FACTSHEET

EAR ECZEMA

Eareczemacanbeanextremelyirrita ngand,at mes,painfulcondi on.Itcanrangefromslightdrynessof

thepinna(thevisible,projec ngpartoftheear)toextensiveskinlossandsoreness,aswellasinfec onofthe
externalandinternalpartsoftheear.Eczemacanaecttheen reearincludingtheearlobes,conchalbowl
(theareaoutsidetheearhole),theearopening(meatus),earcanal(alsoknownastheexternalauditorycanal
the part of the ear which leads to the ear drum) and the ear drum itself (also known as the tympanic
membrane).Theearfolds,backoftheearsandtheareawheretheearsmeetthefacearealsocommonareas
foreczema.
Inflamma onoftheearcanaliscalledo
thepreven onandcontrolofo

sexternaandhasanumberofcauses.Itisimportanttofocuson

sexternaas,ifle untreated,eczemaorinfec oninthisareacanworsen

andspreadoutwardstothepinnaandsurroundingskin.

TYPES OF EAR ECZEMA

Thereareanumberofcausesofeareczemaanditisalwaysbesttoconsultyourdoctorifyouthinkyoumay
haveit,inordertogeteec vetreatmentandpreventflareups.Severaldierenttypesofeczemamayaect
theear.Thesearelistedonpage2.

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FACTSHEET
EAR ECZEMA
Atopic eczema
Theearsandskinbehindtheearsarefrequentlyaectedinpeoplewithatopiceczema.Aswithotherareas
of the body, the eczematous skin is red, dry and itchy, and can easily become infected, especially if
scratched and the skin is broken. A common area for ear eczema in people with atopic eczema is at the
junc onbetweentheearlobeandtheface.Eczemainthisareacancausepainfulcracks(fissures)inthe
skin,whichcantheneasilybecomeinfected.Some meseczemacanaectthewholeofthepinna.

Seborrhoeic eczema (dermatitis)

Seborrhoeiceczemaaectsareasofthebodywheretherearesebaceousglands,includingtheears,scalp,
faceandtrunk.Initsmildestform,seborrhoeicderma

ssimplycausesscalingandrednessattheentrance

totheexternalearcanal.Initsmoresevereforms,rednessandcrustycracksdevelopintheearfoldsand
extendtotheexternalear,andthescalpandneckcanalsobeaected.

Asteatotic eczema
Thistypeofeczemaaectsolderpeople.Theexposedearisvulnerabletochangesinclimate,whichleads
to dry, scaly and itchy skin causing asteato c eczema. Aggrava ng factors include overwashing, cold or
windyweather,centralhea ng,lowhumidityindoorsandaircondi oning.

Contact dermatitis
Theexternaleariscommonlyaectedbybothirritantandcontactderma

s.

Irritant contact dermas resultswhentheskinssurfaceisirritatedbyasubstancethatcausestheskinto

becomedry,redanditchy.Examplesofsubstancesthatcancauseirritantcontactderma

saroundand

insidetheearsareshampoos,hairgels,hairspray,permsolu onandperfume.
Allergic contact dermas mayappearasaresultofyourbodyreac ngtoapar cularsubstancetowhich
youareallergic.Everydayitemsthatcancauseallergiccontactderma

saroundandinsidetheearsinclude

thefollowing:

Products used for the hair and scalp (e.g. shampoo, condi oner, gels, hairspray, hair dye, perm
solu on,hairpinsandgrips,hairnetsandbathingcaps).

Earringsandstuds,especiallythosecontainingnickel.

Plas c, rubber or metal ear appliances (e.g. hearing aids and moulds, spectacles, head and
earphones,mobilephone/ipodreceivers,earplugs).

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FACTSHEET
EAR ECZEMA

Objectsusedtocleanorscratchtheear.

Cosme csandtoiletries(e.g.makeup,perfumeandsoap).

Topicalmedicaments(e.g.ointments,creamsandgels).

Allergenstransferredtotheearsviathefingers(e.g.nailvarnish,plantresinfrompoisonivy,oak).

