Ear eczema is a challenging condition to treat. The condition can range from mild to chronic eczema, affecting both the outer and the inner ear (sometimes behind or on its cartilage).
It is characterized by symptoms such as itching, severe dryness of skin or inner ear, flakiness of skin, soreness, and inflammation of the ear. At times, it is extremely irritating and can be a cause of frustration especially if the condition has no recession phase, or keeps getting severe.
What causes it?
Eczema is a non-specific term that is used to refer to a variety of skin inflammations (dermatitis). As such, there are varying categories. They include:
- Contact Dermatitis
The exact cause, including eczema in ears, remains unknown. However, allergy appears to play an integral role in the development of the condition. Allergic contact dermatitis can exhibit the appearance its.
For instance, the nickel metal found in cheap earrings can trigger the development of contact dermatitis or mild eczema on the earlobes. Also, contact with irritants in the external auditory meatus, such as an antibiotic or antihistamine eardrops or any other medication can lead to the mild case.
Types of ear eczema you can get
1. Atopic Eczema
The term “atopy” is a medical term referring to three associated conditions, asthma, rhinoconjunctivitis (Hay-fever), and eczema. It is is the most prevalent skin manifestation of atopy, especially in childhood and early adulthood.
This condition frequently affects the ears and the skin behind the ears. The junction between the earlobe and the face is another common location for atopic eczema. When in this area can be painful as it leads to fissures in the skin. Other symptoms include red, dry, scaly, itchy skin.
Seborrheic Eczema (Dermatitis)
This is a chronic type or relapsing type of eczema. It mainly affects the face, scalp, ear, and trunk. The cause remains unknown. Medical practitioners usually associate the condition with a proliferation of certain species of the skin. This condition is common in infants. However, there are adult manifestations of the condition. Prevalence of the condition is highest among young adults and the elderly.
There are certain factors associated with severe seborrheic eczema. They include:
- Oily skin
- Family history of psoriasis, or seborrheic dermatitis
- Immunosuppression: e.g a recipient of organ transplant, HIV infection, or others.
- Psychiatric and neurological conditions: e.g Parkinson’s Disease, Tardive dyskinesia, depression.
The term “asteatotic” means “lack of fat.” This type of eczema is a result of very dry skin (xerosis). This condition is common among older populations. Although asteatotic eczema is common on the lower leg, the ear and other parts of the body can exhibit this condition. The skin appears cracked (hence its other name Eczema craquelé).
It occurs due to loss of water in the outermost layer of the skin (stratum corneum). This can be triggered by a genetic predisposition or environmental factors. Examples of environmental triggers include over-washing or excessive bathing, exposure to low humidity, or harsh weather.
Aside from the older populations, the condition can develop due to complications of inherited or acquired forms of ichthyosis. Alternatively, systemic causes such as malnutrition (zinc and fatty acids), lymphoma, cachexia, hypothyroidism can trigger the condition.
Similar to atopic dermatitis, contact dermatitis is a type of eczema that looks like a rash. This condition occurs when you come into contact with something that your skin is allergic to, leading to itchiness and redness.
There are types of contact dermatitis. The first one is irritant dermatitis. This occurs when your skin becomes irritated due to a certain substance. For instance, a certain face cream or body lotion, shampoo, hairspray or other hair products.
The second one is allergic contact dermatitis. This occurs if your body is allergic to a certain substance. The most popular cause of allergic contact dermatitis is ear studs, especially those containing nickel. Cosmetics intended for the hair and scalp as well as other metal objects coming into contact with the ear can trigger the condition.
Lastly, there is another rare form of eczema known as contact urticaria (hives). This condition leads to an immediate swelling and redness the moment the skin comes into contact with a certain irritant. The irritant leads to a severe allergic reaction (anaphylactic reaction), that also leads to contact urticaria.
In most instances, chronic eczema occurs in association with the kind occurring in other areas of the body. Otitis externa is a form of eczema that occurs in the external auditory canal and the meatus. Otitis is majorly caused by infection (either bacterial or fungal). Alternatively, the condition is also associated with other noninfectious systemic processes. Common symptoms of otitis include:
- Discomfort emanating from the external auditory canal
- Excessive moisture, discharge together with trauma
- Erythema (Skin redness)
Treatment you should try
Due to the nature of the ear, this condition can lead to further complications. The scale-like skin flaking off can accumulate in the ear leading to blockage and pain. Ear eczema can also lead to other infections such as Staphylococcus aureus. This is especially common in wet conditions, for instance, after swimming. Lastly, the itching may make a person poke things or irritate the canal leading to further injury.
As a consequence, there is a need for immediate treatment if you suspect that you may be suffering from eczema. Treatment of the condition depends on the type you have. This will require a proper diagnosis from your medical practitioner.
Treatment for atopic, seborrheic and asteatotic eczema may involve the use of a topical cream and in some instances an antifungal cream (for instance, in the case of seborrheic).
Eczema occurring inside the ear canal may lead to a prescription for steroid drops. Alternatively, if contact dermatitis is the cause, then you may be referred to a dermatologist for treatment.
Treatment also includes avoiding irritants, improved ear hygiene, and topical corticosteroid treatment, and antihistamines.
It is sad to read about the daily struggles that people with eczema experience. Some have learned to cope with it. Still, the itching, inflammation, and soreness can be a cause of frustration. It is advisable to be gentle with your ears and avoid hair cosmetics with harsh ingredients. The National Eczema Association has some recommendations concerning some mild shampoos that you can use.
You can gently wash the ears using water and an emollient wash. You can use a damp cotton bud to gently clean the external are and the bowl area. Avoid inserting anything into the ear as you may damage the skin in inside the canal. After cleaning them, completely dry them and apply a moisturizer. You can use natural alternatives such as olive oil, almond oil, or coconut oil. Avoid itching or inserting anything in the ear.
If you want to go for a swim, remember to use ear plugs.
There are instances where the inner ear canal becomes infected due to a build-up of wax and scaly skin. To solve this issue, you can visit a dermatologist for a clean-up, for instance, the “Aural toilet” clean-up. This technique is usually carried out under a microscope and the practitioner proceeds to clean out the canal. You can have this procedure done at least twice a year.
Lastly, if the condition becomes uncomfortable, do not ignore it. Visit your medical practitioner for a proper diagnosis and more effective treatment approach.
- Amanda Oakley. Dermatology Made Easy, Royal College of General Practitioners,
- Richard Ashton, Barbara Leppard, Hywel Cooper. Differential Diagnosis in Dermatology, 4th Edition, CRC Press,