Skin Rash Behind Ears – Causes and Treatment

What is an ear rash?

A rash refers to an area of the skin that is irritated, reddish, swollen, itchy and painful. These rashes can progress to blisters and open wounds. Skin rashes are a common problem that can occur anywhere on the body surface.  It tends to be more common regions of the body like the skin folds. However, any part of the exposed skin is susceptible to developing a rash due to various reasons.

Rashes can appear behind the ears since it contains skin folds that can retain moisture. Rashes behind the ears could also occur through the spread of skin infections that originate in the scalp and the neck. Severe or persistent rashes typically warrant a visit to the dermatologist for appropriate diagnosis and treatment.

Causes of Rashes behind the Ears

There are multiple factors that can cause rash behind the ears. These include weather conditions, genetic factors, infections and allergies. The following are some of the common causative factors for the skin rash seen behind ears:

Atopic dermatitis

The term dermatitis refers to the inflammation of the skin. Atopic dermatitis (or eczema) is characterized by a dry and itchy skin that swells and becomes reddish whenever the condition flares up. Blisters with a fluid discharge can also form as the condition worsens. Atopic dermatitis is most common in babies and small children, but it can occur in adults as well. This condition predominantly affects regions of the body that have skin folds, including the region behind the ears.

The cause of atopic dermatitis is a combination of genetic and environmental factors. It has been seen to occur most commonly in people with a predisposition to allergies. In fact, individuals who have family members with a history of asthma and allergic rhinitis (also known as hay fever) are more susceptible to having atopic dermatitis. Even though eczema is a chronic disease, it is not dangerous.

Contact dermatitis

Contact dermatitis refers to the skin rash that occurs after something disagreeable touches the skin. Typical symptoms include a rash that is swollen, red and itchy. Unlike atopic dermatitis, contact dermatitis can affect anyone regardless of age. In fact, it is likely that the majority of people are susceptible to getting contact dermatitis with various offending substances.

Contact dermatitis is usually triggered by an allergic reaction to some substance that is normally harmless. The factors that trigger the rash in contact dermatitis differ from person to person, which indicates the involvement of genetic predisposition in the skin’s reaction to a particular substance. Some common irritants that could trigger allergic contact dermatitis behind ears include hair care products such as soaps, shampoos, cosmetics, jewelry, and even the tips of the spectacles that touch the temples. Exposure to certain chemicals at work might also be the culprit.

Seborrheic dermatitis

Seborrheic dermatitis is characterized by scaly, crusty, itchy and yellowish skin. This yellow crusting is a characteristic feature of this form of rash and it usually occurs in oily skin areas found in the scalp, face and chest regions. Dandruff is also a common scalp manifestation of seborrheic dermatitis. This rash usually begins on the scalp and then spreads down to the skin on the face and behind the ears.

Seborrheic dermatitis can occur in individuals of any age group. In babies, it usually affects the scalp and is referred to as cradle cap. A variety of causes have been implicated including inflammatory reaction to a naturally occurring fungi on the scalp, a weak immune system, excessive vitamin A intake, and lack of nutrients such as zinc, biotin, pyridoxine, and riboflavin. However, the exact cause of seborrheic dermatitis is not understood.

Scalp psoriasis

Psoriasis mainly affects the skin on knees, elbows and scalp. However, scalp psoriasis can also extend down to the forehead, neck and the skin behind the ears. This type of rash can occur in individuals of any age group and usually affects both sides of the body. The rash due to scalp psoriasis can either be in the form of red, scaly, and itchy plaques or appear as smooth and shiny areas. In other cases, it may not have either of these two appearances (atypical psoriasis). In addition to the skin, psoriasis may also affect the joints in the body, leading to psoriatic arthritis.

Psoriasis is usually characterized by an ebb and flow in the occurrence of the rash symptoms. The symptoms may flare up suddenly at one time and then go away almost completely (known as remission) at other times. The exact cause of psoriasis is not known but it is thought to be an autoimmune disorder that has a genetic basis but is triggered by environmental factors.

Skin infections

Tinea capitis and impetigo are two of the most common infectious causes of rash behind the ears.

  • Tinea capitis (also known as the scalp ringworm) is an infection caused by a class of fungi known as dermatophytes. This fungus has a predilection for the human skin. Tinea capitis usually causes rash in regions such as the scalp, feet, and groin. The skin in other areas of the body could also be affected. The rash typically shows up as a circular patch that is itchy, dry and scaly.
  • Impetigo is a contagious infection that is mainly caused by bacteria of the Staphylococcus family. The rashes in impetigo are usually painful and appear as red, swollen blisters than can cut open the skin. The condition can become serious if not treated promptly.

Treatment for Rash behind Ears

Currently, there is no definite cure for atopic dermatitis. If the offending allergen can be identified, contact with it can be prevented. Application of moisturizers, topical corticosteroids (e.g., hydrocortisone), and vitamin D are some of the treatment options that help in managing the condition.

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In cases of contact dermatitis, it is imperative to find the triggering agent/allergen for the rashes so that exposure to it can be avoided. Usually the rash would clear up on its own in a few weeks if contact with the offending allergen is removed. Anti-itch creams or lotions can help in suppressing the itch during this period.

Anti-fungal medicines like ketoconazole are effective in the treatment of seborrheic dermatitis. Psoriasis also doesn’t have a cure at the moment. However, treatment options to manage the condition include application of corticosteroid creams, moisturizers, and phototherapy. A rash behind ears caused by bacteria or fungi are treated with anti-bacterial and anti-fungal creams or oral medications.

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