Ear eczema – symptoms, causes and treatment

Ear eczema is a common type of eczema that appears around or behind the ears. This condition often causes discolouration, dry skin, and itchiness in and around the ears. It can be triggered by various factors, including allergens, irritants, infections, stress, and genetics.

Understanding the symptoms and causes of ear eczema can help in determining the proper treatment and ways to prevent it from reoccurring. Find out more about the causes, symptoms, types of ear eczema, and how to treat ear eczema below.

Ear eczema is a skin condition that causes the skin in and around your ears to become dry, discoloured, itchy, and bumpy. It can appear on the outside of the ear, including earlobes, inside ear canals (the tube-like ear part that connects the outer ear to the eardrum), the ear opening, behind ears, or on skin between ears and face. While ear eczema is generally not dangerous, it needs treatment to relieve discomfort, prevent complications, and improve quality of life.

In severe ear eczema cases, the skin might crack or leak a thick yellow or white fluid (pus). You might also experience a ringing noise (tinnitus) or hearing loss if the eczema affects the ear canals. Eczema damages the skin’s barrier function, making the skin more sensitive and prone to infection and dryness.

Ear eczema symptoms can vary depending on the type and severity of the condition, but the main symptoms include:

• Redness: The skin around and inside the ears appears red and inflamed.
• Itchy skin: persistent itching, which can further irritate the skin.
• Dryness: the skin may become unusually dry, flaky, and scaly.
• Swelling: inflammation can cause the skin to swell, making the affected areas puffy.
• Discolouration: the affected skin might become darker or lighter than the surrounding areas, especially after inflammation has subsided
• Blisters: severe cases may present with small, fluid-filled blisters that can rupture and ooze.
• Oozing: the skin may have thick, yellowish fluid, indicating infection.

These symptoms can impact various areas of the ear, such as the outer ear, earlobes, and the skin inside the ear canal, and can greatly affect overall comfort and daily life.

The causes of eczema in ears vary depending on the type of eczema. There are several different types of eczema that may affect the ear, including atopic eczema, seborrhoeic dermatitis, asteatosis eczema, and contact dermatitis. Find out below about the causes of each ear eczema type:

Atopic eczema, or atopic dermatitis, is the most common type of eczema. It is usually caused by genetic factors, immune system dysfunction, and environmental triggers such as allergens (pollen, dust mites, pet dander) and irritants (harsh soaps, detergents). The affected areas, including the outer ear, earlobes, and the skin inside the ear canal, typically show redness and inflammation. The skin also becomes dry, scaly, and flaky, often leading to a rough texture. Read more about atopic dermatitis.

Seborrhoeic dermatitis is also known as ear canal eczema, as it often affects the tube-like structure connecting the outer ear to the eardrum. Excess oil production and hormonal changes can contribute to the development of seborrhoeic dermatitis, so it generally affects areas of the body that have sebaceous glands (which produce oil), such as the ear canal. Read more about seborrhoeic dermatitis.

Allergic contact dermatitis (allergic eczema) is triggered by allergic reactions to certain materials, leading to dryness, itching, inflammation, or redness in the inner or outer ears. This can occur if you come into contact with allergens such as cosmetics, detergents, fragrances, metals, hair products, and others. Read more about allergic contact dermatitis.

Asteatotic eczema is mainly caused by dry skin. It often occurs in dry environments or during winter when humidity is low. Other factors can also influence asteatotic eczema on ears, including ageing, as older adults are more prone to naturally drier skin, some medications, such as diuretics (water tablets) and statins (lipid-lowering medications), nutrient deficiencies, and irritants.

If you’re unsure what may cause eczema in your ears, ask your dermatologist to help you determine what’s causing the reaction.

To determine if you have ear eczema, a doctor will typically perform a basic examination of your ears. They may use an otoscope—a lighted instrument—to inspect your external ear canal for any signs of irritation. Additionally, the doctor will ask about your symptoms and check for common eczema indicators, such as discolouration and dryness.

