If You Notice This Mark on Your Ear, Here’s What It Might Signal
Most people assume heart problems are only discovered through lab work, scans, or hospital visits. But sometimes the body gives quiet visual clues. One of the most talked-about is a small line on the earlobe known as Frank’s Sign. It has been studied for decades as a possible outward hint of what may be happening inside the cardiovascular system.
What Is Frank’s Sign?
Frank’s Sign, also called the diagonal earlobe crease or DELC, appears as a slanted line across the earlobe at roughly a 30 to 45 degree angle. It usually runs from the area near the ear canal down to the lower edge of the lobe.
It was first described in 1973 by physician Sanders T. Frank, who noticed the crease repeatedly in patients with angina. Unlike ordinary wrinkles, this line often cuts through the full thickness of the earlobe and remains visible even when the ear is gently pulled.
Why the Earlobe Matters
The earlobe is structurally different from most of the ear. It contains no cartilage and relies on very small end arteries for blood flow, with no backup circulation. Because of this, subtle changes in blood vessels may show up there earlier than elsewhere.
Researchers believe the crease may reflect microvascular damage, similar to the blood vessel changes seen in atherosclerosis, the process behind many heart-related conditions.
Conditions Often Linked to Frank’s Sign
Frank’s Sign is not a diagnosis, but studies have found it appears more often in people with certain conditions, including:
Coronary artery disease
Previous heart attack
Peripheral artery disease
Ischemic stroke
High blood pressure
Type 2 diabetes
Metabolic syndrome
Creases on both earlobes tend to show a stronger association than a crease on just one side.
Why the Crease May Form
Doctors do not agree on a single cause, but several leading theories exist:
Reduced blood flow in the tiny vessels of the earlobe
Widespread aging changes in blood vessels throughout the body
Shortened telomeres, which are linked to accelerated biological aging
Loss of elastin and collagen, also seen in aging or diseased arteries
Taken together, these ideas suggest the crease may reflect overall vascular health rather than simple skin aging.
Does Age Change Its Meaning?
Yes. The sign tends to be more meaningful in people under 60, where normal aging is less likely to explain the crease. In older adults, earlobe changes are more common, so the finding carries less weight on its own.
Different Creases, Different Levels of Concern
Doctors sometimes look at how the crease appears:
Partial versus complete
Shallow versus deep
One-sided versus both sides
A deep, complete crease on both earlobes may raise more concern than a faint or partial line on just one.
What Frank’s Sign Does Not Mean
There are several common misconceptions worth clearing up:
It does not confirm heart disease
It does not replace medical testing
It does not mean urgent treatment is required
It is not caused by earrings, sleep position, or body weight
Should You Worry?
If you notice a diagonal crease on your earlobe, especially if you are under 60 or have risk factors like smoking, diabetes, high blood pressure, or a family history of heart disease, it’s reasonable to mention it at your next check-up.
A doctor can then decide whether further evaluation, such as blood work or heart screening, makes sense.
The Bottom Line
Frank’s Sign is best understood as a visual cue, not a diagnosis. It highlights how cardiovascular health can affect the body in subtle ways and may serve as a reminder to pay attention to prevention, lifestyle, and regular medical care.
