You may know psoriasis as the itchy skin condition that shows up in places like the elbows, knees, scalp, and back. But it can affect parts of the body you may not expect, like your ears.
Most of the time, symptoms appear on the outside of the ear as well as in the crease behind it. But they can happen inside the ear canal, too. But the condition doesn’t reach deeper to affect more delicate parts like the eardrum.
Whether your condition is mild or severe, you have several treatment options to ease symptoms on and in your ears.
Symptoms
When the condition affects your ears, you may have:
- Red, dry patches of skin on your ear
- Silvery or crusty scales called plaques
- Scales that build up inside your ear canal
- Itching, burning, or tenderness inside and outside the ear
- A clogged feeling inside your ear
- Trouble hearing
If you scratch and pick at the affected areas or try to clear out the buildup inside your ear, that could lead to bleeding and more irritation and inflammation. It may even cause the psoriasis to spread to nearby areas.
Causes
No one knows exactly what causes psoriasis or what makes it appear on a certain part of your body. But scientists do know that the condition begins when the immune system attacks your skin cells. That action causes your skin to grow new cells more often, which build up on the surface and create the plaques and other symptoms you can see.
Genes also play a role in the condition, which often runs in families, though not always.
Psoriasis often appears in response to a trigger, such as:
- Stress
- A cut, bad sunburn, or other injury to the skin
- An infection
- Smoking
- Drinking a lot of alcohol
- A lack of vitamin D
- Some medications, including beta-blockers for high blood pressure, drugs for malaria, or lithium for bipolar disorder
Treatment
Since the skin of your ears is thinner and more delicate than in other places, treating psoriasis here takes extra care. Your doctor will likely prescribe a low- to a medium-strength steroid that you can put into your ear canal in drops or rub on the outside of your ear and behind it. Be careful when you use these medicines – they can affect your eardrum. Ask your doctor exactly how to apply them.
You could also get a prescription for a scale removal medicine, such as calcipotriene (Dovonex) or tazarotene (Tazorac), mixed with corticosteroid cream, lotion, or ointment. And you can try over-the-counter moisturizers to help keep the skin on the outside of your ears comfortable and less irritated.
Your doctor can also prescribe nonsteroidal topical creams like tapinarof (Vtama) and roflumilast (Zoryve). The two topicals are FDA-approved to treat plaque psoriasis in adults. You’ll need to apply it to the affected areas on or around your ears once a day.
You can use both creams on most body parts affected by psoriasis, including sensitive skin folds (inverse psoriasis) and your face where you’re more likely to have thinner skin. If you notice skin irritation, burning, itching, or stinging that doesn’t go away or is too bothersome, tell your doctor.
If scale buildup blocks your ear canal, you shouldn’t try to remove it yourself – you could damage your inner ear or eardrum in the process. Your best bet is to ask your doctor to remove the debris from your ears for you.
Some people may need medicines that work throughout the body to treat their psoriasis, especially if it’s moderate or severe. Options include medications you take by mouth, steroid shots, or biologic drugs that alter your immune system. Light therapy – when you expose your skin to ultraviolet rays with your doctor’s guidance – is another way to treat psoriasis, especially in sensitive areas, like around the face. Your doctor will help you find a treatment that’s best for your skin.
Complications
The main complication of ear psoriasis is that the buildup of scales and plaques can block your ear canal enough that you have temporary hearing problems. The problem should go away when your doctor removes the blockage.
Even if the condition doesn’t affect the skin in and around your ears, psoriasis itself may make you more likely to get a mild form of hearing loss called sudden sensorineural hearing loss (SSNHL). One study found that people with psoriasis were 50% more likely to be diagnosed with SSNHL. The link isn’t clear, but researchers think it may happen when the immune system attacks a part of the inner ear called the cochlea. If you have hearing loss that comes on over a few days, let your doctor know ASAP.
