What to know about ear eczema
People with ear eczema may notice dry, flaky skin in or around their ears. This symptom may develop after contact with specific triggers, such as beauty products or metal jewelry.
Ear eczema may lead to infection and inflammation of the ear canal, called acute otitis externa. Using a range of treatment and prevention methods, people can often reduce ear eczema symptoms and flares.
What is ear eczema?
Eczema can develop inside or outside the ear.
Image credit: Klaus D. Peter, 2008
Ear eczema is a red, itchy rash that develops on the outside of the ear or inside the ear canal.
Ear eczema can sometimes arise without any triggers, in which case it is called aural eczematoid dermatitis. People who are prone to seborrheic dermatitis or psoriasis are more likely than others to have aural eczematoid dermatitis.
Contact with certain irritants can also cause ear eczema. This type of eczema is called contact dermatitis. Soaps, hair dyes, and metal jewelry can all trigger contact dermatitis in and around the ears.
Babies and children commonly get areas of eczema on the face, including the ears. This inflammatory skin condition is not contagious.
Ear eczema causes symptoms that are similar to those of eczema on other parts of the body. People with ear eczema may experience:
- dry, scaly skin around the ear
- dry, scaly skin inside the ear canal
- redness and swelling
- itchiness in or around the ear canal
- clear discharge from the ear
The symptoms of ear eczema can also affect the area behind the ear and the crease where the ear attaches to the head.
For most people, the symptoms of eczema will be mild to moderate. However, in some cases, the itching can become intense and lead to the following:
- red, swollen, or dark skin
- areas of very dry, sensitive skin
- scaly patches that may be rough or leathery
- oozing, bleeding, or crusting areas of inflamed skin
- infected skin in the ear canal
People should avoid scratching eczema, as this can lead to very inflamed areas of skin that may bleed and make eczema symptoms worse.
Doctors and researchers are not sure exactly what causes eczema, but they believe that many factors may play a role.
These factors might include a gene mutation that affects a protein called filaggrin, which develops a protective barrier on the skin. This mutation could leave the skin vulnerable to irritation and infection.
Many people with eczema also have overactive immune systems. When they encounter a trigger, their immune system reacts by causing skin inflammation.
Common triggers for eczema include:
- soaps, detergents, and baby wipes
- common allergens
- some metals, including nickel
- scented lotions, soaps, and perfumes
- rough fabrics, such as wool
- some disinfectants
- cigarette smoke
Doctors can often diagnose eczema, including ear eczema, with a routine physical examination. As well as carrying out a visual assessment of the area, they will ask the individual about any symptoms.
In some cases, doctors may order skin tests to help diagnose the specific form of eczema or identify which allergens are triggering the person's symptoms.
The primary treatment for people with eczema generally involves using home remedies and making lifestyle changes.
Home remedies for ear eczema include the following:
- washing the ears each night with warm, but not hot, water
- using fragrance-free moisturizers on the ears immediately after bathing to lock in moisture
- preventing any triggers, such as jewelry, from coming into contact with the ears
- wearing a hat that covers the ears in cold weather, as cold temperatures can trigger flares
- avoiding irritants that have caused eczema flares in the past
- using over-the-counter (OTC) anti-itch creams that contain hydrocortisone, which reduces itchiness and swelling
- switching to gentle cleansers and products that are suitable for sensitive skin
A doctor may recommend ear drops for eczema in the ear canal.
For some people with ear eczema, home remedies and lifestyle changes are insufficient to manage the condition.
It may take some trial and error to find an effective treatment for ear eczema. However, a doctor can recommend different treatment options or combinations of treatments.
The treatment for ear eczema may include a combination of the following:
- ear drops, if the eczema is in the ear canal
- prescription creams for the skin, such as antifungal creams, steroids, or barrier creams
- systemic medications that reduce the immune system's response to triggers
- biologics, which are medications that target the immune system reaction
- phototherapy, which uses a machine to shine UVB light onto affected areas of skin
What else could it be?
People may mistake ear eczema for other skin conditions with similar symptoms, including:
- skin allergies
- fungal infections
In most cases, a doctor can identify eczema and recommend suitable treatments.
Ear eczema is not usually severe. However, the itchiness and dry skin can be frustrating, and these symptoms can get worse if people scratch the affected area. Eczema inside the ear can also make people prone to ear canal infections.
However, with proper treatment, eczema generally clears up with no long-term effects. Most people with ear eczema can successfully manage their condition with the help of a doctor and some home remedies and lifestyle changes.