Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Whenpsoriasisplaques—red, scaly patches of skin—affect the ears, they are usually limited to the external ear (auricle and earlobe) and/or the ear canal. Psoriasis on external ear skin may be itchy, painful, and tender. Psoriasis in ears may additionally impact your hearing.
This article discusses the symptoms, causes, diagnosis, andtreatment of psoriasisin, on, and around the ears.
Verywell / Nusha Ashjaee
Ear Psoriasis Symptoms
Symptoms of psoriasis in the ears or on ear skin may include:
Generally speaking, it is rare to have psoriasis plaques on the ear only. Typically, there will be evidence of psoriatic lesions elsewhere on the body—such as the elbows, knees,scalp, or back.
If you have not previously been diagnosed with psoriasis, ear psoriasis symptoms may be confusing since they can mimic other ear conditions such asswimmer’s ear. This is especially true if the plaques only occur in the ear canal, rather than on visible ear skin.
In some cases, it may take a complete physical exam to make the connection between a spattering of plaques on one part of the body and hearing problems only in one ear.
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Balance Issues and Vertigo
Psoriasis usually doesn’t impact the organs of the middle or inner ear, including the eardrum or tympanic canal. However, on rare occasion, psoriasis can co-occur with psoriatic arthritis—an associated autoimmune disorder that does.
Psoriatic arthritis can affect tissues of the middle and inner ear, causingvertigo(the sensation that you are spinning or in motion) and balance problems. It can also cause sensorineural hearing loss, which results from damage to the inner ear or theauditory nerve.
According to a 2014 study in theJournal of Rheumatology,60% of people with psoriatic arthritis experience some level of hearing loss, while 23% experience vertigo or balance problems.
Causes of Ear Psoriasis
For reasons poorly understood, the immune system will suddenly attack its own healthy cells and tissues. With psoriasis specifically, skin cells called keratinocytes are the target of the assault. These cells make up around 90% of the outer layer of skin (epidermis).
The inflammatory response will effectively speed up the division and growth of these cells, causing them to build up faster than they can be shed. As the cells are propelled to the surface, they create thered, dry, and inflamed patchescharacteristic of psoriasis.
Psoriasis of the ear is not well studied, and it’s unclear why some people develop the condition and others don’t. However, ear psoriasis may affect 3.6% to 37% of people with psoriasis.
If psoriatic arthritis is involved, the organs of the middle ear (including the cochlea and stapes) may become targets of inflammation and impairment.
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How Do You Know If You Have Psoriasis in Your Ear?
Ear psoriasis is generally diagnosed with a physical exam.In addition to identifying the characteristic plaques, the healthcare provider will review your medical history to assess your risk for the disease (including a family history of psoriasis orother autoimmune disorders).
The physical exam will include an inspection of the ear canal with a lighted device called an otoscope.
If the results of the physical exam are inconclusive, the practitioner may take a scraping of skin cells and examine them under a microscope. Psoriatic skin cells tend to have an abnormally dense and compact appearance, unlike that of similar skin conditions likeeczema.
Because there are no blood or imaging tests to definitively diagnose psoriasis, a healthcare provider may check for other conditions if you are experiencing hearing loss. These include otitis externa (swimmer’s ear), viral infections,otitis media, andcontact dermatitisof the ear canal.
If vertigo is involved, you may need to see an ear, nose, and throat specialist called anotolaryngologistfor a complete diagnostic evaluation. This will include hearing and balance tests,magnetic resonance imaging (MRI)scans of the internal ear structure, and arheumatoid factor (RF) blood testif psoriatic arthritis is suspected.
How Do I Get Rid of Psoriasis in My Ears?
Ear psoriasis can’t be cured, but there are medications that can help temper the inflammation and keep flares under control.
Some may be prescribed to people with psoriasis regardless of where their plaques are. Others specifically target the ear. Professional ear wax removal may be necessary to treat hearing loss.
Medications
Some medications used to treat ear psoriasis include:
Moderate-to-severe psoriasis may require systemic medications to temper the immune response that triggers flares. Depending on the severity of your symptoms, these may include:
These oral and injectable medications are also effective in managing symptoms of psoriatic arthritis.
Before using any over-the-counter psoriasis remedy, speak with your healthcare provider to make sure it is appropriate for the ear. Some of these medications are not suitable for the delicate tissues of the auditory canal and adjacent eardrum.
Phototherapy
Phototherapy, also known aslight therapy, can also be used to treat some types of psoriasis. This treatment involves exposing the skin to controlled amounts of ultraviolet (UV) radiation.
A specific type of light therapy calledexcimer laser therapycan be effective in treating smaller areas of the body, such as the ears.
Ear Wax Removal
If you have hearing loss, your healthcare provider will likely want toremove the buildup of wax and skin cellsfrom the ear canal. This alone can help restore hearing loss, though you may have to have this done on a regular basis to keep the ear canal clear.
Never use cotton swabsto remove wax from the ear canal, as doing so can push the wax deeper into the ear and may even end up rupturing the eardrum.
