Online influencers make a range of bogus health claims, from trying to convince us that cinnamon has the same weight-loss effect as a GLP-1 to blaming cortisol for nearly all of our beauty woes. Sometimes they’re so astoundingly convincing; soon enough you’re seeing the claims spread everywhere, and everyone speaks about them like they’re understood facts.
That’s why my hand flew to my ear when I first saw an influencer claim that a simple crease on your earlobe could indicate a serious underlying cardiac condition. Could our earlobes be a window into our hearts?
We asked some seasoned doctors if there was anything behind this odd-sounding and much-touted theory. Unlike most health claims made by influencers, it turns out there is some truth to the TikTok videos that had me examining my earlobes.
Here’s what your earlobes can tell you about your health and when it’s time to make an appointment with your provider:
What type of earlobe crease should you look for?
Not every wrinkle or line on your ear is a sign of something sinister. Wrinkles develop over time, including on your earlobe, so new lines may be nothing more than an indicator that you are getting older.
The specific type of earlobe crease doctors are sometimes concerned about is a diagonal earlobe crease. This type of crease is also known as Frank’s sign, named after Dr. Sanders T. Frank, who first noticed a correlation between DELCs and certain cardiac conditions.
Frank’s sign has a distinctive appearance that is obvious to most people. It extends 45 degrees from the earlobe to the tragus, the small, stiff piece of cartilage that sits directly over the opening to the ear canal, explained Dr. Walter Robertson, chief of cardiology for Kaiser Permanente Northwest in Oregon. Some people with Frank’s sign have a crease on one ear, while others have the crease on both ears.
Frank’s sign “is often deeper and more defined than the fine wrinkles,” noted Dr. Dipti Itchhaporia, an interventional cardiologist at Hoag, a healthcare system in Southern California, and a nationally recognized leader in cardiovascular disease prevention. “Normal age-related wrinkles tend to be smaller, less defined and occur in multiple directions. Frank’s sign is usually a single, noticeable diagonal groove that crosses much or all of the earlobe.”
Peter Togel via Getty Images
What does having Frank’s sign mean?
If you look in the mirror and see Frank’s sign, don’t be alarmed. Sometimes a DELC is meaningless. Frank’s sign “can and does occur by natural aging process without any underlying cardiovascular disease, which is why providers do not rely on this finding alone to guide clinical management,” Robertson said.
However, you shouldn’t ignore a DELC either. Frank first observed a correlation between people with a distinctive earlobe crease and certain types of atherosclerotic cardiovascular disease, such as coronary artery disease, cerebrovascular disease and peripheral vascular disease, in 1973, Robertson explained.
Since then, studies have found that Frank’s observations were correct, and there is a notable correlation between Frank’s sign and cardiovascular disease, which may indicate an increased risk of strokes and heart attacks. Longer, deeper creases on both ears or developing Frank’s sign before 60 could indicate an even higher risk.
It’s easy to check for Frank’s sign by looking in the mirror. However, because Frank’s sign is only one indication that something might be wrong, Robertson advised against obsessing over your earlobes.
“You do not need to make this a frequent habit. Glancing at your earlobes once or twice a year is plenty,” he said.
Additionally, Itchhaporia stressed that many people with heart disease do not have the crease, so the lack of Frank’s sign doesn’t mean you don’t or won’t have cardiovascular issues. As a result, it’s still important to maintain heart-healthy habits and get regular checkups even if your ear lobes remain smooth throughout your lifetime.
What should you do if you suspect you have Frank’s sign?
If you look at your earlobes and notice Frank’s sign or have any concerns about wrinkles on your earlobe, don’t panic.
“Think of it as a possible clue or risk marker, not a diagnosis,” Itchhaporia said. “Frank’s sign has attracted attention because it is easy to observe, but it remains an imperfect and somewhat controversial marker.”
While you should discuss your earlobe findings with your primary care physician, it’s not urgent, and the discussion can usually wait until your next routine appointment, Robertson explained.
If your doctor is concerned about your Frank’s sign, they may perform other tests, especially if you have other risk factors, such as obesity or smoking, or a family history of cardiovascular disease.
Your doctor’s plan will depend on your age, symptoms and overall risk profile, according to Itchhaporia. Testing may include measuring blood pressure, checking cholesterol levels, screening for diabetes, obtaining a coronary artery calcium score, undergoing a stress test or ordering cardiac imaging.
The goal of delving deeper into Frank’s sign is not to treat the crease, which isn’t harmful. Instead, your doctor will try to identify any underlying risk factors or conditions that would require intervention, Itchhaporia noted. Even if treatment is warranted, the crease is unlikely to disappear.
As tempting as it is to believe that a small, easy-to-spot line could prevent a heart attack or stroke, Itchhaporia cautioned against putting too much stock in the crease.
“Managing blood pressure, cholesterol, blood sugar, weight, physical activity, diet and smoking cessation can significantly reduce cardiovascular risk, regardless of whether the crease is present,” she said.