Tying String Around Ear Keloid for Removal?

Question

I was reading someone saying that they tied a string around their earlobe keloid to cut off the circulation and the keloid dried up. I was wondering, does it really work?

Otto Joseph Placik, MD · Answer

Tying a string will strangulate the blood supply to any structure and result in it falling off. This includes keloids. This question is both technical and prognostic.

Can you tie a string around the base? Is it narrow enough?
Will it recur (come back)?

Certainly there is little blood supply, and keloids are dense as well as tender. So this may be uncomfortable. It may also not produce a satisfactory result from an apeearance point of view. However, there would appear to be little risk.
In summary, this could work but it clearly is not the standard of care.

Stephen Prendiville, MD · Answer

This "string strangulation" method may very well work. However, it is important to understand that a keloid is an abnormal wound healing response with different histological characteristics than normal scar tissue. Your method may solve the problem, but it is generally agreed that any form of keloid excision carries with it a 50% recurrence rate. Don't be surprised if it returns within a few months.

Vincent N. Zubowicz, MD · Answer

You are suggesting unconventional treatment but it might work.  However, once it falls off, the recurrence rate would be high unless it is simulataneously treated with steroids or pressure.

Anil R. Shah, MD · Answer

Keloids are one of the most difficult scars to treat. Creams, topicals, and home remedies such as tying a string to a keloid are impractical and highly unlikely to work. Seek information from an expert in scars to help guide you in improving your keloids.

Raffy Karamanoukian, MD, FACS · Answer

Ear keloids are common and progressive. Management of ear keloids should begin with conservative measures such as pressure management, silicone application, TAC injection, and observation. Tying a keloid with a string is not a good idea as it may cause chronic inflammation and infection, which can further incite progression and enlargement of the keloid scars.

Jeffrey Ellis, MD · Answer

Be very cautious about doing anything to traumatize or irritate a keloid scar.  It may grow even larger.

	It is best to find a surgeon with expertise in management of keloids, as in the right hands you could do very well.

Boris Volshteyn, MD, MS · Answer

Cutting off the blood supply to keloid may or may not work.  If the base is very narrow it may be helpful, if i is wide, you may not be able to tie it off completely.  Also, keloids are quite sensitive to pain, so expect a bit of discomfort.

	If you are successful in cutting off the blood supply and the main part of keloid falls off, there are still 2 problems to deal with: part that is left inside (root so to speak) and high possibility if recurrence at the stump. And then you have to start all over.

	The idea is interesting but is not a standard of care today.

	Sincerely, Boris Volshteyn MD

John P. Di Saia, MD · Answer

I would not advise this "tie the string around it" treatment for a keloid scar. The scar might even get larger by doing this. Get a proper evaluation and then proceed from there.
Best Regards.

Harold J. Kaplan, MD · Answer

Hi Ryeeguy,
It is possible to limit blood flow to an ear keloid using the treatment you have asked about.  The problem is that the process will be very difficult, painful and may very well lead to infection.
There is no treatment option that's guaranteed to remove a keloid permanently, but we have had some luck with surgical removal combined with follow up steroid injections. The initial surgery removes the keloid and the injections limit the possibility for regrowth. We've found that this leads to the highest response rate.

Tying String Around Ear Keloid for Removal?

Answers (9)

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