External ear eczema

Overview

External ear eczema, also called aural eczema, is a skin condition that causes redness, itching, and flaking of the skin on the outer ear and the ear canal. It is a type of eczema (dermatitis) that affects the skin of the ear, not the ear itself inside the head.

Yes, external ear eczema is a common skin condition. Many people experience it at some point in their lives.

It can affect anyone, but it is more common in people who already have eczema elsewhere on the body, such as on the face or hands. It also occurs more often in people with allergies, asthma, or hay fever. It can affect children and adults, and may be more common in older adults due to dry skin.

Symptoms

Common symptoms

• Itching inside or around the ear
• Redness, dryness, or flaking of the skin on the outer ear or in the ear canal
• Crusting or scaling
• A feeling of fullness or discomfort in the ear
• Slight hearing loss if the ear canal swells or fills with flakes

Symptoms in children

• May be more irritated and cause scratching, which can lead to skin breakdown

Symptoms in older adults

• Dry, fragile skin may make the condition more uncomfortable
• May be mistaken for age-related skin changes

Causes

Main causes

• Eczema itself, often related to atopic dermatitis (a type of eczema)
• Contact with irritating substances like hair products, earrings, or hearing aids
• Allergic reaction to something touching the ear (like nickel in earrings)
• Dry skin from cold weather or low humidity
• Frequent scratching or cleaning of the ear canal

Risk factors

• Personal or family history of eczema, allergies, asthma, or hay fever
• Using earplugs, headphones, or hearing aids for long periods
• Having very dry skin in general
• Working in a dusty or dry environment

When to see a doctor

See a doctor urgently if:

• If you have severe pain in the ear, especially when moving the ear or pressing on it
• If you have a high fever with ear symptoms
• If you notice yellow or green fluid draining from the ear

Book a routine appointment if:

• If the itching or rash does not improve with gentle self-care after a week or two
• If you have hearing loss that does not go away
• If you think your ear is infected (redness spreading, tenderness)

Diagnosis

A doctor or nurse will look at your ear using a small light called an otoscope. They will check for redness, swelling, flaking, or infection. They will ask about your symptoms, any allergies, and if you have had eczema before.

Tests that may be done

• Usually no tests are needed. In some cases, a swab may be taken to check for infection.

What to expect at your appointment

The exam is quick and painless. The doctor will explain what they see and recommend a treatment plan. If needed, they may refer you to a skin specialist (dermatologist) or an ear specialist (ENT doctor).

Treatment

Treatment focuses on soothing the skin, reducing itching, and preventing infection. Most cases can be managed with self-care and over-the-counter remedies, but a doctor may prescribe stronger treatments if needed.

Self-care at home

• Keep the ear area clean and dry. Gently wash with lukewarm water and pat dry.
• Use a fragrance-free moisturiser on the outer ear to prevent dryness. Avoid putting moisturiser inside the ear canal.
• Avoid scratching. Keep fingernails short to reduce skin damage.
• Remove any earrings or hearing aids for a few days to let the skin heal.
• Protect the ear from cold, wind, and harsh soaps or hair products.

Medical treatments

A doctor may recommend a mild steroid cream or ointment to reduce inflammation and itching. If an infection is present, they may prescribe antibiotic ear drops. Always follow the doctor's instructions on how to use any medicine. Do not use over-the-counter ear drops without checking first.

When is surgery considered?

Surgery is almost never needed for external ear eczema. Very rarely, if there is a severe complication like an abscess, a small procedure might be required, but this is extremely uncommon.

Living with this condition

Living with external ear eczema often means being gentle with your ears. Avoid using cotton buds or inserting anything into the ear canal, as this can make the condition worse. Moisturising the outer ear daily helps keep the skin healthy.

Lifestyle tips

• Choose hypoallergenic earrings if you wear them.
• Clean hearing aids or headphones regularly as per the manufacturer's instructions.
• Avoid swimming in chlorinated pools if your ears are sore, or use a swim cap to keep water out.

Diet and exercise

No specific diet is proven to help, but eating a balanced diet supports overall skin health. Exercise is fine, but if you sweat heavily, make sure to dry your ears afterwards to prevent irritation.

Mental health and emotional wellbeing

Eczema can be frustrating and itchy. It may affect sleep or self-esteem. It is okay to feel upset or stressed about it. If you feel it is affecting your mood, talk to your doctor or a counsellor. For urgent mental health support, contact a crisis helpline in your area.

Prevention

You cannot always prevent external ear eczema, but you can reduce flare-ups by avoiding triggers. Keep the skin moisturised, protect your ears from harsh weather, and avoid inserting objects into the ear canal.

Complications

If left untreated

• Secondary bacterial or fungal infection of the ear canal
• Increased risk of chronic inflammation and scarring
• Hearing loss due to swelling or buildup of skin flakes

Long-term outlook

With proper care, most people see improvement within a few weeks. The condition can come and go, but it is usually manageable. Treatment is effective and complications are rare. There is no permanent damage in most cases.

Find support

International organisations

• International Eczema Council

Local organisations

• National Eczema Society (UK) · United Kingdom
• National Eczema Association (US) · United States

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