Seborrheic dermatitis (aka dandruff) can involve the ears. Ear involvement is, in fact, quite common in people prone to dandruff.
Often, Dr. Bailey will find ear dandruff during a skin exam, but her patients were entirely unaware that they had ear dandruff. Other times, the itch is so vexing that patients come in complaining of having intensely itchy ears that they can’t ever seem to control. When the itch extends down the ear canal, it is an itch that can’t be scratched. Sticking sharp objects like ink pens down the ear canal is a BAD idea and often leads to infection. Better to treat the cause!
What Is Ear Dandruff?
Seborrheic dermatitis of the ear most commonly involves the fold behind the ear where the scale may be moist and crusty. The skin around the opening can also crust, but the scale here is often white and thick. It can extend down the canal and tortuously tickle the canal hairs. Any part of the ear can be prone to dandruff and the crust may become so thick that you may think you actually have a growth. The point is that ear dandruff needs control for many reasons. If you can’t control it with home remedies, see your doctor.
Like seborrheic dermatitis on the face and scalp, ear seborrheic dermatitis is treatable and controllable, but it is not curable. This means, you can use medicated soaps, shampoos, and creams to clear the rash, but it will come back over time. Scientists don’t know what causes seborrheic dermatitis, which is why the cause of flair ups is unknown.
A normal skin yeast called pityrosporum is often flourishing in skin with active seborrhea rash. Also, more problems with seborrhea are seen during the winter months and in people who aren’t able to bathe or wash the affected area frequently. Many of Dr. Bailey's patients who suffer from seborrhea also note that the rash flairs when they’re under stress, are ill, or when they are eating an unusual amount of bad fats, junk food, refined carbohydrates, or sugar in their diet. People with central nervous system disorders such as Parkinson’s also have greater problems with seborrhea.
Dermatologist's Treatment Tips for Seborrheic Dermatitis of the Ears
Dr. Cynthia Bailey recommends vigorous and daily washing of the ear skin using a wash cloth and medicated dandruff shampoo or soaps to help prevent a flair up of the rash. Her favorite products and those that she finds most effective are products with the highest allowed amount of zinc pyrithione, which is 2%. This medicated ingredient is available in our Foaming Zinc Cleanser. There is also a full 2% in our Calming Zinc Soap.
If the crusty ear dandruff won’t clear up, then Dr. Bailey recommends using medicated creams until the rash clears. Patients use the creams until the rash has stayed clear for at least a few weeks.
Dr. Bailey's Detailed Treatment Instructions
To treat and prevent itchy, crusty ears from dandruff, Dr. Bailey recommends the following steps.
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 the skin scale is important because they further irritate the rash. First use your favorite soap or cleanser and the wash cloth to loosen and remove scale and crust. Rinse well. Know that thick wash cloths are usually too bulky to get a good scrubbing of the fine ear folds.
Do a second lather using a medicated dandruff soap, shampoo, or cleanser to wash your ear skin. Leave that product on your skin for as much as five minutes before rinsing it off well. As mentioned, Dr. Bailey has found that products with a full 2% zinc pyrithione work the best. Our Calming Zinc Soap contains the maximal level of this ingredient in a natural soap base for sensitive skin. If your skin is excessively oily or if you are also treating your hairy scalp, use our Foaming Zinc Cleanser, which also delivers the maximal level of medicated 2% zinc pyrithione to treat dandruff. It is an excellent shampoo that is perfect for hairy areas like your scalp too. You could also use one of the other dandruff shampoo or soap products that Dr. Bailey recommended in her blog post, Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis. For really stubborn ear seborrhea, Dr. Bailey often has her patients rotate at least three active medicated ingredients just as she recommends 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 outlined above to help control the seborrhea fast and before the crust builds up. Treat the ears until a few weeks after they clear up. It’s also a good idea to start this treatment when you expect the rash to flare up, like during the winter, periods of stress, and the holidays, when seborrhea seems to be at its worst.
What if Medicated Cleansers and Shampoos Don’t Clear the Crusty Ear Problem?
If washing your ears with a wash cloth and the medicated products mentioned above don’t entirely control your ear rash, then you can try to treat the problem with medicated creams.
In her practice, Dr. Bailey first recommends Lotrimin cream (the generic name is clotrimazole cream) applied twice a day to the involved ear skin. This cream can be gently applied in a thin layer to the entrance of the ear canal with a Q-tip type cotton applicator. It is really important NOT to put the cotton applicator down into the ear canal. As the cream warms it will melt into the canal.
If the Lotrimin does not begin to work within a few weeks, then Dr. Bailey adds 1% hydrocortisone cream after the Lotrimin application. Dr. Bailey tells her patients to apply a thin coat of the Lotrimin followed by a thin coat of the hydrocortisone twice a day. The cortisone cream should not be used for extended periods of time because it can thin the skin. This means that if the ear rash doesn’t clear up within a month it’s time to go to the 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. Dr. Bailey has 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. So, DON’T STICK OBJECTS IN YOUR EAR CANAL TO SCRATCH THE ITCH!
Another really important point is that ears get skin cancer and other unusual tumors. If you think you have crusting and scale from seborrhea, but the problem persists despite the skin care recommended above, then it’s time to see a doctor for an accurate diagnosis.
Dermatologist’s Recommendation for the Best Products for Itchy, Crusty, Scaly Ears
To help you treat ears affected by dandruff, Dr. Bailey recommends the use of:
- Foaming Zinc Cleanser (for the scalp and oily and/or hairy skin)
- Calming Zinc Soap (for the face, ears and dry and/or sensitive skin)
- A thin wash cloth
- Naturally Best Bar Soap and Green Tea Antioxidant Skin Therapy Cream to fight dandruff
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. Our Calming Zinc Soap and Green Tea Antioxidant Skin Therapy Cream are Dr. Bailey's favorite treatments for facial dandruff. Also we have combined them in our Facial Redness Relief Kit since both work together to calm and reduce seborrheic dermatitis. The Green Tea Antioxidant Skin Therapy Cream can be used on the ears to help fight dandruff and crust.
Find the type of dandruff that you have and click below to see the routine I recommend:
Treatment for crusty ears from dandruff (seborrheic dermatitis)