ARTICLEPSORIASIS

What to Do If You Get Psoriasis on Your Ears

By Claire Gillespie

Reviewed by Allison Truong, M.D.

April 25, 2022

According to the National Psoriasis Foundation, around 50 percent of people with psoriasis get it on their face, most commonly on the eyebrows, between the nose and mouth, on the upper forehead, and on the hairline. But some get psoriasis on the outer ears, on the earlobes, behind the ears, or in the ear canal. The ear can be a particularly troublesome area for psoriasis, so we asked dermatologists for some tips on managing flares that appear there.

What Does Psoriasis Look Like on the Ears?

In most cases, people with psoriasis on their ears have scaling elsewhere on the face or scalp, says Susan Bard, M.D., a board-certified dermatologist in private practice in Brooklyn, New York.

Like psoriasis on other parts of the body, psoriasis on the ear can cause itch, redness, and scaling. In extreme cases, scaling may build up and block the ear canal, which may result in temporary hearing loss.

“There is one type of psoriasis called sebopsoriasis, which is an overlap between psoriasis and seborrheic dermatitis,” says Tanya Nino, M.D., a board-certified dermatologist with St. Joseph Heritage Medical Group in Orange County, California. “I see this more commonly on the ears,” she says, but it can appear on the scalp and face at the same time.

If you have both psoriasis and seborrheic dermatitis on your ears, you may be diagnosed with sebopsoriasis. Known as “cradle cap” in infants, this presents as red bumps and yellow, slightly greasy scales that can sometimes be very itchy.

What Can Be Done About Psoriasis on the Ear?

There’s currently no cure for psoriasis, but your dermatologist can prescribe a treatment based on your symptoms and whether they’re considered to be mild, moderate, or severe.

Also, pay the area special care. One of the most important things you can do is try not to pick at your ears. Picking or scratching at your plaques can cause bleeding and make them worse. Keep your ears clean with mild, fragrance-free soap, and use soft towels to pat them dry. And while it’s tempting to use your finger or a cotton swab to remove scales from your ear canal, it isn’t a good idea—as it may push scales further into the ear and cause a blockage.

“When scales mix with ear wax, they can create an obstruction,” says Bard. When this happens, she recommends her patients visit an ear, nose, and throat (ENT) specialist for safe removal of the debris. Your dermatologist might suggest trying a commercial earwax softener or drops of warm mineral oil to gently soften and loosen ear wax at home. For more stubborn scales in the ear canal, your doctor may also recommend certain prescription oil drops that are designed to be safe for the ear.

What Treatments Are Used for Psoriasis on the Ear?

Some of the topical medications prescribed for psoriasis on other parts of the body may be suitable to use on the earlobe, and behind the ear, as well. For example, over-the-counter hydrocortisone or calcipotriene ointments can help to relieve itching and soften scales.

Nino says it’s often easier to use creams and ointments on the outer ear and the back of the ear, but certain topicals should not be used on the delicate tissues of the ear canal and inner ear.

“Typically, I will prescribe a topical steroid in an oil formulation to help spread the medication easily without creating a lot of buildup within the canal,” says Nino.

Talk over the pros and cons of potential medications with your doctor to help you decide which is right for you. For example, if you have longer hair, topical treatments applied to your ears can easily get all over. “Creams can rub in more easily than ointments and be less messy,” Nino says. “However, I usually let my patients know that ointments tend to be more soothing and more effective, and I will give them the choice.”

Can Psoriasis Affect Hearing?

If you also have psoriatic arthritis, the middle ear organs (including the cochlea and stapes) may become inflamed and that could affect hearing. According to a study published in The Journal of Rheumatology, 60 percent of people with psoriatic arthritis experience some amount of hearing loss, and 23 percent have vertigo or balance problems.

Another study, published in the American Journal of Clinical Dermatology found that people who have been diagnosed with psoriasis are at a substantially higher risk of sudden deafness. This is when the ability to hear decreases notably over three or fewer days. While there are various possible causes for this, experts theorize that people who have psoriasis are in greater danger due to the type of quick inflammation that occurs during a flare-up of psoriasis symptoms. If this takes place in or around the cochlea, it could impede hearing.

This is yet another example of how psoriasis—so quickly labeled by many as just a skin condition—can affect all parts of the body, not to mention the mind. If you have psoriasis or psoriatic arthritis, it’s crucial to keep a close eye on all aspects of your health, including your hearing, and to report any changes to your primary care doctor.

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