Pressure after keloid removal: what the research says
After an ear keloid is removed, the main worry is that it comes back. Pressure on the earlobe is one of the steps doctors use to lower that chance. This page explains what pressure therapy is, how it has been done on the ear, and what the published studies found, including their limits.
What is pressure therapy for keloids?
Pressure therapy means holding steady pressure on the area where a keloid was removed, while the new scar forms. It is used as an add-on step after surgery, not instead of it.3
Why it might help is not fully understood. One review explains that the leading idea is that pressure reduces oxygen in the tissue, which kills off some of the cells that build scar tissue.3
One review describes the ear as easily amenable to pressure.3
Why is pressure used after surgery?
Because surgery on its own is often followed by a return. One review reported that ear keloids came back in 50 to 100 percent of cases after removal with no step afterward.3 Removing a keloid leaves a fresh wound, and the add-on steps aim to stop that wound from forming a new keloid.3
How has pressure been applied to the ear?
Many devices have been used, from magnets to custom-made acrylic stents.3 Others include compression earrings, spring clips, binder clips, and magnetic discs.67
A hospital in Korea used magnets for pressure after surgery for more than seven years.1 The same team also tried applying magnets early, together with a hydrocolloid dressing, right after surgery.2
Different devices press with different force. One team in India built a simple sensor to measure the pressure from ear keloid clips. The pressure varied from clip to clip. Spring clips could be adjusted, while binder clips and magnet discs could not.7 The authors warn that uncontrolled pressure can injure the skin.7
What did the studies find?
The largest study of magnets. Between 2002 and 2010, the Korean hospital removed 1,436 ear keloids in 883 patients and followed each removal with magnet pressure. After 18 months, 89.4 percent of the patients had no return of their keloid.1 About 70 percent of these patients had already had treatment fail at another hospital.1 Keloids were more likely to return in people with past treatment, slower-growing keloids, and a higher body mass index.1
A comparison of dressings. The same team looked at what happens in the first two days after surgery. All 80 patients wore magnets for six months afterward. Forty of them also had a hydrocolloid dressing with a magnet pressed onto it on the day of surgery and the day after; 40 matched patients from earlier records had ordinary gauze dressings. Over 18 months, keloids came back in 2 of 40 (5 percent) with the early magnet dressing and 7 of 40 (17.5 percent) with gauze. Because both groups wore magnets, this study does not compare magnets with no magnets.2
A review of compression studies. A 2024 analysis pooled the published studies of compression after keloid removal. With compression earrings, about 11 percent of keloids came back. With silicone gel sheets it was about 13 percent, and with both together about 9 percent. The differences were not statistically significant.6 Most of the compression-earring keloids in that pooled analysis come from the 2011 Korean study described above, so the two are not independent.6
A study where add-ons made no clear difference. A US study followed 94 children and teens who had surgery for earlobe keloids. Keloids came back in 28.7 percent of them. In this group, add-on steps such as steroid injection, compression, and radiation did not appear to change how often keloids returned.4
What are the limits of this research?
Some of the numbers are encouraging, but the evidence has real gaps. Here is what to keep in mind.
- Much of it comes from one place. The two magnet studies come from the same hospital and the same team.12 The large study reports one center's own protocol.1
- The comparison was not randomized. In the dressing study, the comparison group was drawn from past patients, and each group had only 40 people.2
- Most of the pooled studies were small. One large study supplied most of the keloids in the compression-earring group; the rest were small, and devices and routines varied. The authors of the 2024 analysis say there were too few studies in each group to tell which approach works best.6 One review makes the same point about ear keloid research in general: most studies are small and follow patients for a short time.3
- Follow-up may be too short. The magnet studies followed patients for 18 months.12 In the US study of children and teens, the median time before a keloid returned was 23 months.4
- Not every study agrees. The US study did not find a clear benefit from compression or other add-ons.4
Put simply, pressure after removal has been studied many times and has some encouraging numbers behind it, but most of the studies are small, and the largest come from a single hospital.
What should I ask my dermatologist?
- Is pressure a good fit after my surgery, and what else would you combine it with?
- How soon after surgery should I start?
- How many hours a day should I wear it, and for how many weeks or months?
- How tight should it feel, and what signs mean I should take it off?
- How often should I come back for checks, and for how long?
Keep your follow-up visits even if the ear looks fine. A keloid can return well after the first year.4
Where Keloid Buds fit
Keloid Buds are magnetic compression discs designed for the ear. They were not tested in the studies cited in this article. If you and your dermatologist decide pressure belongs in your plan, ask whether a kit like this suits you. See what is in the kit.
This article is general information, not medical advice. Talk to your dermatologist.