Itchy, Crusty, Scaly Ears: More on Seborrheic Dermatitis

seborrheic dermatitis (dandruff) causes itchy earsSeborrheic dermatitis (aka dandruff) can involve the ears and is in fact quite common.  My patients with seborrheic dermatitis of the ears often complain mostly about the itching, which can occur on the ear or in the ear canal.  They may also complain about the scaly crust that develops on the front of the ear or behind the crease of the ear.  Lastly, they may actually have such thick crust that they think they have a lesion or growth and come in for me to check it to be certain that it is not a cancer.

Like seborrheic dermatitis on the face and scalp, ear seborrheic dermatitis is treatable but not curable.  That means, you can use medicated soaps, shampoos and creams to control the rash, but it will come back over time.  Scientists don’t know what causes seborrhiec dermatitis and so we don’t know why it flairs up.  I do see much more seborrhea during the winter months and in people who aren’t able to bathe or wash the affected area frequently.  Many of my seborrhea patient’s also note that their rash flairs when they’re under stress, are ill, or when they are eating an unusual amount of fat, carbohydrates or sugar in their diet.

My treatment tips for seborrheic dermatitis of the ears if fairly straight forward.

  • I recommend vigorous and daily washing of the ear skin using a wash cloth and medicated dandruff shampoos or soaps to help prevent a flair up of the rash.
  • If the rash flairs up anyway,  I then recommend using medicated creams until the rash clears.

My detailed treatment instructions are as follows………

Dermatologist Dr. Cynthia Bailey’s Treatment for Seborrheic Dermatitis of the Ears

Maintenance Care to Help Prevent Itching, Crusting and Scaling Ear Skin

  • Wash your ears often (ideally every day) with a thin fiber wash cloth that you can press into the folds of the ear skin and into the crease behind the ear.  Wet the ear first to help soften the skin crust and scale.  Removing the crust and skin scale is important because they further irritate the rash, so scrub vigorously when you wash with the wash cloth.  Thick wash cloths are usually too bulky to get a good scrubbing of the fine ear folds.
  • Use a medicated soap or shampoo to wash your ear skin.  I’ve found that medicated products with zinc pyrithione work the best.  My Calming Zinc Soap contains the maximal level of this medicine in a non-foaming base for sensitive skin.  If your skin is excessively oily my OTB Medicated Cleanser #2 cleans and lifts oil while also delivering the maximal level of zinc pyrithione.  It has a foaming agent that makes it perfect for hairy areas like your scalp too.  You could also use one of the other dandruff shampoo or soap products that I recommended in my blog post on Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis. For really stubborn ear seborrhea, I often have my patients rotate at least 3 active medicated ingredients just as I recommend for scalp seborrhea.
  • You can expect periods of remission from your seborrhea, and you can quit treating your ears during these times.  The minute you notice any itching, scale or crust on your ears, get your medicated products out and start washing your ears as I outlined above to help snuff out the seborrhea fast.  Treat the ears until they clear up plus at least a month.  It’s also a good idea to start this treatment when you expect the rash to flair up, like during the holidays, when seborrhea seems to be at its worst.

 

My face is so much less red than it used to be.

“Plus, when I used to get out of the shower my face would be scaly, now it’s soft! The Clarisonic is great and it helps the Replenix work even better than before.” Sheila W

 

Treatment of Itching, Crusting and Scaling Ear Skin

If washing your ears with the wash cloth and medicated products that I mentioned above doesn’t entirely control your ear seborrhea, then you can try to clear the scale, crust and itching with medicated creams.

  • First try Lotrimin cream (the generic name is clotrimazole cream) applied twice a day to the involved ear skin.  You can gently apply a thin layer to the entrance of the ear canal with a Q-tip type cotton applicator, but do not put the cotton applicator down into the ear canal.
  • If the Lotrimin does not begin to work within a few weeks, you can add 1% hydrocortisone cream after the Lotrimin application.  Apply a thin coat of one then the other twice a day. The cortisone cream should not be use for extended periods of time because it can thin the skin, so if the rash doesn’t clear up within a month you should see your doctor.

Important health precautions for your ears:

  • Your ear canal may contain germs that are different than the rest of your skin.  These germs can cause unusual and hard to treat infections of the ear skin.  Because of this, it’s important not to damage the skin by vigorously scratching, even though the skin itches.  I’ve seen desperate people try to scratch the itch inside the ear canal by putting pointed objects into the ear canal (like ink pens), damaging the skin and getting a roaring infection.  Of course….. DON’T STICK SHARP OBJECTS IN YOUR EAR CANAL TO SCRATCH THE ITCH!
  • Ears get skin cancer and other unusual cancerous and noncancerous tumors.  If you think you have crusting and scale from seborrhea, but the problem persists despite the over the counter treatment that I recommended above, you need to see your doctor, a dermatologist or ear/nose/throat specialist and have the problem evaluated.

Dermatologist’s Recommendation For The Best Products For Itchy, Crusty, Scaly Ears:

OTB Medicated Cleanser #2 (for the scalp and oily and/or hairy skin)

Dermatologist's Dandruff Cleanser and Shampoo

Calming Zinc Soap (for the face and dry and/or sensitive skin)

Calming Zinc Soap

A thin wash cloth

Lotrimin Cream and/or over-the-counter hydrocortisone cream

Note: if you have dandruff on your ears you may well have it on your face.  It often manifests there as a dry scale on your eyebrows and around your nose.  My Calming Zinc Soap and Replenix CF Cream are my favorite treatments for facial dandruff!

Replenix CF Cream

Replenix CF Cream for dandruff

My Seborrheic Dermatitis Series:

Dermatologist’s Tips for Dry Flaky Skin on Your Face and Scalp; Tis the Season for Seborrheic Dermatitis

Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis

Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis-Part 2

Remedies for Really Stubborn Scalp Seborrheic Dermatitis

Dermatologist’s Tips for Treating Facial Seborrheic Dermatitis: It Looks Like Dry Skin, But It’s a Rash!

Dr. Cynthia Bailey’s Tips for Facial Seborrheic Dermatitis Control

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