Itchy, Crusty, Scaly Ears: More on Seborrheic Dermatitis

Itchy, crusty, scaly ears are rarely talked about. Crust on, in and behind the ear is not something you read about in glossy magazines, fashionable websites or even talk about in casual conversation. But scaly ears are a common problem.

My patients with scaly ears often complain mostly about the itching, which can occur on the ear or in the ear canal. They may also complain about the crust on their scaly ears. This 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. Crusty ears are usually caused by seborrheic dermatitis. 

Seborrheic dermatitis (aka dandruff) commonly involves the ears. 

Like seborrheic dermatitis on the face and scalp, seborrheic dermatitis and scaly ears are 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 flares 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 patients also note that their rash flairs when they’re under stress, ill or when eating an unusual amount of fat, carbohydrates, wheat, or sugar in their diet.

What are the best treatment tips for seborrheic dermatitis of the ears?

1. Vigorous daily washing of the ear skin using a wash cloth and medicated dandruff shampoos or soaps to help prevent seborrhea from flaring up.
2. Apply healing skin creams and oils to help quiet the inflammation and help support a remission.
3. If the rash flares up anyway, use medicated creams until the rash clears.

My detailed treatment instructions are as follows...

Dermatologist Dr. Cynthia Bailey's Treatment for Scaly Ears from Seborrheic Dermatitis

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

Wash your scaly ears often (ideally every day) with a thin fiber wash cloth.

Scrub inside all the folds and surface of the ear 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 zinc pyrithione bar soap contains the maximal level of this medicine in a non-foaming base for sensitive skin. It is also my top choice for facial seborrheic dermatitis.

Once your ear skin is no longer crusty and itchy, you can stop the pyrithione zinc. Know that you can expect periods of remission from your seborrhea. But 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.

Apply soothing products that help the crusty and inflamed ear skin heal

After washing, I recommend that my patients apply my Green Tea Antioxidant Skin Therapy to help calm skin inflammation that drives the crust formation and itch. This can be topped with my Omega Enriched Booster Oil that helps heal skin barrier and has mild antimicrobial cypress oil. This combination sooths crusty and itchy ear seborrhea.

You want to help snuff out the seborrhea fast. Treat the ears until they clear up, plus at least a month to help sustain a remission. It’s also a good idea to start this treatment when you expect the rash to flare up, like during the holidays, when seborrhea seems to be at its worst. Treating dandruff of the scalp, face, ears and body takes work but it is worth the effort.

Both of these products help heal seborrhea and keep it in remission. 

“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 Green Tea Antioxidant Skin Therapy work so well.” Sheila W

Dermatologist's Topical Treatment of Itching and Crusting Scaly Ears

If washing your ears with the wash cloth and medicated products followed by applying Green Tea Cream and my Omega Enriched Oil 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). Apply it 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 used 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.

What are the important health precautions for your ear skin?

• 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 Recommendations for the 4 Best Products for Itchy, Crusty, Scaly Ears

1. Foaming Zinc Cleanser (for the scalp and oily and/or hairy skin)

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

3. Green Tea Antioxidant Skin Therapy

4. Omega Enriched Booster Oil

Combine these with a thin wash cloth and Lotrimin Cream and/or over-the-counter hydrocortisone cream and you have a great 'tool chest' to tackle crusty ears.

Do you have facial dandruff along with crusty ears?

It's common to suffer from both problems at the same time. On the face, dandruff often manifests as a dry scale on your eyebrows and around your nose. 

My Calming Zinc Soap and Green Tea Antioxidant Skin Therapy are my favorite treatments for facial dandruff! Also, I have combined them in my Facial Redness Relief Kit since both work together to calm and reduce seborrheic dermatitis. Top it with my Omega Enriched Booster Oil. 

How do you know if you may have facial dandruff?

Is there redness and 'dry' flaky scale on your face in your brows, forehead, along the side of your nose and chin? See the diagram here for the facial distribution of seborrhea. This is the common distribution of facial flaking and redness from seborrhea.

I invite you to visit my Advice Pages for Seborrheic Dermatitis to see my in depth advice for seborrheic dermatitis on other areas of your skin. If you have seborrhea of the ear you may have it on your face, scalp etc.

Photo Attribution: CC BY 2.0