It might sound like an anatomical quirk better suited for fanciful novels than medical diagnosis, but a certain type of earlobe crease could be a sign of the times deep inside the body. Specifically, a new study has found a link between people with bilateral diagonal earlobe creases and an increased risk of coronary artery disease.
Doctors often say to seek that which is hidden by observing what is not. A connection between ear wrinkles and heart disease may sound kooky, but when you think about it, external cues are used all the time as markers of disease or ill-health – for example, obesity (diabetes), clouding of the eye’s lens (cataracts), and discoloration of the skin (liver disease).
Coronary artery disease is one of the leading causes of death worldwide, which is why scientists are on the lookout for more ways in which to identify and treat it. The condition is due to plaque buildup in the arteries, which hardens and narrows the passageways. This ultimately restricts blood flow to the heart, which can become starved of oxygen.
Bilateral earlobe creases, also known as Frank’s sign, have been studied before. First published about in 1973, the link has been explored many times over. However, the research is not absolute and the mechanisms behind the connection is yet to be determined.
For this research, published in the journal BMJ Open, the team from China studied the difference between unilateral and bilateral earlobe creases in relation to coronary artery disease. Pictured below, the difference lies in whether the crease affects one or two ears.

These wrinkles were defined as a deep diagonal crease (>1 mm) extending slantwise from the tragus to the outer earlobe and covering at least two-thirds of the length of the lobe.
To determine whether there is a link between these creases and coronary artery disease, the team examined the ears of 558 participants aged 36-91 years old who underwent coronary angiography.
The team found that those with bilateral earlobe creases were at a significantly increased risk of coronary artery disease than those with unilateral creases – although both were at an increased risk compared with those with non-creased ears.
Previous research has suggested that the link could be due to impaired circulation, however more investigation needs to be undertaken.
While it’s possible the deep creases are an indicator of heart disease, it could also be the result of other factors, such as a heredity trait, trauma from heavy earrings, or even just an anatomical anomaly. At the heart of the matter, this study adds to the canon of research, but more needs to be done to explore the correlation and its cause.
