Why is the skin in my ears flaking?

What could be causing the flakes?

Seborrhoeic dermatitis is an inflammatory skin condition that affects areas including the scalp, eyebrows, sides of the nose and ears. Flaking in several of those places is a useful clue. Around or inside the ears, it can cause dry or greasy scales, cracks, crusting and oozing. In darker skin, the rash can look lighter or darker rather than red.34

Contact dermatitis means inflammation after something touches the skin. Shampoo, hair dye, fragrance and nickel jewellery are possible triggers; hearing aids, earplugs and locally applied products can also cause irritation or allergy. A familiar product is not automatically innocent: an allergy can develop after years of use. Repeated reactions sometimes need patch testing to identify the trigger.156

Eczema can cause intense itching with involvement of the outer ears, face and neck. Psoriasis can produce thicker, silvery scales and often also affects the scalp. Inside the canal, inflammation is called otitis externa. It can come from a skin condition or infection, and water, soap, shampoo and damage from scratching can contribute.12

Normal ear wax contains shed skin cells, hairs and gland secretions, which gives it a more complicated recipe than its branding suggests. Hearing aid moulds can interfere with normal shedding, allowing skin and wax debris to collect.7

What can I do at home?

1. 1Stop scratching, poking or using cotton buds inside the ears. These can damage the canal and push wax farther in.
2. 2Keep soap, shampoo and water out of the canal. Clean only around and behind the ear, then let the canal dry naturally rather than inserting tissue or a towel.
3. 3For dry skin on the outer ear, use a gentle soap free wash and a light moisturiser after washing. Moisturiser can also help around the bowl of the ear and at the canal entrance.
4. 4Avoid suspected product or jewellery triggers. For itching or flakes deeper inside the canal, ask a pharmacist or clinician about suitable treatment rather than putting skincare products inside.

Which treatment helps, and how long does it take?

For seborrhoeic dermatitis on exposed skin, antifungal creams reduce the yeast involved in inflammation. A clinician can prescribe a brief course of a mild steroid for inflamed areas; medicated eardrops are an option for canal involvement. Adult seborrhoeic dermatitis often needs ongoing treatment because it can return after treatment stops. These adult treatments are not suitable for babies.4

Contact dermatitis usually clears within two to three weeks, but can return if the trigger remains. Infected otitis externa often needs prescribed drops or spray containing an antibiotic and steroid. Treatment commonly lasts seven to ten days; follow the prescribed course. Treated acute infection generally settles within that period. A possible hole in the eardrum changes which products are safe, so do not choose shop bought ear treatments in that situation.125

What if my ear feels blocked?

Ear wax protects against dirt and germs, despite being a substance with no apparent public relations department. Excess wax and shed skin can cause blockage, itching or reduced hearing; swelling from inflammation can also reduce hearing. A healthcare professional can examine the canal and remove accumulated debris if needed.127

When should I get my ears checked?

Get medical assessment for pain, discharge, swelling, reduced hearing or persistent canal symptoms. Severe pain, fever or swelling beyond the canal need prompt attention. Diabetes or a weakened immune system makes suspected ear infection more concerning. If treatment does not settle the problem, return for reassessment; a swab or referral to an ear, nose and throat specialist can help guide the next treatment.12