Medically reviewed by Anju Goel, MD
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- A Frank’s sign is a diagonal crease on the earlobe that may be associated with increased cardiovascular risk.
- Research suggests it could reflect aging changes or reduced blood vessel function in the body.
- Its presence does not confirm heart disease, but it should prompt a medical evaluation of risk factors.
A Frank’s sign, also known as a diagonal earlobe crease (DELC), is a permanent visible crease on one or both earlobes that runs diagonally. Research shows that the presence of a Frank's sign may indicate a higher risk of developing cardiovascular (heart) disease.
What It Looks Like
A Frank's sign is a deep wrinkle-like crease that forms on one or both earlobes. It's more common in Caucasians and is more likely to appear with age, often as a diagonal line on the earlobe that extends downward.
Why It Happens
Research suggests that a Frank's sign could be the result of the redistribution of connective tissue and poor density of capillaries (microscopic blood vessels) within the earlobe.
Other research found that a Frank's sign could form as the result of accelerated aging or from changes to the body's smallest blood vessels (such as damage to or narrowing of blood vessels). However, studies are ongoing to confirm the exact mechanisms behind its formation.
What Are The Risks?
In early studies, a Frank's sign was commonly observed in people with a history of coronary artery disease (a common type of heart disease), ischemic changes (the reduction of blood flow and oxygen to a part of the body), or angina pectoris (chest pain or discomfort resulting from reduced blood flow and oxygen to the heart).
Recently, researchers have found that a Frank's sign is a strong marker for heart disease risk across multiple studies. Research also shows it may be an early indicator of peripheral microangiopathy, a disease of the small blood vessels located in tissues outside of the heart and brain.
While the presence of a Frank's sign on the earlobe remains controversial among some doctors, it may be worth discussing with your healthcare provider. Research shows there is a strong link between having a Frank's sign and increased risk of heart disease.
How It's Diagnosed
A healthcare provider, such as a medical doctor, can diagnose a Frank's sign through a physical examination. The formation of a Frank's sign does not necessarily mean you have a heart problem or heart disease, but it can't hurt to see your healthcare provider to evaluate your heart health and heart disease risk factors.
In evaluating cardiovascular risk, your healthcare provider might speak to you about your lifestyle habits and perform diagnostic tests to determine if you have any other risk factors, which include smoking, diabetes, or high blood pressure, in addition to the presence of Frank's sign.
How To Prevent It
While it is not possible to prevent the formation of a Frank's sign, there are ways you can reduce your risk of heart disease.
To reduce your risk, the American Heart Association recommends adopting healthy lifestyle habits, such as consuming nourishing whole foods, avoiding smoking and secondhand smoke, engaging in regular physical activity, managing stress, and maintaining a healthy weight.
When to Speak to a Healthcare Provider
If you notice the formation of a Frank's sign on one or both earlobes (especially if you also have risk factors for heart disease, such as diabetes, high cholesterol, or high blood pressure), discuss it with your healthcare provider for diagnosis and to discuss preventative measures.
Additionally, if you have a Frank's sign and are experiencing symptoms of a heart attack or stroke, such as chest discomfort, shortness of breath, sudden vision changes, facial drooping, nausea, or lightheadedness, visit your nearest emergency room (ER).
