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Everything You Need to Know About Eczema on the Ears

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Eczema is a common skin condition that can affect any part of your skin, including your hands, neck, inner arms, legs, and face — and even your ears.

When eczema affects the area around the ears, it can cause discomfort, itching, redness, and dry, flaky skin. It may lead to inflection and other complications as well.

The key to finding relief is understanding the specific types of eczema that affect your ears, how this eczema is triggered, and effective management strategies.

Eczema on your ears can take different forms, each with its own characteristics and underlying causes.

Atopic Dermatitis

The most common and chronic form of eczema is atopic dermatitis.

Experts estimate that atopic dermatitis affects around 200 million people around the world, according to a review of 344 studies.

 In the United States specifically, more than 9.6 million children and 16.5 million adults have the condition.

Statistics are lacking when it comes to how commonly it affects the ears specifically.

Like many types of eczema, atopic dermatitis happens when an overactive immune system produces inflammation and causes the skin barrier to dry out and become irritated. It may also result from a weakened skin barrier, environmental triggers, and genetics.

This noncontagious condition is typically associated with symptoms in places where the body flexes, such as inside your elbows or behind your knees.

But any area of the skin can develop atopic dermatitis, including the ears, says JiaDe “Jeff” Yu, MD, a dermatologist and the director of the Contact and Occupational Dermatology Clinic at Massachusetts General Hospital in Boston.

Dr. Yu says that the outside part of your ear can be particularly vulnerable to atopic dermatitis because it tends to dry out easily, unlike certain areas of the body that have more oil and sweat glands, such as your armpits, groin, and scalp.

Symptoms are similar to what would occur elsewhere on the body: “Itching, scaling, and redness are by far the most common,” Yu says. The rash can look purple, dark brown, or an ashy gray or white color on darker skin tones.

The rash may hurt, he says, “especially if scratching has led to open sores and a bacterial infection.”

Seborrheic Dermatitis

If you are experiencing itching, scaling, and color changes on or in your ears, the problem may not be atopic dermatitis. You may be dealing with seborrheic dermatitis, which is common on the ears and can look a lot like eczema.

The condition occurs in approximately 3 to 5 percent of the population globally.

 Once again, however, research into the prevalence of seborrheic dermatitis on the ear specifically is lacking.
It typically takes the form of a dry, scaly, flaky rash that may burn or itch. On the ear, you might experience crusting, cracks in your skin, or oozing if it becomes infected.

“Seborrheic dermatitis is a fancy term for dandruff. It can occur anywhere the skin is oil-rich, such as inside the ears and the ear canal. It less often involves the external ear,” says Yu. The crease behind the ears and even the eyebrows can be affected, though.

The underlying cause of seborrheic dermatitis may be the body’s reaction to a yeast-like fungi on the skin known as Malassezia.

“It may be that the Malassezia eats the increased sebum and then the immune system reacts to the overgrowth of the yeast on the skin,” says Peter Lio, MD, a Chicago-based dermatologist who is on the board and clinical advisory council of the National Eczema Association.

Heat, sweat, and the entrapment of sweat and oils in the skin can all be factors in seborrheic dermatitis as well, Yu says.

In order to manage flare-ups, it’s crucial to understand what triggers eczema on your ears. Atopic and seborrheic dermatitis have distinct triggers, but there is some overlap.

Atopic Dermatitis Triggers

Atopic dermatitis can occur when your skin has an allergic reaction to substances it touches. In this case, it’s known as contact dermatitis.

Common triggers for allergy-related ear eczema include:

  • Certain Metals Some of the metals used in jewelry are common culprits, says Yu, and can cause a reaction on the earlobes and outer ear. Nickel and copper are two examples.

     Because some cell phones are made with nickel, they can cause a skin reaction, according to an older case study.

  • Headphones and Earplugs In-ear headphones and foam earplugs can trigger a reaction, potentially affecting the ear canal.

  • Products for Hair and Scalp Care These products — including shampoos, conditioners, hair sprays, and hair dyes — can get in and around your ears, triggering a reaction.
Other irritants can include:

  • Soaps and detergents
  • Cosmetics and toiletries
  • Topical medications
  • Objects used to clean the ear
  • Allergens transferred to your ears from your fingers
  • Certain, fabrics, like wool
Environmental factors may include:

  • Cold, dry air
  • Changing temperatures
  • Sweat
  • Stress

Picking at or rubbing the skin in and around the ears can also trigger a flare-up.

“It is best to avoid scratching and rubbing these areas,” says Dr. Lio.

Seborrheic Dermatitis Triggers

Seborrheic dermatitis is often linked to the overgrowth of Malassezia yeast, and has these possible triggers.

