Cauliflower ear, also sometimes called wrestler’s ear or sports ear, is a medical condition known as perichondria hematoma, a deformity caused by blunt force trauma to the ear. It happens because blood accumulates in the ear's tissues, disrupting blood supply to healthy cartilage. The result is fibrosis, a thickening or scarring of tissue, which leads to the resulting cauliflower ear.
This condition is particularly common among athletes, as it can happen in any activity where there are shearing or impact forces occurring to the ear. Cartilage is already an area with low vascularity or bloodflow, and the resulting trauma and inflammation from these blows result in devascularizing the cartilage and leading to this scarring to occur. The earliest records of this condition date back to early Roman and Greek history, with accounts of damaged ears on wrestlers and boxers. This is very common in some sports, with one study showing 84% of national champion-level Finnish martial artists having cauliflower ear.
Many folks who have experienced this are interested in potentially getting piercings later in life. However, cauliflower ear presents a unique challenge in regards to piercing. This distorted tissue is a form of scar tissue and damaged cartilage below that. Trying to pierce through this tissue could actually worsen the cauliflower ear by allowing further inflammation and devascularization. I would suggest only piercing intact areas of the ear away from the fibrosis of the cauliflower ear. This may mean that some folks with this condition have nowhere safe to pierce on their ears if their case is severe enough. If you’ve ever handled this tissue in person you know that it feels incredibly brittle and fragile, and usually has extra low blood flow.
While I know it’s disappointing to hear that you are unable to get something pierced and difficult to disappoint a client, it’s important we be honest in this situation. If we know something won’t be able to heal successfully, and furthermore if we know it may cause increased trauma and damage to your already injured ear, it’s unethical of us as piercers to move forward with piercing you.