Based on your symptoms or medical history, your healthcare provider may also perform a biopsy if required. This procedure involves taking a small sample of skin cells from the affected area and examining it under a microscope. A biopsy of the ear's skin tissue can help the doctor rule out similar conditions, such as psoriasis. If there’s any doubt, your doctor may also do blood and skin tests for allergies to look for other possible causes of your symptoms. 

There are several ways you can do to treat ear eczema. your health provider will tell you what type of eczema you have and what treatment is right for you.

Apply fragrance-free, hypoallergenic moisturisers several times a day, especially after bathing. Look for ointments or creams containing ingredients like Ceramides, Licochalcone A, Omega-3 and Omega-6. These ingredients can help to soothe your skin, reduce redness, and replenish its protective barrier.

Eucerin AtoControl Face Care Cream is clinically and dermatologically proven to hydrate, soothe, and reduce dryness. It is enriched with Licochalcone-A and Ceramides, which help regenerate and strengthen your skin’s barrier, relieving tightness and itchiness.

If eczema flares up, the AtoControl Acute Care Cream can be applied as often as needed on affected areas and has been shown to support sleep. The cream contains Licochalcone-A, anti-bacterial Decanediol, Methoxypropandiol (MPD), and Ceramides, can help strengthen the skin’s barrier, alleviate dryness, and relieve itchiness at a sensory level, thereby reducing the need to scratch.

Use a soft, damp cloth to clean your ears gently. Avoid using cotton swabs or inserting anything into your ear canal, as this can irritate the skin and worsen eczema. If you need to wash the area, use a mild, fragrance-free soap. Rinse thoroughly and pat the area dry with a soft towel.

Use lukewarm water for bathing to avoid drying out the skin. Limit your shower time to 5 – 10 minutes.

Identify the triggers of eczema and avoid known triggers, such as shampoos, hair products, or earrings made from materials like nickel. Make sure to use hair and skin care products that are free of perfumes, dyes, and alcohol.

Use a humidifier in your home, especially during dry seasons, to keep the air moist and prevent your skin from drying out.

• Hydrocortisone Cream: You can apply a mild hydrocortisone cream to small, itchy patches of eczema on your ears. Make sure to be cautious when using it near the ear canal and follow the instructions carefully.
• Antihistamines: Oral antihistamines can help reduce itching, especially if it's severe or affects your sleep.

Try not to scratch the affected areas, as this can lead to infection and further irritation. If necessary, keep your nails short and wear cotton gloves at night.

With proper treatment, your ear eczema should disappear after one to three weeks. However, no treatment can guarantee the complete elimination of the symptoms, and flare-ups may still occur. Once you identify and understand the causes, you may prevent flare-ups from happening as often.

There are several steps you can take to prevent outbreaks of eczema in your ears:

1. Create a skincare routine and follow your healthcare professional’s recommendation to keep your skin healthy.
2. Don’t use any wool and silk materials like scarf or clothes as they can dry out your skin.
3. Shower or bath with mild soap and pat your dry skin instead of rubbing it.
4. Apply a fragrance-free, hypoallergenic moisturiser cream to your ears daily to keep the skin hydrated and prevent dryness, especially after drying your skin. Use creams containing ceramides or other ingredients that help strengthen the skin’s barrier, reducing the likelihood of flare-ups.
5. Maintain good ear hygiene by cleaning your ears regularly, as well as your headphones.
6. Protect your skin from extreme temperatures and avoid sudden changes in temperature and humidity.
7. Drink plenty of water- at least eight glasses of water each day to keep your skin hydrated from the inside out.
8. Maintain a balanced diet rich in anti-inflammatory foods like omega-3 fatty acids (e.g., fish, flaxseed, and walnuts) to support your skin health.

Ear eczema can be very uncomfortable, affect your quality of life, and make you feel self-conscious. It can also be concerning if it affects your hearing. However, it's very common and normal for people to have eczema on their ears. With proper treatment and care, you can reduce its impact. Consult with a healthcare provider as soon as you notice any signs of ear eczema.