Hygiene
If you develop psoriasis on or in the ear, the best thing to do is avoid fidgeting with the ear. Do not pick or scratch the lesions, which may only cause bleeding and make them worse.
Keep your ears clean and dry using only the mildest soaps and softest towels.
Avoiding Psoriasis Triggers
In addition, you should work with your practitioner toidentify the triggersthat can instigate a flare. These vary from one person to the next and may include stress,medications, cold temperatures, skin trauma, infections, and alcohol.
Some of these triggers may be avoidable. For example, a medication you are taking may be able to be switched for another one. Or if stress is a trigger, mind-body therapies likemeditation, guided imagery,deep breathing exercises, and progressive muscle relaxation (PMR) may help manage your emotions.
Sunlight can often help reduce psoriasis plaques, but limit your exposure to no more than 30 to 40 minutes (and wear plenty ofhigh-SPF sunscreen).
If experiencing anxiety or depression as a result of your condition, consider seeing a mental health professional who can help you sort through your emotions and prescribe antidepressants or anxiolytic(anti-anxiety) medications, if needed.
How Psoriasis Is Treated
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Memar O, Caughlin B, Djalilian HR.Psoriatic involvement of the ear.The Hearing Journal. 2019;72(1):44. doi:10.1097/01.HJ.0000552754.82111.04Amor-dorado JC, Barreira-fernandez MP, Pina T, Vázquez-rodríguez TR, Llorca J, González-gay MA.Investigations into audiovestibular manifestations in patients with psoriatic arthritis.J Rheumatol. 2014;41(10):2018-26. doi:10.3899/jrheum.140559Joly-tonetti N, Wibawa JID, Bell M, Tobin DJ.An explanation for the mysterious distribution of melanin in human skin: a rare example of asymmetric (melanin) organelle distribution during mitosis of basal layer progenitor keratinocytes.Br J Dermatol.2018;179(5):1115-1126. doi:10.1111/bjd.16926Blake A, Enos C, Armstrong AW, et al.Results of a survey of the national psoriasis foundation medical board on the management of ear psoriasis.Journal of Psoriasis and Psoriatic Arthritis. 2020;5(1):28-31. doi:10.1177/2475530319891954Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.The Psoriasis and Psoriatic Arthritis Foundation.Psoriasis and Sensitive Areas.National Library of Medicine.Outer ear infection: What helps if earwax builds up?Sbidian E, Mezzarobba M, Shourick J, et al.Choice of Systemic Drugs for the Management of Moderate-to-severe Psoriasis: A Cross-country Comparison Based on National Health Insurance Data.Acta Derm Venereol. 2021;101(6):adv00473. doi:10.2340/00015555-3765American Academy of Dermatology.Psoriasis treatment: phototherapy.National Institute on Deafness and Other Communication Disorders.Why You Shouldn’t Use Cotton Swabs to Clean Your Ears.UT Health Houston McGovern Medical School.Itchy Ears.American Academy of Dermatology Association.ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?Tampa M, Sarbu MI, Mitran MI, Mitran CI, Matei C, Georgescu SR.The Pathophysiological Mechanisms and the Quest for Biomarkers in Psoriasis, a Stress-Related Skin Disease.Dis Markers. 2018;2018:5823684. doi:10.1155/2018/5823684The Psoriasis and Psoriatic Alliance.Psoriasis and the Sun.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Memar O, Caughlin B, Djalilian HR.Psoriatic involvement of the ear.The Hearing Journal. 2019;72(1):44. doi:10.1097/01.HJ.0000552754.82111.04Amor-dorado JC, Barreira-fernandez MP, Pina T, Vázquez-rodríguez TR, Llorca J, González-gay MA.Investigations into audiovestibular manifestations in patients with psoriatic arthritis.J Rheumatol. 2014;41(10):2018-26. doi:10.3899/jrheum.140559Joly-tonetti N, Wibawa JID, Bell M, Tobin DJ.An explanation for the mysterious distribution of melanin in human skin: a rare example of asymmetric (melanin) organelle distribution during mitosis of basal layer progenitor keratinocytes.Br J Dermatol.2018;179(5):1115-1126. doi:10.1111/bjd.16926Blake A, Enos C, Armstrong AW, et al.Results of a survey of the national psoriasis foundation medical board on the management of ear psoriasis.Journal of Psoriasis and Psoriatic Arthritis. 2020;5(1):28-31. doi:10.1177/2475530319891954Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.The Psoriasis and Psoriatic Arthritis Foundation.Psoriasis and Sensitive Areas.National Library of Medicine.Outer ear infection: What helps if earwax builds up?Sbidian E, Mezzarobba M, Shourick J, et al.Choice of Systemic Drugs for the Management of Moderate-to-severe Psoriasis: A Cross-country Comparison Based on National Health Insurance Data.Acta Derm Venereol. 