These patches often appear on the elbows, knees, legs, back, and scalp, but psoriasis can affect any area of skin. It can even affect delicate areas such as the mouth and inside of the ears.
What is psoriasis?
Psoriasis is a skin condition that cannot be spread or caught.
For reasons not fully understood, people with psoriasis have an overactive immune system that causes a fast production of excess skin cells.
Normal skin cells take about 28 days to produce. During this time, old skin cells are shed, making room for the new ones.
With psoriasis, the body creates new skin cells in just 3 or 4 days, and the old cells do not have time to slough off.
This creates a collection of old and new cells on the affected area, resulting in thick scales that may be red or silvery. These scales often itch, crack, bleed, and cause pain.
Experts do not know why psoriasis appears in certain areas, or why some people have psoriasis in the ears and others do not. They do know, however, that it cannot be spread through contact.
An article in the journal American Family Physician states that psoriasis is not contagious. A person cannot "catch" psoriasis and cannot spread it to other parts of their body by scratching or touching.
Psoriasis in and around the ears
The ears are a less common area for psoriasis to appear, but if a person develops psoriasis in the ears they may face severe emotional and physical challenges.
Because the scales of psoriasis cause a red, rough appearance, psoriasis on a person's face and ears can cause embarrassment or self-consciousness.
In addition, facial skin is often more sensitive than elbows, knees, and scalp, so some treatments may be too harsh.
Some people find that psoriasis gets worse over time. This can occur when something triggers a flare, but it is often unclear why psoriasis grows or gets worse in some people. Sometimes, new areas, such as the ears, become affected.
Developing psoriasis in the ears is not related to cleanliness, touching, or other factors.
If scales and wax build up inside the ear, the ear canal can become blocked, causing itching, pain, and hearing loss. Keeping the ear canal clear of scales helps avoid hearing loss and improve comfort. A person who develops psoriasis in their ear should consult a doctor to discuss an appropriate medication that is safe for the ears.
Some treatments for psoriasis may not be safe for use in the ears.
There is no cure for psoriasis, but it can often be managed with medications. Those with psoriasis in the ears may require close medical care to keep flares under control and to avoid problems such as hearing loss.
Some psoriasis medications should not be used inside the ears. The delicate eardrum may be harmed by some topical creams and ointments. For this reason, patients should ask their doctor about medicines that are safe for the ear canal.
Options may include:
- Liquid forms of steroids that can be dropped into the ear.
- Liquid steroids mixed with another psoriasis medication, such as a vitamin D cream.
- Antifungal dandruff shampoos used while bathing to help clean the ear and kill fungus.
- Pills that help decrease the immune system reaction that causes psoriasis. This type of therapy may help if a patient has psoriasis in the ears or other sensitive areas and drops or creams are not effective.
- Warm olive oil dropped into the ear. The oil can help keep wax moist and lubricated, enabling it to move out of the ears. This can help keep the ears clean by preventing the wax from building up on top of psoriasis scales.
If ear psoriasis interferes with hearing or causes discomfort, a doctor can remove the scales and wax safely and effectively.
Individuals should not stick objects in their ears or try to remove the scales themselves. Accidentally pushing the debris further into the ear can make the problem worse by causing a blockage, damaging the eardrum, or injuring the skin.
Psoriasis triggers can vary from person to person. Some people find that certain triggers make their psoriasis temporarily worse before it returns to normal again.
Others experience a permanent worsening of scales and symptoms.
Either way, most people with psoriasis should try to avoid triggers whenever possible. Those with psoriasis in the ears may find that a flare can suddenly affect hearing, and this can be particularly bothersome and stressful.
Common triggers of psoriasis include:
- Stress: Although stress cannot always be avoided, it can be managed to help avoid flares. Relaxation, regular exercise, deep breathing, and meditation may help.
- Medications: Some medicines can make psoriasis worse, including some for high blood pressure, heart disease, arthritis, mental health disorders, and malaria. A person can work with their doctor to find medications that won't aggravate psoriasis.
- Cuts, scrapes, sunburn, and other skin injuries: Any trauma to the skin can cause a new flare of psoriasis in the affected area.
- Certain illnesses: The body's immune system kicks in when an illness strikes. This can trigger a psoriasis flare too. Some illnesses such as strep throat, ear infections, tonsillitis, and even common colds can cause flares.
Avoiding triggers as much as possible can improve the management of this condition, whether it affects the ears, face, or other parts of the body.
Psoriasis and hearing loss
Regular ear exams may be suggested for people with psoriasis in the ears.
Even if a person does not have psoriasis in the ears but has psoriasis elsewhere, they may experience hearing loss.
A study in the American Journal of Clinical Dermatology found that people with psoriasis were more likely to develop sudden deafness.
This type of hearing loss comes on quickly, usually within 3 days or fewer. It is more common in people over the age of 50.
The link between psoriasis and sudden deafness is not completely understood, but it may be due to the immune system damaging part of the inner ear. Approximately 50 percent of those who experience sudden deafness regain some or all hearing within 2-3 weeks, and 85 percent regain some of their hearing loss.
Regular hearing checks may be recommended for those with psoriasis and psoriatic arthritis to help detect hearing loss early and get treatment.
Living with psoriasis in the ears
Psoriasis can be emotionally and physically challenging for many people, but it can be managed with close care from a doctor.
Whether the flares occur in the ears or elsewhere, finding an effective treatment is key to minimizing symptoms and flares.
Regular hearing checks and ear exams can ensure that ear-related complications are addressed early.
Finding the right medications may take time, as one treatment does not work for everyone.
Some people find that their psoriasis medication stops working over time, and that it has to be changed.
Once an effective treatment is found, many people are able to lead full, active lives with psoriasis.