Ear eczema, also known as atopic dermatitis or allergic contact dermatitis of the ear, is a common skin condition that can be both uncomfortable and frustrating. It causes redness, itching, and often, crusting or scaling of the skin in the ear canal. While it can be challenging to manage, there are effective strategies and treatment options available.
According to the National Eczema Society, eczema affects over 1 in 10 adults and 1 in 5 children in the UK. The condition can have a significant impact on quality of life, leading to sleep disturbances, anxiety, and depression. The British Skin Foundation also highlights the prevalence of eczema in the UK, stating that it is one of the most common skin conditions. They emphasise the importance of early diagnosis and treatment to prevent complications and improve outcomes.
Ear eczema can be an extremely irritating and, at times, painful condition. It can range from slight dryness of the pinna (the visible, projecting part of the ear) to extensive skin loss and soreness, as well as infection of the external and internal parts of the ear. Eczema can affect the entire ear including the earlobes, conchal bowl (the area outside the ear hole), the ear opening (meatus), ear canal (also known as the external auditory canal – the part of the ear that leads to the ear drum) and the ear drum itself (also known as the tympanic membrane). The ear folds, backs of the ears and the area where the ears meet the face are also common areas for eczema (National Eczema Society, 2024).
There are a number of different types of eczema that can affect the ear canal. With each of them having various causes and triggers. See below to understand them better
Atopic eczema
The ears and skin behind the ears are frequently affected in people with atopic eczema. As with other areas of the body, the eczematous skin here is dry, itchy and red or darker than a person’s usual skin colour, depending on skin tone. It can easily become infected, especially if the skin is scratched and breaks. A common site of ear eczema in people with atopic eczema is the junction between the earlobe and the face. Eczema in this area can cause painful cracks (fissures) in the skin, which can then easily become infected. Sometimes eczema can affect the whole of the pinna and track down the ear canal.
Seborrhoeic dermatitis
Seborrhoeic dermatitis is a form of eczema triggered by an over-reaction of the skin’s immune system to an overgrowth of a harmless yeast called malassesia that lives on the skin. People who have this type of eczema often have dandruff on the scalp and itchy, flaky skin with a yellowish, greasy scale in typical seborrhoeic dermatitis areas, which include the face (along the smile lines and eyebrows), centre of the chest and sometimes the eyelids and ears.
Around the ears, seborrhoeic dermatitis often takes the form of inflammation of the ear canal and along the hairline behind the ear (the post-auricular area), which can lead to painful fissures or cracks. It can sometimes be confused with psoriasis.
Asteatotic eczema
This type of eczema affects older people. The exposed ear is vulnerable to changes in weather and temperature, which lead to dry, scaly and itchy skin causing asteatotic eczema. Aggravating factors include over-washing, cold or windy weather, central heating, low humidity indoors and air-conditioning.
Contact dermatitis
The external ear is commonly affected by both irritant and allergic contact dermatitis.
Irritant contact dermatitis comes about when the skin’s surface is irritated by a substance that causes the skin to become dry, itchy and red or darker than a person’s usual skin colour, depending on skin tone. Examples of substances that can cause irritant contact dermatitis around and inside the ears are shampoo, hair gel, hair spray, perm solution, hair colourant and perfume.
Allergic contact dermatitis develops as a result of your body reacting to a particular substance to which you are allergic. Everyday items that can cause allergic contact dermatitis around and inside the ears include the following:
It is estimated that 1 in 5 children and 1 in 10 adults in the UK suffer from eczema, making it one of the most prevalent skin conditions experienced across all age groups.
Earwax, while often seen as a nuisance, serves a crucial purpose in protecting the ear canal. It traps dirt and debris, preventing them from reaching the delicate structures of the inner ear. However, excessive earwax can create a warm, moist environment that can contribute to ear eczema.
Regular earwax removal can help alleviate ear eczema symptoms and prevent further irritation. There are several methods for earwax removal:
→ Over-the-counter earwax removal solutions: These solutions are available at pharmacies and can be used at home to soften earwax and facilitate its removal. Be careful with some of the ingredients as they can actually worsen your symptoms. It's always best to discuss this with the pharmacist.
→ Microsuction: This is a safe and effective method that involves using a gentle suction device to remove earwax. It is often performed by a healthcare professional, such as an audiologist or ear, nose, and throat (ENT) specialist.
The best treatment for ear eczema will depend on the severity of the condition and the underlying cause. Here are some common treatment options:
→ Topical corticosteroids: These are steroid creams or ointments that can help reduce inflammation, itching, and redness. They come in varying strengths, so it's important to consult with a healthcare professional to determine the most appropriate option.
