Earlobe Crease Linked to Heart Disease Risk
A diagonal crease on the earlobe, known as Frank's Sign, has been linked to increased cardiovascular disease risk in multiple studies, though researchers debate whether the sign alone indicates danger in asymptomatic people.
Associate Professor Jesada Dondvongpant, a biology lecturer at Chulalongkorn University's Faculty of Science, has addressed a viral health claim circulating on TikTok and medical pages: does a diagonal crease on the earlobe indicate heart disease risk?
The crease is known as Frank's Sign or Diagonal Earlobe Crease (DELC). Multiple research studies have found a connection between Frank's Sign and cardiovascular disease risk, including coronary artery stenosis, stroke, and atherosclerosis. The condition was named after cardiologist Sanders T. Frank, who observed it in 20 patients with angina.
Since its initial discovery in cardiac patients, larger studies have identified DELC in patients with coronary artery disease, peripheral artery disease, and cerebrovascular disease. Clinically, cardiologists frequently observe Frank's Sign in cardiac patients who have undergone coronary artery bypass surgery, and hospital-based studies have found a link between DELC and cardiovascular disease.
However, debate continues over whether individuals with DELC but no symptoms carry increased risk for severe vascular disease. Notably, this association does not appear clearly in diabetic patients, and some studies show no statistically significant correlation with any vascular disease.
The cause of DELC remains unclear. Some reports suggest microvascular disease in the earlobe's terminal blood vessels, while others point to shortened telomere length in Japanese patients with metabolic syndrome—a mechanism linked to general aging and atherosclerosis.
DELC is currently graded by depth, length, bilaterality, and angle: unilateral incomplete (least severe), unilateral complete (moderate), and bilateral complete (most severe). However, this classification does not necessarily correlate with increased cardiovascular events. Notably, even prominent figures like former U.S. President George W. Bush and filmmaker Steven Spielberg have been found to have DELC.
