Ear Eczema: Symptoms, Causes, Diagnosis

What Is Ear Eczema?

Itchy, irritated, dry, red areas on your skin? You may be experiencing a flare-up of eczema.

Also known as atopic dermatitis or atopic eczema, eczema is the umbrella term used to describe allergic skin conditions that may occur across the body.

There are a variety of different types of this condition, and there are a few common areas where you may experience a flare-up, including the hands, neck, and inner elbows or knees.

Eczema can even develop on your ear and in your ear canal. 

While ear eczema can be uncomfortable, there are a number of ways to manage eczema that occurs in the ears, depending on the cause and type of eczema you’re diagnosed with.

This article will go over common symptoms of ear eczema, as well as causes, the diagnosis, and treatment.

We will also review treatment options and next steps when experiencing a flare-up, and discuss when to consult a health care professional.   

Symptoms of Ear Eczema

Ear eczema can cause irritation, discomfort, itching, and sometimes pain.

It can affect all parts of the ear, including your ear lobes, the outside of the ear hole (conchal bowl), the opening of the ear (meatus), the area behind the ear, the creases of the ear and ear folds, as well as internal parts of the ear, like the ear canal (external auditory canal), and the eardrum itself (tympanic membrane). 

Some common symptoms of ear eczema include: 

• Dry skin
• Red skin
• Scaly skin
• Itchy and cracked skin
• Skin flaking and loss
• Occasional thin discharge from your ear

Symptoms often flare up in the winter, when the air is drier. 

What Causes Ear Eczema?

There are a number of different factors that can cause eczema, including: having a personal or family history of eczema; using certain types of personal care products, fragrances, and beauty products; being in the presence of certain environmental conditions, allergens, or irritants; or having a specific allergic reaction.

Additionally, it’s important to note that there are three different types of eczema that commonly affect your ear region. 

Seborrheic dermatitis

Seborrheic dermatitis (or seborrheic eczema) usually occurs in parts of the body that produce more oil and where there are sebaceous glands, such as the scalp, face, upper chest, and back.

Although the exact cause is unknown, it is thought to be due to a combination of oil gland activity, normal yeast living in the skin, changes in the skin barrier, and genetics.

Signs of seborrheic dermatitis include rough, scaly, red skin that sometimes forms yellow or white crusting, flakes, or drainage.

In severe cases, painful cracks can develop on the skin around the ears and scalp. 

Infants and babies often experience seborrheic dermatitis in the form of cradle cap (which causes crusting and flaking of the scalp), and can also exhibit a red rash to the scalp, neck, face, upper back, and shoulders.

Other risk factors for adults include stress or fatigue, extreme weather, obesity, nervous system disorders, as well as conditions that may suppress your immune system, like HIV/AIDS. 

Asteatotic eczema

When the skin becomes dry, itchy, white, and cracked, it may be asteatotic eczema (also known as xerotic eczema or eczema craquelé).

This type of eczema often occurs in older adults, but may occur at any age.

Asteatotic eczema typically occurs when the skin is exposed to extreme weather changes, such as wind, indoor heating, or with overwashing of the affected area (such as in the case of excessive hand or face-washing).

While environment and weather are common causes of asteatotic eczema, it may also develop from dehydration or malnutrition, frequent bathing in hot water, and use of some medications, like diuretics.

Allergic eczema

Allergic eczema, a form of contact dermatitis or skin allergic reaction, is the result of direct contact with something you’re allergic to.

Common triggers of allergic eczema include hair products (like hair spray or shampoo), earrings, cellphones, headphones and earbuds, earplugs, makeup and perfume, amongst other personal care products, or allergens like poison ivy or poison oak.

Food and environmental allergies may also contribute to allergic eczema flares.

Symptoms of allergic contact dermatitis include itching, red patches, sensitive skin, and raised bumps.

If eczema symptoms present after you have started using a new personal care product or changed environments, allergic eczema may be the cause.

Diagnosis

In order to get a diagnosis for ear eczema and determine which type of atopic dermatitis you may have, you will need to see a medical professional or your health care provider.

A provider can usually make a diagnosis based on physical examination of your skin and by reviewing your medical history.

It is also possible they may perform a patch test to confirm the cause of your condition, as well as allergy tests, though most cases can be diagnosed without testing. 

Treatment

Treatment of ear eczema depends on the cause and type of eczema.

Mild cases resolve quickly, but depending on the cause or severity, it can take several months or even years to get certain eczema outbreaks under control.

Even after successful treatment, it is possible for the symptoms to return, or for you to experience intermittent flares. 

Your provider may recommend or prescribe a topical medical cream or ointment to control itching and dryness and help repair your skin.

One common option is a corticosteroid cream, which comes in both over-the-counter (hydrocortisone 1%) and prescription forms (triamcinolone, desonide, and others).

Some other creams contain a medication called a calcineurin inhibitor (tacrolimus and pimecrolimus) which works in a different way than corticosteroids and is available by prescription only.

Be sure to avoid strong sunlight while using and only use these as directed.

Ear drops may also be prescribed, including steroid drops.

When using ear drops, be sure not to push cotton balls into your ear. 

In general, ointments work better than creams for the treatment of eczema, but your health care provider can help you to pick the right option for your symptoms.

All medicated creams or ointments work best in combination with a fragrance-free moisturizing ointment or cream like Eucerin or Aquaphor, which helps create a moisture barrier and protect the skin. 

Some natural remedies and therapies can also help with eczema flares.

Some small studies have shown that honey ear drops may work to treat chronic eczematous external otitis, and can help with symptoms like itching.

Only sterile medical honey should be used for this purpose, and this has not been thoroughly studied or found to be more effective than medical ear drops or ointments.

In general, food products should never be inserted in the ear unless recommended by your medical provider.

Wet dressings and bandages can help severe cases of atopic dermatitis.

Light therapy has also been shown to help skin using artificial light forms like UVA and UVB, though direct sunlight and tanning cause skin cancer and can make skin conditions like eczema worse.

It is important to avoid scratching and irritation as much as possible.

Learn to recognize signs early so you can start treatment immediately, and try moisturizing regularly with an emollient cream or ointment formulated for sensitive skin.

Avoid harsh soaps, fragrances, and extreme weather. 

For infants with the form of seborrheic eczema known as cradle cap, no formal treatment is needed.

Instead, the Mayo Clinic suggests washing your baby’s hair with a mild, fragrance-free shampoo and gently rubbing the scaly skin off the head with a washcloth of fingers.

Your pediatrician can recommend further treatments if cradle cap symptoms are severe or causing itching or discomfort.

Outlook

Ear eczema is common, and while it may take some time to relieve your symptoms, it is generally a manageable condition.

It may be hard to formally cure your ear eczema, so be sure to use moisturizers and avoid irritants even between flare-ups.

Chronic ear eczema may contribute to other ear conditions, such as otitis externa (swimmer’s ear) and other types of ear infections.

Excessive itching may also result in open sores which can lead to bacterial infections.

If this occurs, seek medical advice from your health care provider who can determine if antibiotic treatment is needed.

Could It Be Something Else?

While dry, itchy, red skin and irritation on your ear may be a result of eczema, there are a number of skin conditions that may present with similar symptoms such as:

• Psoriasis
• Allergies
• Fungal infections
• Dandruff

A healthcare provider can help you figure out the exact cause of your specific symptoms.

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