→ Moisturisers: Applying a good moisturiser regularly can help soothe the skin and prevent dryness, which can exacerbate eczema. Look for moisturisers that are fragrance-free and hypoallergenic.
→ Antihistamines: Oral antihistamines can be used to alleviate itching and other symptoms associated with allergic reactions. However, it's important to consult with a doctor before starting any new medication.
→ Avoidance of irritants and allergens: Identifying and avoiding irritants and allergens that trigger ear eczema can help prevent flare-ups. This may involve reading product labels carefully and avoiding potential irritants like harsh soaps, detergents, or perfumes.
→ Lifestyle changes: Stress management techniques, such as relaxation exercises or meditation, can help reduce the severity of eczema symptoms. Additionally, maintaining a healthy diet and getting enough sleep can also contribute to overall well-being.
Managing ear eczema requires a gentle and consistent approach to skincare and hygiene. Begin by avoiding harsh soaps or cleaning products that might irritate the sensitive skin inside and around your ears. Instead, use lukewarm water and a mild, fragrance-free cleanser to carefully wash the affected areas, patting dry with a soft towel instead of rubbing. Apply a hypoallergenic moisturiser specifically designed for sensitive skin, focusing on keeping the ear area hydrated without causing further inflammation. It's crucial to identify and avoid potential triggers like certain metals, hair products, or skin care items that might cause a flare-up. When experiencing an active eczema outbreak, consider using a prescribed topical corticosteroid cream as directed by your healthcare provider, and resist the urge to scratch, which can lead to infection and additional skin damage. Protect your ears from extreme temperatures and humidity, and consider wearing soft, breathable materials that won't irritate the skin. If you wear hearing aids or earbuds, clean them regularly and take breaks to allow your skin to breathe. For persistent or severe symptoms, consult a dermatologist who can provide personalised treatment and help you develop a comprehensive management plan tailored to your specific condition.
Custom fit earplugs can be an effective tool in managing ear eczema by minimising potential irritants and creating a protective barrier that reduces skin inflammation. These specialised earplugs are designed to precisely match the unique contours of your ear canal, which means they create a more comfortable and seamless fit compared to standard, one-size-fits-all options. By providing a perfect seal, custom earplugs help prevent moisture buildup, which is a common trigger for eczema flare-ups, as excess humidity can create an environment conducive to skin irritation and potential fungal or bacterial growth.
The materials used in custom-fit earplugs can be specifically selected to be hypoallergenic and non-reactive, reducing the risk of additional skin reactions. Unlike generic earplugs made from latex or silicone that might cause allergic responses, custom earplugs can be crafted from medical-grade materials that are less likely to provoke an inflammatory response. Additionally, their precise fit means less friction and rubbing against sensitive ear canal skin, which can help prevent mechanical irritation that might exacerbate eczema symptoms.
For individuals who swim, work in dusty environments, or are exposed to moisture or potential skin irritants, custom earplugs offer a protective solution that can help maintain a more stable and controlled ear environment. They create a barrier against external allergens, water, and potential irritants while allowing the skin to breathe, which is crucial in managing eczema effectively. Find out more by visiting our custom fit earplug page dedicated to provide improved hearing protection.
While many cases of ear eczema can be managed with over-the-counter treatments and careful self-care, there are several critical signs that indicate you should seek professional medical attention promptly. If you experience persistent symptoms that do not improve after two weeks of home treatment, such as continuous inflammation, intense itching, or spreading redness, it's time to consult a healthcare professional. Additionally, any signs of infection—including increased pain, yellow or green discharge, fever, or swelling that extends beyond the ear canal—require immediate medical evaluation. Pay close attention if the eczema causes significant disruption to your daily life, such as sleep disturbances, hearing difficulties, or psychological distress from constant discomfort. People with pre-existing conditions like asthma or allergies, or those with a compromised immune system, should be especially vigilant and seek medical advice earlier in the progression of symptoms. Dermatologists and ENT specialists can provide advanced diagnostic tests to identify specific triggers, prescribe stronger topical or systemic medications, and develop a comprehensive treatment plan tailored to your unique skin condition. Remember that untreated or improperly managed ear eczema can potentially lead to more serious complications like chronic skin damage, recurring infections, or permanent changes to the ear canal's skin structure, so proactive medical intervention is crucial for long-term ear health and comfort.
For more information on ear eczema signs and symtpoms and ways to mange your condition. Check out our helpful information page where you can find links to various leading organisations.
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