How Does Atopic Dermatitis Affect the Ears?
Some people experience atopic dermatitis (eczema) in the skin behind the ears or in the junction between the ear and the face. It may also affect the pinna (entire outer portion), or the inner portion of the ear. This may be referred to as ear eczema, as atopic dermatitis is a type of eczema.
Eczema around the ears
Like other areas of the body, atopic dermatitis around the ears causes dryness, redness, and itchiness. Atopic dermatitis around the ears can cause painful cracks in the skin. These cracks are also called fissures, and in addition to being painful, they increase the risk of infection.1
What causes ear eczema?
People with atopic dermatitis have a damaged skin barrier. In some people with atopic dermatitis, the damaged skin barrier can be connected to a decrease or lack of filaggrin in the skin. Filaggrin is a protein that plays a key role in the structure and formation of the corneal layer of the skin. The lack of filaggrin has been traced back to genetic mutations in the FLG gene.
Damage to the skin barrier
This damage to the skin barrier leads to a reduced ability to maintain the skin’s natural amount of water, as well as the sores and rash of atopic dermatitis. The damaged skin barrier may also allow for the entry of airborne allergens to enter the skin, which could lead to an inflammatory response by the immune system.2 Atopic dermatitis is also characterized by an intense itch, which leads to repeated scratching. Scratching can also lead to breaks or tears in the skin.1
Good skin care is an important part of treating atopic dermatitis, including when it flares on the ears. Ears should be gently washed with just water or moisturizing bar soap. After washing, the ears should be thoroughly dried. The skin on and around the ears should also be moisturized, as moisturizers can help repair the skin barrier and lock in needed moisture.
There are several topical treatments that may be prescribed for atopic dermatitis and can be used on the skin of the ears, including:
- Topical corticosteroids, to reduce redness, inflammation, and itching
- Topical calcineurin inhibitors, to stop the dysfunctional immune response and reduce redness and itching
- Topical antibiotics, to fight a bacterial infection3
Other symptoms of atopic dermatitis
In addition to cracks behind the ears, atopic dermatitis can cause a rash, scaly patches, itch, bumps or papules, blisters, and a change in skin color. Some people also experience eye symptoms or cracks behind the ears. Over time, the areas of skin affected by atopic dermatitis may become thickened.