Understanding and Comparing Current Practice for Ear Keloid Scars: A Narrative Systematic Review

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing Research

Background:

• Keloid scars are benign fibroproliferative disorders causing excessive tissue growth beyond original wounds.
• High incidence (11 million cases annually), especially in Asian and African populations, poses significant psychosocial and surgical challenges.
• Ear piercings are a common cause of ear keloids, yet their specific pathophysiology and optimal treatments are debated.

Purpose of the Study:

• To evaluate current treatment modalities for ear keloids, specifically those associated with ear piercings.
• To analyze the implications of ear piercing-induced keloids for patient management.
• To identify gaps in knowledge regarding pathophysiology and treatment efficacy.

Main Methods:

• A narrative review synthesizing findings from a systematic search of Medline, Embase, and Mendeley databases.
• Inclusion of 26 studies detailing various surgical and non-surgical treatment methods for ear keloids.
• Analysis of treatment outcomes, focusing on recurrence rates and associated complications.

Main Results:

• Surgical excision is the primary treatment, frequently combined with adjunctive therapies like steroid injections and radiotherapy.
• A considerable average recurrence rate of 20.3% was observed across studies.
• Fractional carbon dioxide laser therapy shows potential as a useful modality with fewer complication risks.

Conclusions:

• Significant variability exists in current ear keloid treatment protocols and outcomes.
• Personalized treatment approaches, considering keloid characteristics and patient preferences, are essential.
• Further research is crucial to standardize ear keloid scar treatments and understand piercing-specific pathophysiology for improved patient outcomes.