From the Research
The most effective treatment for chondrodermatitis nodularis is a combination of conservative measures, including pressure relief and topical treatments, with surgical intervention considered if conservative measures fail, as supported by the most recent and highest quality study 1. The treatment for chondrodermatitis nodularis typically involves a combination of conservative measures and, if necessary, surgical intervention. Initial treatment focuses on relieving pressure on the affected area, usually the ear, by using donut-shaped pillows or padding to prevent direct contact during sleep, as shown to be effective in a study using a 'doughnut pillow' 2. Topical treatments include high-potency corticosteroids like clobetasol propionate 0.05% applied twice daily for 2-4 weeks to reduce inflammation, or intralesional corticosteroid injections (triamcinolone acetonide 5-10 mg/ml) for more persistent cases.
- Topical nitroglycerin 0.2% ointment applied twice daily for 2-3 months may also help by improving blood flow to the cartilage, with a study showing its effectiveness and good tolerance in patients with chondrodermatitis nodularis helicis 3.
- For pain management, oral analgesics such as acetaminophen or NSAIDs can be used. If conservative treatments fail, surgical excision of the nodule with underlying cartilage is often curative, though recurrence is possible, with a cure rate of 82% compared to pressure relief treatment (37%) or nitroglycerin (51%) 1. Cryotherapy, laser therapy, or curettage are alternative procedural options. The condition occurs due to pressure-induced ischemia of the cartilage with subsequent inflammation, which explains why pressure relief is fundamental to successful treatment, as noted in a review of current therapies for chondrodermatitis nodularis helicis 4.