EAR PIERCING
Ear piercing does not cause ear eczema, but problems can occur later on as a consequence of wearing
earringsorstuds.Nickelallergyisverycommonandthechanceofthisdevelopingisgreatlyincreasedifyou
haveyourearspiercedandifanythingmadeevenpartlyfromnickelisworninorontheear.
Ifyoudefinitelyhaveanickelallergy,wearonlyhypoallergenicjewelleryorthatmadeof18caratgold,
puresterlingsilver,pla numorgoodqualitystainlesssteel.Foreignsilver,rolledgold,whitegoldandgold
pla ngshouldbeavoided.
Pierced ears can become infected, par cularly just a er piercing. Make sure you go to a reputable ear
piercingtechniciantogetyourearspierced,andbathethemfrequentlya erwardswithaweakan sep c
solu onun ltheystopweeping.

TREATMENT OF EAR ECZEMA

Treatmentofeareczemawilldependonthecauseandtypeofeczema,whichwillneedtobediagnosedby
yourGP.Possibletreatmentsthatyoumaybeprescribedarelistedbelow.
Foratopic,seborrhoeicorasteato ceczema,applyemollientcreamfrequentlytotheaectedareas.You
maybeprescribedatopicalsteroidonsoreareasbehindtheears,andintheirfolds.Ifyouhaveseborrhoeic
derma

s,atopicalsteroidcombinedwithanan fungalmaybeprescribed.

Applyyourtopicaltreatmentstotheaectedareabyusingaco onbudtogentlypaintonyourcreamor
ointmentaroundtheearpinnaandtheopeningtoyourearcanal(earmeatus).Do not push the coon bud
into your ear.
Ifyouhaveeczemainsidetheearcanal,youwillneedsteroiddrops,whichwillbeprescribedbyyourGPor
otherhealthcareprofessional.
Ifallergiccontactderma

sissuspected,youmaybereferredtoadermatologydepartmenttohelp

diagnosewhatyouareallergictosothatyoucanavoiditinthefuture.

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FACTSHEET
EAR ECZEMA
Seealsothesec ononinfectedeareczemabelow.

CLEANING OF THE EARS AND SELF-CARE

Youcanverygentlywashtheinsideofyourouterearwithwaterorpreferablyanemollientwash.Youcan
alsouseadampco onbudverygentlyinthebowlareaofyourearbutdonotinsertitintotheearcanal.
Nevertrytowashfurtherintotheearsyoucandamagetheskinoftheearcanalbydoingthis.
A erwashing,dryyourearsthoroughlyusingawarm(nothot)hairdryerisagoodwaytoensureyourears
aredry.Avoidscratchingtheinsideofyourears,especiallywithmatchesorhairgripsnotonlycanthese
damageyourearcanalskinordrum,buttheycanalsosetupanallergicreac on.
Theuseofearcandlesisnotadvised.
Ifyougoswimming,useearplugs.Youcangetcustommadeearmouldstofityourearstheyarelikethe
mouldsusedashearingaids.Earmouldscanbemadeandfi edathearingaidcentres(largerchemistssuch
asBootsprovidethisservice,asdoprivateaudiologists).
Oliveoilmaysome mesberecommendedformoisturisingaroundtheearpinnaandlooseningwax.
However,duetorecentresearchontheadverseeectsofoliveoilforpeoplewitheczema,weadvise
againstthis.Instead,wesuggestthatanemollientcream/ointmentisappliedtotreatdryskinaroundthe
earsandintheentrancetotheearcanals,andrefinedpetroleumoil(unfragrancedbabyoil)orsunfloweroil
isusedforso eningearwax(butconsultfirstwithahealthcareprofessional).Waterisnotrecommended,
norarewaxso enerproductsboughtfromchemistsastheymayencouragethebuildupofdebrisandcause
moreinflamma onandirrita on.

INFECTED EAR ECZEMA

Skin aected by eczema and derma

s can become infected, usually by bacteria, especially if the skin

surfaceisbrokenduetodrynessandscratching.Thisissimilartoeczemainfec onsinotherareasoftheskin.
Ear eczema that becomes infected can encourage a buildup of wax, skin scales and hair in the ear canal,
whichcanleadtoblockageandcausetemporarydeafness.Infectedeczemaandearinfec onscanalsoresult
whentheearsarewetforlongperiodsof me forinstanceifyouswima lotandifyouleaveyour ears
dampa erswimmingorwashingyourhair,yourchancesofanearinfec onarefurtherincreased.Pressure
fromhearingaidsandearpiecescanalsoencourageearinfec onsotrytoensuretheyareacomfortablefit.

