Ear Tags & Accessory Auricles

What Are Ear Tags and Accessory Auricles?

Preauricular tags and accessory auricles are small skin-covered protrusions, usually just in front of the ear, present from birth. They are common and usually an isolated finding with no other health implications. Occasionally a tag or accessory auricle contains a core of cartilage. Where multiple congenital anomalies are present alongside ear tags, your paediatrician may recommend hearing and, in some cases, renal screening as part of routine assessment — this is standard practice rather than an indication that anything is necessarily wrong.

Why Remove Them

Removal is usually for cosmetic reasons, at a time that suits the family. There is no medical urgency, which allows removal to be planned for an age at which local anaesthetic is well tolerated.

Timing & Technique

There are two practical windows for removing a simple ear tag or accessory auricle under local anaesthetic, with a gap in between where a general anaesthetic is usually the better option.

In the First Months of Life — the "Feed and Wrap" Technique

Simple ear tags and accessory auricles can often be removed under local anaesthetic in very young babies — typically up to around 6 months of age, though this varies by child and by the size and position of the lesion. This uses a "feed and wrap" technique: the baby is fed and then swaddled snugly, which settles most infants into a natural sleep or a calm, still state for the few minutes the procedure takes. A small amount of local anaesthetic is used, and the whole appointment is usually complete within minutes. This avoids a general anaesthetic altogether for babies young enough to tolerate it.

The Gap: General Anaesthetic Is Usually Kinder

Once a baby is older, more mobile and more aware, the feed and wrap technique is no longer reliable. At this stage a child is often too large and active to be gently settled and held still the way a very young infant can be, but not yet old enough to understand what the procedure involves, or to sit still and cooperate for the time it takes to work carefully around the ear while awake. For most children in this window, a short general anaesthetic is the safer and kinder option.

Anaesthetic risk in children is not fixed — it falls significantly once a child is past early infancy and into the toddler years. For this reason, and particularly where a child has other medical conditions, surgery is often deferred for safety reasons until the child is approximately 3 years old, depending on their individual anaesthetic risk, rather than performed at the earliest opportunity.

Once a Child Is Ready — Local Anaesthetic in Clinic

Once a child is old enough to understand what is being asked of them and can sit still and cooperate for the length of the procedure, it can often be done under local anaesthetic in clinic, supported by topical numbing cream applied in advance to make the injection itself far less noticeable. This is a question of individual readiness — temperament, understanding and ability to stay still — rather than a fixed age, and some children are ready earlier or later than others. See Local Anaesthetic in Children for a full discussion of how this is assessed.

NHS waiting times for this procedure can be lengthy (often several years) as it is not clinically urgent; many families choose to proceed privately for an earlier appointment, at whichever of these windows suits their child.

The Procedure

A brief procedure — the tag or accessory auricle, including any cartilage core, is excised and the skin closed with fine sutures. Performed as a day case with no admission required.

Aftercare

• Keep the wound clean and dry as advised
• Sutures, where used, are typically removed or dissolve within 1–2 weeks
• A small, well-concealed scar is expected, settling further over several months

Risks

Related Patient Guides

• Preparing for Surgery
• Pain Management After Surgery
• Scar Management
• All Patient Guides

Useful Resources

• Great Ormond Street Hospital — patient information