut out and the earlobe repaired. Surgery alone has a high recurrence rate, so it is usually combined with steroid injections afterwards.
- Pressure earrings: worn for several months after removal to reduce recurrence.
- Silicone gel can help the healing scar.
Stubborn keloids that return may need specialist treatments such as radiotherapy, arranged through a specialist centre.
Can I re-pierce my ear?
If you have formed a keloid, you are at risk of forming another with re-piercing. Mr Nassab will advise whether and when re-piercing might be reasonable, usually not until the area has been stable for several months, and never through the old keloid site.
Recovery
Earlobe keloid removal is usually a short procedure under local anaesthetic. Stitches are removed after about a week, followed by review and injections as needed.
Frequently Asked Questions
Will an earlobe keloid go away on its own?
Keloids rarely resolve without treatment.
Can a keloid come back after removal?
Yes. Recurrence is common after surgery alone, which is why injections and pressure earrings are used afterwards.
Are keloids dangerous?
No, they are benign, but any rapidly changing lump should be checked.
Can I have a keloid removed under local anaesthetic?
Yes, earlobe keloid removal is usually done under local anaesthetic.
