Understanding CNH and Protecting the Natural Shape of Your Ear
Chondrodermatitis Nodularis Helicis (CNH) is a painful inflammatory condition that affects the cartilage of the ear, often appearing as a sore, crusted, or raised lesion. Many patients first visit a dermatologist for this issue—only to be left with a noticeable ear deformity after it’s surgically removed. At his San Diego facial plastic surgery practice, Dr. John Hilinski, who specializes in cosmetic and reconstructive ear procedures, treats CNH with a meticulous approach that not only relieves discomfort but also preserves the ear’s natural shape and contour.
Dr. Hilinski, Nicole, and team are absolutely amazing! Dr. Hilinski is very knowledgeable, takes the time to thoroughly explain procedures, and has gone above and beyond with patient care during my procedure and throughout all of my follow-ups.
What Is Chondrodermatitis Nodularis Helicis?
CNH is a benign yet painful lesion that forms on the helix or antihelix (the outer rim) of the ear. It develops when pressure and inflammation compromise the thin skin and cartilage in this area. While CNH is not a form of skin cancer, it can look similar, which is why it is often misdiagnosed or overtreated by excision alone.1
What Causes CNH?
CNH usually results from a combination of pressure, friction, and poor blood supply to the ear cartilage. Contributing factors may include:
- Sleeping on one side of the head repeatedly
- Wearing tight hats, helmets, or headgear
- Chronic sun exposure
- Cold weather or trauma to the ear
- Age-related thinning of the skin over the cartilage
When these factors irritate the area over time, the skin and cartilage break down, leading to pain, redness, and the development of a small but tender nodule.
Symptoms of Chondrodermatitis Nodularis Helicis
Common signs and symptoms of CNH include:
- Tenderness or pain on the outer ear, especially when sleeping on that side
- A raised bump or sore that may crust, bleed, or fail to heal
- Redness or swelling around the affected area
- Sensitivity to touch or pressure
- Discomfort while wearing glasses, masks, or earbuds
Although CNH is non-cancerous, it can mimic more serious conditions. Evaluation by a qualified physician experienced in ear reconstruction is essential for an accurate diagnosis and effective treatment.
How Is CNH Treated?
Treatment depends on the severity of the lesion and whether previous surgeries have altered the ear’s structure. Options may include:
- Pressure relief devices to reduce irritation while sleeping
- Topical or injectable anti-inflammatory medications
- Surgical removal with reconstructive repair, performed by Dr. Hilinski to preserve ear contour and symmetry2
Unlike standard excision, Dr. Hilinski’s surgical approach carefully reshapes the ear, addresses the underlying cartilage inflammation, and minimizes the risk of deformity or recurrence.
When CNH Surgery Leads to Ear Deformity
Many patients initially turn to dermatologists who treat CNH by simply cutting out the lesion. Unfortunately, this approach often fails to account for the complex shape and thin cartilage of the ear, leaving patients with:
- Notched or misshapen ear edges
- Visible depressions or scars
- Asymmetry between the ears
- Persistent pain or recurrence of the lesion
Dr. Hilinski frequently sees patients who have experienced these complications and now seek his expertise to repair the damage and restore the ear’s natural appearance. His reconstructive training allows him to treat CNH while maintaining both the function and aesthetics of the ear.sed on your anatomy and goals.
Why Choose Dr. John Hilinski to Treat CNH?
As a Board-Certified Facial Plastic and Reconstructive Surgeon in San Diego, Dr. John Hilinski has advanced expertise in both cosmetic and reconstructive ear surgery. His deep understanding of ear anatomy allows him to treat CNH with precision while maintaining the ear’s natural curvature. Patients trust Dr. Hilinski for:
Specialized training in facial and ear reconstruction
- Proven experience correcting deformities caused by prior CNH surgeries
- Aesthetic sensitivity that prioritizes natural-looking results
- Compassionate care in a comfortable, patient-centered environment
Preparing for Treatment
During your consultation, Dr. Hilinski will:
- Review your medical history and prior treatments
- Examine both ears and assess any existing deformities or scarring
- Discuss your symptoms, sleeping habits, and lifestyle factors
- Explain your treatment options and expected results
Patients with previous CNH surgery can also review before-and-after photos of similar cases to better understand what reconstruction can achieve.
The Procedure
If surgery is recommended, Dr. Hilinski performs the procedure using local anesthesia in a precise, minimally invasive manner. The affected tissue is carefully removed, and the surrounding cartilage is reshaped or reinforced to restore smooth, natural ear contours. When necessary, he uses reconstructive techniques to correct prior surgical defects and enhance symmetry.
Recovery and Results
Most patients experience mild tenderness or swelling for a few days following surgery. Dr. Hilinski provides detailed post-care instructions to help protect the ear and prevent recurrence, including:
- Avoiding direct pressure on the treated ear
- Sleeping on the opposite side for several weeks
- Protecting the ear from trauma or cold exposure
Patients typically notice significant relief from pain and see a natural, well-contoured ear appearance once healing is complete.
FAQs About CNH Treatment
No. CNH is a benign condition, though it can resemble skin cancer. A proper evaluation is essential for an accurate diagnosis.
Recurrence is possible if the underlying pressure or cartilage irritation isn’t addressed. Dr. Hilinski’s reconstructive technique reduces this risk.
Yes. Dr. Hilinski routinely performs reconstructive procedures to restore a natural ear shape following poor outcomes from previous excisions.
When performed by a facial plastic surgeon experienced in reconstructive techniques, scarring is typically minimal and well-concealed along natural ear folds.
Contact Dr. John Hilinski in San Diego, CA
If you’re experiencing painful ear lesions—or have been left with an ear deformity following CNH surgery—schedule a consultation with Dr. John Hilinski, San Diego’s expert in ear reconstruction and CNH treatment. Relief and restoration are within reach.
Sources
1 Hohman MH, Winters R. Chondrodermatitis Nodularis Helicis. [Updated 2024 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482507/. Accessed November 3, 2025.
2 Juul Nielsen L, Holkmann Olsen C, Lock-Andersen J. Therapeutic Options of Chondrodermatitis Nodularis Helicis. Plast Surg Int. 2016;2016:4340168. doi: 10.1155/2016/4340168. Epub 2016 Jan 27. PMID: 26925262; PMCID: PMC4748103. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC4748103/. Accessed November 3, 2025/