Psoriasis in Your Ears

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. However, 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 psoriasis. It often runs in families, though not always.

The condition often appears in response to a trigger, such as:

Treatment

Since the skin of your ears is thinner and more delicate than other places, treating psoriasis here takes extra care. Your doctor will likely prescribe a low- to 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.

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You could also get a prescription for a scale removal medicine, such as calcipotriene (Dovonex) or tazarotene (Tazorac), mixed with a corticosteroid cream 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.

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.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on July 08, 2019

Sources

SOURCES:

National Psoriasis Foundation: “About Psoriasis,” “Psoriasis on the Face,” “Phototherapy,” “Psoriasis treatments.”

The Hearing Journal: “Psoriatic Involvement of the Ear.”

Psoriasis and Psoriatic Arthritis Alliance: “Psoriasis and Sensitive Areas.”

Massachusetts Ear and Eye: “Sudden Deafness.”

American Journal of Clinical Dermatology: “Risk of sudden sensorineural hearing loss in patients with psoriasis: a retrospective cohort study.”

Sacharitha Bowers, MD, assistant professor of internal medicine, SIU Medicine.

Mayo Clinic: “Psoriasis.”

American Academy of Dermatology: “Psoriasis: Who gets it and causes.”

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