Dear Doctor,

I had my ears pierced over six months ago, for the very first time. Everything was going well. However, I noticed a swelling on my right earlobe about a month ago, and right now, it looks like it is only getting bigger. Did something go wrong? I’m worried because it keeps on swelling and looks like a ball below my ear. Is it an infection? How bad does it get? What causes it and how do I get rid of it?

Tati

Dear Tati

You have not specified whether there is associated pain and or itching with any discharge associated with the swelling? Does it hurt on touch?

Usually, any problem directly related to an ear prick, appears within 24 to 72 hours, latest one week after the prick. Once the hole has healed after a prick, it usually does not pose any problem. Infection is the most immediate problem likely to occur after an ear prick. Chances of infection are higher if good aseptic precautions are not followed while pricking the ear. Diabetics are more prone to such infection.The suture put in can also be infected afterwards, particularly if contaminated by soap and or water. But in case of infection, the pricked site would become swollen, reddish and would hurt on touch. Pus may form inside, which augments the pain. The resultant abscess could burst spontaneously or would have to be incised and drained. Treatment consists of suitable antibiotics and anti-inflammatory drugs.

Allergy to the suture put in to maintain the hole could also manifest as swelling. But this would tend to be itchy and not painful. Pain would occur at site only if infection occurs secondary to itching. If trauma has occurred while pricking the ear, a hematoma can form afterwards due to collection of blood. The swelling would be soft and not painful, unless secondary bacterial infection sets in.

A swelling coming six months after an ear prick could be due to allergy to the material of the screw of some ear studs or some earring worn. Risk of allergy is said to be less with gold or silver as they are supposed to be inert metals. Any subsequent trauma to the ear lobe occurring unknowingly can also cause a hematoma. This would manifest as soft swelling, not painful on touch. A progressively increasing swelling can occur over the ear lobe due to causes unrelated to the ear prick. A cyst is one such example. It may be fluid filled or filled with some inflammatory debris if inflammation has occurred. Treatment of such a cystic swelling is by surgical excision. It is better for you to get the swelling examined and undergo suitable treatment.

Dr Rachna is a specialist in internal medicine at Ruhengeri Hospital

rachna212002@yahoo.co.uk