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FACTSHEET
EAR ECZEMA

Symptoms of infec on inside the ear include earache, itching, pain, redness, weeping, swelling and an
unpleasant smell or dirtycoloured discharge (o en yellow or green) from inside the ear. If you have any of
thesesigns,makeanappointmenttoseeyourGP.Pleasenote:Eardischargethatisclearisnormalifyouhave
eareczema,especiallywheneczemaisac ve(weepyeczema).
Ifyouthinkyoureareczemaisinfected,seeyourGP.Youmaybeprescribedacombina onprepara on
containingamixtureofan bio candtopicalsteroidforbacterialinfec ons,oranan fungalandtopicalsteroid
forfungalinfec ons.Youshouldcompletethecourseoftreatment.

AURAL TOILET BY HEALTH CARE PROFESSIONALS

Abuildupofwaxandtheflakyskinfrompatchesofeczemacanproducealotofdebrisintheearcanaland
thiscaneasilygetinfected,especiallywhenwaterispresent.Soprevenonofearinfec oniskey.
Manual cleaningoftheearbyahealthcareprofessionaliscalledauraltoiletandiso enrecommended to
removethedebrisandscalethatcanbuildupintheearcanal.Itisdoneunderamicroscope,eitherusingapick
orhook(JohnsonHorneprobe)orusingmicrosuc on,anelectricsuc onsystem.
Microsuc onisalsorecommendedifearwaxistrulyimpacted,andisconsideredsaferanddefinitelybe er
thanflushingtheearswithwaterespeciallyforpeoplewitheareczema.AlthoughmanyGPprac cesoerear
syringingand/orearirriga on(anelectronicmachineforwashingtheears)toremoveearwax,waterbased
methodsarenotrecommendedforpeoplewitheareczema,unlessitisverymild.Some mesregularaural
toiletisrecommended(onceortwiceayear)topreventwaxandeczemadebrisbuildup.
Auraltoiletcanbeperformedbyauralcarenurses/technicians,orsome mesbyspeciallytrainedprac ce
nurses.AskyourGPforareferraltotheauralcareservice(provisionmayvaryaroundtheUK).Alterna vely,
thisservicemaybeprovidedprivatelybyaudiologistsyourhealthcentremaybeabletomakea
recommenda on.

IN SUMMARY
Ear eczema can be an extremely irrita ng condi on and since it is dicult to look into the ears without
specialistequipment,itiso enhardtoknowwhatisgoingon,par cularlyinthecaseofyoungchildren.
Iftheearsbecomeuncomfortable,dontignoreititisalwaysbesttoseeyourGP/healthcareprofessional,
whocanuseaspecialtorchtolookinside.O enthiswillrevealthecauseofeardiscomfortandtheproblem
canthenberesolved,usingoneofthemanytreatmentsavailableforeareczemaandearinfec ons.
Factsheet updated June 2015

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FACTSHEET

National Eczema Society 2015

The National Eczema Society is a charity registered in England and Wales (number 1009671) and in
Scotland (number SCO43669) and is a company limited by guarantee, (registered in England number
2685083). Registered office 11 Murray Street, LONDON, NW1 9RE.

We are dedicated to improving the quality of life of people with eczema and their carers.

Eczema affects FIVE MILLION adults and children in the UK every year.

All our information is clinically evidence based and written by or verified by dermatology experts.

The National Eczema Society receives no Government or Health Service funding, relying entirely on
voluntary income from the general public, companies and Trusts.

DISCLAIMER
These details are provided only as a general guide. Individual circumstances differ and the National Eczema
Society does not prescribe, give medical advice or endorse products or treatments. We hope you will find the
information useful but it does not replace and should not replace the essential guidance given by your general
practitioner, dermatologist or dermatology nurse.

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