The mystery of the split earlobe

The ancient art of body piercing has rejuvenated in the recent years as part of the fashion process. The ear is the most frequent body part to be pierced to wear jewelry. Split earlobes are commonly presented to plastic surgeons and the recurrence rate is high. The etiology of the acquired split earlobe was thought to be attributable to either trauma or heavy earrings. In this study, the authors explored the cause of the split earlobe and recurrence after surgical repair. Twenty-five patients who were using gold earrings presented with split earlobe and were studied, and the etiology of the condition was analyzed. A questionnaire was completed and the tissue obtained during surgical repair of the split earlobes was submitted for histopathological studies. This group of patients was compared with 17 subjects having stretched earlobe who were using heavy gold earrings. The control group consists of 50 subjects using gold earrings with normal earlobes. Clinical presentation and the histological studies suggest that allergy to metals used in the earring could lead to split earlobe. There is a difference between the split earlobe and stretched earlobe; the latter results from constant pull by heavy earrings. The authors present a new theory regarding the etiology of split earlobe and recommend that avoiding the offending metal in the earring is indispensable to prevent recurrence.