  • Excess oil production in areas with more (sebum) glands make these areas, including the ears, more susceptible.
  • Heat and sweat create a favorable environment for yeast overgrowth.
  • Infrequent washing can allow yeast and oil to build up.
  • Stress and fatigue can contribute to flare-ups as well.
Similar to atopic dermatitis on your ears, seborrheic dermatitis may also result from changes in temperatures or weather, cold and dry air, harsh hair products or soaps, and certain medications.

To minimize eczema flare-ups, Yu recommends the following:

  • Avoid costume jewelry or opt for styles made with metals that are unlikely to trigger an allergic reaction, such as surgical steel, titanium, gold, silver, or platinum.
  • Try not to wear headphones or earplugs for extended periods.
  • Minimize exposure to cold, dry air. Use a humidifier indoors and earmuffs outdoors during cold weather months.

“Take your jewelry off every night. Don’t shower in it. Don’t sleep in it,” says Gail Porter, who has atopic dermatitis as well as occasional bouts of seborrheic dermatitis on the scalp and behind her ears.

Try to also avoid fabrics that can irritate your ears, like wool or silk. For atopic dermatitis caused by allergens, try to limit any exposure to things you know cause an allergic reaction or irritation in your skin.

It’s best to use a mild soap when bathing or showering, and pat your skin dry once you’re done. Apply a thick emollient to the ears, such as Vaseline, to seal in moisture, Yu says.

“Very few people moisturize around the ears, and this may also help explain why eczema is more likely,” Lio says.

A regular skin-care routine can help keep seborrheic dermatitis symptoms at bay.

The National Eczema Foundation recommends washing affected areas each day with a gentle, 2 percent zinc pyrithione cleanser (Head & Shoulders and Selsun Blue are over-the-counter examples), followed by a moisturizer.

In general, the American Academy of Dermatologists recommends that Black people — who may have curly, tightly coiled, or straightened hair that is more fragile, dry, and prone to breakage — should wash once per week or every other week.

Porter, who is Black, says washing her hair at least once a week has helped eliminate flakes and itchiness in both areas.

To avoid problems in the creases behind her ears, she is careful to dry that area thoroughly after each shampoo.

“Don’t allow it to stay damp,” Porter says. This is because too much contact with water can irritate the skin, especially if you don’t moisturize right away.

Aside from taking steps for prevention, such as moisturizing, you can treat both types of eczema around the ears with topical medications prescribed by a doctor.

Atopic Dermatitis

A doctor can perform a patch test on an area of skin to determine whether a particular substance might cause an allergic reaction that could trigger an atopic dermatitis flare-up.

Topical medications used to treat atopic dermatitis involving the ears include:

Treating atopic dermatitis in the ear area can be a challenge because the skin is delicate and sometimes hard to access, says Lio.

“If [the eczema] is just below and behind the ear, usually creams or ointments can work well in those areas,” he says. “If there are cuts or fissures, it can be better to use a greasy ointment that is less likely to sting than a cream, gel, or liquid. Things get more difficult if the ear canal itself has eczema: Then we often use oil-based [steroid] ear drops to help get a bit inside and cool the inflammation and itch.”

Porter has found that moisturizing her ears and face with an over-the-counter lotion that contained colloidal oatmeal brought relief: “I just started rubbing it on my ears, behind them, and on my face. The eczema’s pretty much almost gone now.”

In fact, research supports the idea that colloidal oatmeal protects the skin barrier, moisturizes, and has anti-inflammatory properties — and that it may ease the severity of eczema symptoms.

Seborrheic Dermatitis

Yu uses several types of medication to treat seborrheic dermatitis.

“Generally, I try to reduce the Malassezia yeast with an [antifungal] cleanser of some sort, such as ketoconazole or ciclopirox. Then, I have patients use an anti-inflammatory topical preparation such as a corticosteroid, or a nonsteroidal agent such as a topical calcineurin inhibitor,” he says.

Antifungal creams are a treatment option as well.

Eczema is a chronic condition that typically comes and goes. If your symptoms are not responding to standard treatments or are getting worse, your rash becomes infected, or you develop a fever or other non-skin-related symptoms, talk with your doctor or dermatologist.

They may want to test for other underlying conditions and may recommend alternative treatment approaches.

Though the doctor may have started by prescribing creams and lotions, they may recommend oral medications or medications given as a shot instead. For more serious cases, they may consider a specific form of light therapy.

  • Eczema, a common skin condition that causes an itchy rash and other skin symptoms, can affect the area in and around your ears.
  • Two types of eczema that occur around the ears are atopic dermatitis and seborrheic dermatitis. Common causes of the former include allergies to certain metals in jewelry and other irritants, while the latter may result from the body’s reaction to a type of yeast.
  • Eczema is a chronic skin condition that typically comes and goes. Symptoms can be managed by avoiding triggers and using topical medications. If your symptoms are not responding to treatment, contact your doctor.

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