Treatment for Crusty Ears from Dandruff (Seborrheic Dermatitis)
By Cynthia Bailey MD.
Crusty ears from dandruff is more common than you think. Seborrheic dermatitis (aka dandruff) can involve the ears. Ear involvement is, in fact, quite common in people prone to dandruff.
I often find ear dandruff during a skin exam. Patients are usually entirely unaware that they have 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 curvy folds on the front of the ear may be creased with scale too. There may even be a little moisture and tenderness of the skin, which can feel like a cut or wound.
The skin around the opening of the ear canal 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.
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 from time to time.
What causes dandruff of the ear?
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 my 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
I recommend 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. My favorite products are those that contain the highest allowed amount of zinc pyrithione, which is 2%. This medicated ingredient is available in my Foaming Zinc Cleanser and Calming Zinc Soap.
If the crusty ear dandruff won’t clear up, then I use 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 for Crusty Ear Seborrhea/Dandruff
To treat and prevent itchy, crusty ears from dandruff, my patients use the following steps.
- Wash the ears often (ideally every day) with a thin fiber wash cloth that 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, they use their 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.
- A second lather is done using a medicated dandruff soap, shampoo, or cleanser to wash the ear skin.
- This product is left on the skin for as much as five minutes before rinsing it off well. It will leave behind a layer of pyrithione zinc. Patients use either Calming Zinc Soap (which contains the maximal level of pyrithione zinc in a natural soap base for sensitive skin) or Foaming Zinc Cleanser, which also delivers the maximal level of medicated 2% zinc pyrithione in a foaming base that is also a great shampoo perfect for hairy areas.
- You could alternate these with one of the other dandruff shampoo or soap products that I list in the blog post, Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis. For really stubborn ear seborrhea, I often have patients rotate at least three active medicated ingredients just as I recommends for scalp seborrhea.
Is crusty ear dandruff curable?
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.
How Do You Treat Crusty Ear Problems if Medicated Cleansers and Shampoos Don’t Clear Up the 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.
I first use 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 I may add 1% hydrocortisone cream after the Lotrimin application. I always tell 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 Suffering from Crusty Dandruff
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 have 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, my favorite products include:
- 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
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, Green Tea Antioxidant Skin Therapy Cream and a soothing aloe vera containing moisturizing cream that helps heal the seborrhea-damaged skin barrier. This routine is highly effective and popular remedy for facial seborrhea. I've combined it in my Facial Flaking and Redness Solution Kit since both work together to calm and reduce seborrheic dermatitis. The Green Tea Antioxidant Skin Therapy and Daily Moisturizing Face Cream can also be applied to the ears to help maintain remissions.