Everything You Need to Know About Eczema on the Ears

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

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

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.

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

Seborrheic Dermatitis

“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

• 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.

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

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

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• 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.

• 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

• 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

• 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.

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.

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.

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.

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

• Low- to medium-strength topical steroids, such as over-the-counter hydrocortisone cream
• Topical calcineurin inhibitors
• Topical PDE4 inhibitors
• Topical JAK inhibitors

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

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.”

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.

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.

• 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.