Surgical and compressive treatment of ear lobe keloids

SUMMARY Background: Keloids are the result of a pathological cicatrisation process in which fibroblasts synthesize excessive amounts of collagen. The etiology these scars in not known. Ear lobe keloids are associated to the use of earrings, piercing, trauma, burns and surgery. Apart from the esthetic consequences, keloids may cause pain, pruritus and paresthesias. The management is controversial and includes surgical and non surgical procedures. Aim: To report the results of the treatment of ear lobe keloids. Material and methods: Retrospective revision of medical records of nine patients (aged 7 to 78 years, seven females) with ear lobe keloids. All keloids were surgically removed and one week after removing the sutures, compression was started with individually designed devises. Patients were followed for six months to three years. Results: Only one patient experienced a relapse of the keloid and was successfully treated with local infiltration with corticoids. All patients have soft, flat and asymptomatic scars. Conclusions: Compression can notably improve ear lobe keloid treatment. A treatment algorithm is proposed.