Lump Behind Ear: Causes, Treatments, and Risks

Discovering a lump behind your ear can be alarming, in part because it’s so difficult to get a good look at what’s going on.

While it’s always a good idea to have a healthcare provider examine any new bump on your body, know that, most of the time, a lump behind the ear isn’t cause for concern.

In this article, I’ll look at the most common and most serious possible causes of lumps that appear behind the ear.

Then I’ll discuss how you can perform a self-check of any growths that appear in this area and how your doctor will check any lumps to arrive at a diagnosis.

Lastly I’ll overview treatment options for lumps behind the ear and explain when to see a doctor about this issue.

Lump Behind Ear Possible Causes

There are many possible causes for a lump behind the ear.

To distinguish between these potential explanations, doctors will first try to identify the kind of lump.

Possibilities could include a cyst, pimple, tumor, swollen lymph node, or carcinoma. 

Some of these growths are associated with more harmful cancers or rare genetic disorders.

But most lumps behind the ears are common types of cysts and are typically associated with less-threatening skin issues. 

Most common causes

Many lumps behind the ears arise when either something prevents dead skin cells from shedding or oil glands become blocked.

Then skin cells or oil can build up below the skin’s upper surfaces, creating masses called cysts. 

Though mostly benign, these skin cysts can become unsightly or uncomfortable, especially if they grow larger than a pimple.

They can also cause pain, become infected and filled with pus, or rupture.

Two of the most common types of cysts that grow behind the ear are sebaceous cysts and epidermoid cysts. 

Sebaceous cysts: These sack-like lumps form when dead skin cells block the sebaceous oil glands that are attached to skin follicles. These blockages cause a buildup of sebum (a.k.a. oil). Sebaceous cysts share similarities with acne pimples and whiteheads. However, they are larger, grow slowly, and rupture in different ways.

Epidermoid cysts: These lumps arise from a blockage that occurs when the skin’s surface folds in on itself around a hair follicle opening (a.k.a. pore). This causes dead skin cells to build up, forming a lump.

A third common reason for swelling behind the ear is a swollen lymph node.

This is usually related to a localized infection or irritation and resolves once the offending agent is removed or treated.

In some cases, this could be an indication of something more serious, so see a healthcare provider to be sure.

More serious causes

Lumps behind the ear can also have more serious or uncommon causes, including the following: 

• Basal cell carcinoma: This slow-growing skin cancer can look and feel like a small, pearly bump that sometimes resembles a mole or a pimple.

• Squamous cell carcinoma: This sometimes looks like an open sore with a raised border; other times, it looks like a wart.

• Temporal bone tumors: In some rare cases, basal or squamous cell skin cancer can spread to the part of the skull bone that’s behind the ears and cause these bumps.

• Gorlin syndrome: People with this rare genetic disorder develop tumors, cysts, and skin pits all over their bodies, sometimes including behind the ears. 

• Gardner syndrome: This is another rare genetic disorder that can lead to thousands of polyps and cysts throughout the body. While most form in the colon, cysts can form in other locations, including behind the ear.

• Infections: Viral, fungal, and bacterial infections may cause unusual swollen patches behind the ear.

Self Check and Diagnosis Guide

The best way to self-check an ear lump is to sit or stand in an area with good lighting and use mirrors to check the bump as well as possible.

Note if the lump is:

• Growing
• Hard and immovable
• Painful or tender to the touch
• Red, itchy or inflamed
• Leaking foul-smelling fluid

If any of this applies, see a healthcare provider.

In addition to a physical exam, they may order a biopsy to test for the presence of cancer or a skin culture to see if the lump can be traced to a particular kind of infection.

A biopsy means they will remove a small amount of skin to examine under a microscope; a skin culture calls for swabbing an open cyst to collect a sample to test.

Possible Treatment

Most lumps behind the ear are slow-growing and noncancerous.

Sometimes they shrink or disappear on their own.

However, if an ear lump is infected or cancerous, treatment is necessary.

• Treatment for infected lumps: Steroid injections, oral antibiotics, or draining the painful lump may help eliminate the infection. 

• Treatment for cancerous lumps: Surgery is the preferred treatment method for any harmful cyst, carcinoma, or other growth. Radiation therapy may be used as a secondary treatment. Surgery can also remove bothersome noncancerous bumps.

When to See a Medical Provider

Make an appointment to see a healthcare provider if you notice any new growths behind your ears.

Although most are cystic nodules and most cystic nodules are not harmful, some skin cancers look like cystic nodules or may develop alongside them and should always be checked.

Also seek medical attention if the lump behind your ear becomes painful, red, itchy, or inflamed, as these may be signs of infection. 

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