2021;101(6):adv00473. doi:10.2340/00015555-3765American Academy of Dermatology.Psoriasis treatment: phototherapy.National Institute on Deafness and Other Communication Disorders.Why You Shouldn’t Use Cotton Swabs to Clean Your Ears.UT Health Houston McGovern Medical School.Itchy Ears.American Academy of Dermatology Association.ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?Tampa M, Sarbu MI, Mitran MI, Mitran CI, Matei C, Georgescu SR.The Pathophysiological Mechanisms and the Quest for Biomarkers in Psoriasis, a Stress-Related Skin Disease.Dis Markers. 2018;2018:5823684. doi:10.1155/2018/5823684The Psoriasis and Psoriatic Alliance.Psoriasis and the Sun.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Memar O, Caughlin B, Djalilian HR.Psoriatic involvement of the ear.The Hearing Journal. 2019;72(1):44. doi:10.1097/01.HJ.0000552754.82111.04Amor-dorado JC, Barreira-fernandez MP, Pina T, Vázquez-rodríguez TR, Llorca J, González-gay MA.Investigations into audiovestibular manifestations in patients with psoriatic arthritis.J Rheumatol. 2014;41(10):2018-26. doi:10.3899/jrheum.140559Joly-tonetti N, Wibawa JID, Bell M, Tobin DJ.An explanation for the mysterious distribution of melanin in human skin: a rare example of asymmetric (melanin) organelle distribution during mitosis of basal layer progenitor keratinocytes.Br J Dermatol.2018;179(5):1115-1126. doi:10.1111/bjd.16926Blake A, Enos C, Armstrong AW, et al.Results of a survey of the national psoriasis foundation medical board on the management of ear psoriasis.Journal of Psoriasis and Psoriatic Arthritis. 2020;5(1):28-31. doi:10.1177/2475530319891954Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.The Psoriasis and Psoriatic Arthritis Foundation.Psoriasis and Sensitive Areas.National Library of Medicine.Outer ear infection: What helps if earwax builds up?Sbidian E, Mezzarobba M, Shourick J, et al.Choice of Systemic Drugs for the Management of Moderate-to-severe Psoriasis: A Cross-country Comparison Based on National Health Insurance Data.Acta Derm Venereol. 2021;101(6):adv00473. doi:10.2340/00015555-3765American Academy of Dermatology.Psoriasis treatment: phototherapy.National Institute on Deafness and Other Communication Disorders.Why You Shouldn’t Use Cotton Swabs to Clean Your Ears.UT Health Houston McGovern Medical School.Itchy Ears.American Academy of Dermatology Association.ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?Tampa M, Sarbu MI, Mitran MI, Mitran CI, Matei C, Georgescu SR.The Pathophysiological Mechanisms and the Quest for Biomarkers in Psoriasis, a Stress-Related Skin Disease.Dis Markers. 2018;2018:5823684. doi:10.1155/2018/5823684The Psoriasis and Psoriatic Alliance.Psoriasis and the Sun.
Memar O, Caughlin B, Djalilian HR.Psoriatic involvement of the ear.The Hearing Journal. 2019;72(1):44. doi:10.1097/01.HJ.0000552754.82111.04
Amor-dorado JC, Barreira-fernandez MP, Pina T, Vázquez-rodríguez TR, Llorca J, González-gay MA.Investigations into audiovestibular manifestations in patients with psoriatic arthritis.J Rheumatol. 2014;41(10):2018-26. doi:10.3899/jrheum.140559
Joly-tonetti N, Wibawa JID, Bell M, Tobin DJ.An explanation for the mysterious distribution of melanin in human skin: a rare example of asymmetric (melanin) organelle distribution during mitosis of basal layer progenitor keratinocytes.Br J Dermatol.2018;179(5):1115-1126. doi:10.1111/bjd.16926
Blake A, Enos C, Armstrong AW, et al.Results of a survey of the national psoriasis foundation medical board on the management of ear psoriasis.Journal of Psoriasis and Psoriatic Arthritis. 2020;5(1):28-31. doi:10.1177/2475530319891954
Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.
The Psoriasis and Psoriatic Arthritis Foundation.Psoriasis and Sensitive Areas.
National Library of Medicine.Outer ear infection: What helps if earwax builds up?
Sbidian E, Mezzarobba M, Shourick J, et al.Choice of Systemic Drugs for the Management of Moderate-to-severe Psoriasis: A Cross-country Comparison Based on National Health Insurance Data.Acta Derm Venereol. 2021;101(6):adv00473. doi:10.2340/00015555-3765
American Academy of Dermatology.Psoriasis treatment: phototherapy.
National Institute on Deafness and Other Communication Disorders.Why You Shouldn’t Use Cotton Swabs to Clean Your Ears.
UT Health Houston McGovern Medical School.Itchy Ears.
American Academy of Dermatology Association.ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?
Tampa M, Sarbu MI, Mitran MI, Mitran CI, Matei C, Georgescu SR.The Pathophysiological Mechanisms and the Quest for Biomarkers in Psoriasis, a Stress-Related Skin Disease.Dis Markers. 2018;2018:5823684. doi:10.1155/2018/5823684
The Psoriasis and Psoriatic Alliance.Psoriasis and the Sun.
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