Thursday, August 25, 2011

Pressure Treatment of Auricular Keloids

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active.

I have written of keloid treatment (general, not site specific) previously.  I have always tried to include pressure treatment as part of the plan when treating keloids of the ear lobe.   This pressure treatment came in the form of pressure earrings  -- clip-on, disc-shaped. 
The recent article (full reference below) in the Archives of Facial Plastic Surgery journal introduces a new pressure device which looks like it will work better than what has been available (photo credit) 
and as can be seen in this photo the upper ear can be treated with pressure which has not been possible with the clip earrings. (photo credit)

These devices were custom made which makes them more expensive than off-the-shelve pressure earrings and may make them difficult to get if no one is available in your area to make them.
From the article:
Pressure therapy was popularized in the 1970s after clinicians noticed that pressure stockings used over lower extremity burns caused scars to mature faster with decreased erythema and thickness.  Pressure causes localized hypoxia, resulting in fibroblast degeneration and disintegration owing to decreased intercollagenous cohesion and increased collagenase activity.
Furthermore, pressure has been shown to shorten scar formation time, reorient collagen fibers within the scar to become parallel to skin surface, increase hyaluronic acid levels, and decrease chondroitin sulfate levels, all of which help to flatten the initially elevated scar tissue and reduce recurrence rates.
According to various reviews and guidelines, pressure therapy is a long-standing therapeutic option for keloids, producing thinning and pliability. Although the precise biomolecular mechanism of compression is not understood, success rates of at least a partial reduction of derailed scars, from 60% to 85%, have been reported from a monotherapeutic regimen of pressure therapy. The combination of surgery with postoperative pressure treatment showed good response rates of about 90% to 100%, especially after excision of auricular keloids. ………
Overnight use of the new pressure device seems to be an effective extension of established auricular keloid therapy, with additional potential for prophylaxis of recurrence. Preliminary work was presented and intended to produce a demonstration of an optimized treatment modality. Analysis of this therapeutic regimen based on a larger sample size, and long-term follow-up will be the substance of a future report.

Auricular Keloids: Combined Therapy With a New Pressure Device; Gregor M. Bran, Jörn Brom, Karl Hörmann, Boris A. Stuck; Arch Facial Plast Surg. 2011;Published online August 15, 2011. doi:10.1001/archfacial.2011.57


Mia said...

I would really like to know who sells this device or who i can contact in regards to making one for me i have battled keloids for years all my life the first time was a success with pressure until i turned 20 and went down the peircing my ears lane again then these things have come back pressure is the only sure thing that works but keeping it on the ears can be hard please contact me back this information can really change my life.

rlbates said...

The authors of the paper had them custom made for each patient

Movies for you said...

who would i contact to make an custum earring ,and were would i go to make one ,and who did the auther of this articl go to to make those earrings any help would would be most appericated.

rlbates said...

I do not know. If a patient came to me asking for one, I'd try to find an orthodist to make one for them. But it might be difficult.

Anonymous said...

Dr. Bates I have come to you for surgery in the past and want to thank you again For the job you did. I have had a keloid on my left ear on the middle upper part of my ear. I have an appointment on April 26th to have it removed by a local dermatologist but when I spoke to him about pressure therapy he didn't know what I was talking about, which was not very reassuring. My worst fear is that it will grow back even larger, as now it is already about 17 millimeters. I want to make sure I make the right decision but a pressure device is something I definitely want to try after it is removed. Do you still practice?

rlbates said...

Anon (3/22/12): Thank you for your kind words. I am no longer in practice, but there are several good plastic surgeons available in Little Rock. If it is your earlobe, you can always get the off-the-shelf pressure ear rings yourself and use them. You might even print out this post and take it with you with your questions written on the sheet. Best to you.