Lump Behind the Ear

Lump Behind the Ear

Painful or painless lumps may develop behind ears in the event of infections, bone overgrowth, allergies or due to certain types of cancers. These etiological factors as well as the accompanying symptoms and treatment options have been described in this article.
A lump behind the ear may be the result of a swollen lymph node or formation of cysts, benign tumors or malignant growths. Sometimes they are hard and painful; sometimes tender and movable; in other cases, they do not cause any pain at all and are soft to touch. These lumps or lesions may change in size but rarely do they exceed the size of a pea. In most cases, they disappear after a short amount of time. However, their persistence demands medical attention.

Given below are some of the factors and conditions that lead to the development of lumps behind the ear, as well as the treatment options available.

Acne
Acne is characterized by the formation of papules, pimples, and small nodules on the skin surface. These may develop due to hormonal changes and abnormally high levels of androgens (in males as well as females), stress, staph infections, or genetic predisposition.

Treatment: In most cases, they heal or reduce with time. However, if they persist, chemical agents like benzoyl peroxidase or retinoids may be prescribed. In case of staph infections, antibiotics coupled with the use of antiseptic creams and lotions may be advised. In severe cases of hormonal imbalance, anti-androgenic medications or hormonal therapy may be prescribed.
Swollen Lymph Nodes
Swelling of lymph nodes present behind the ear may give rise to a pea-sized lump that is filled with white blood cells and molecules of the immune system. The lump is soft and tender, and may be painful at times. It may also be accompanied by fever and fatigue.

It indicates the presence of an infection and reduces when the infection subsides. Common cold, strep throat, viral and bacterial sinusitis, and diseases like tuberculosis, cat-scratch disease, yaws, tularemia as well as parasitic infections like toxoplasmosis may involve swelling of lymph nodes behind the ear.

Treatment: Generally an antibiotic therapy, coupled with anti-inflammatory medication and analgesics, is prescribed in order to deal with bacterial infections. In case of parasitic infections, specific anti-parasitic drugs and broad-spectrum antibiotics are prescribed.
Mastoiditis
It refers to an infection in the mastoid bone, which consists of a honeycomb-like structure filled with air spaces, and is present behind the ear. Middle ear infections may spread to the mastoid bone leading to inflammation and structural disruptions. This is manifested as ear pain, redness, swelling, and formation of a bump behind the ear. Other symptoms include headache, fever, hearing loss, drainage from the ear, and irritability.

Treatment: Intravenous antibiotics like ceftriaxone and oral antibiotics as well as ear drops are prescribed to promote drainage. In certain cases, surgical treatment may be advised to drain the purulent fluid by removing a part of the mastoid bone (mastoidectomy). In case of middle ear infections, surgical drainage of the middle ear (myringotomy) may be advised.
Sebaceous and Epidermal Cysts
Cysts that arise due to blocked sebaceous glands followed by an accumulation of sebum are termed as sebaceous cysts. Epidermal cysts comprise accumulated keratin, giving rise to lumps under the skin surface. These cysts may get infected with bacteria and become purulent.

Treatment: The treatment options include the use of hydrogen peroxide gels and anti-inflammatory agents. Antibiotics may be prescribed in case of pus formation. Home remedies like warm compresses and heating pads may be advised to aid the drainage of pus. In severe cases, surgical excision of the cyst or laser therapy may be advised.
Benign Tumors
Benign tumors originating from soft tissues present behind the ear may appear as knots or lumps. Fatty lipoma is a type of tumor that develops from adipose tissue. It manifests as a soft, painless, and movable lump. Benign tumors that develop from tissues of the salivary gland may extend up to the parts behind the ear and are characterized by painless lumps that may or may not increase in size.

Another type of benign growth that may occur on the mastoid bone behind the ear is cholesteatoma, which consists of squamous epithelial cells. In simple terms, this condition involves an abnormal skin formation in the internal ear parts which otherwise do not have a layer of skin. Such malformation leads to destruction of the tissues around it and may appear as a lump below the normal skin surface behind the ear. The accompanying symptoms include dizziness, drainage in the ear, and hearing loss in the respective ear.

Treatment: Lipomas generally do not pose severe health issues and are most often excised for cosmetic reasons. However, sometimes, they may become painful and cause difficulty in jaw movements. They are excised through a small surgical procedure performed under local anesthesia. Liposuction and chemical destruction of the tumor may be advised in certain cases, depending on the size and histological investigations.
Cancer
Different forms of cancers or malignant growths that may occur in the region behind the ear include skin cancers, salivary gland cancers like parotid gland carcinoma, certain lymphomas, as well as angiosarcoma that originates from cells lining the blood vessels. The lumps due to malignant growths are generally painless and will increase in size.

Treatment: The treatment options available include destruction of cancerous growths by chemicals or radiation, surgical excision, and chemotherapy. The precise set of treatment options depends on the type of cancer and its stage, as well as size of the lump.
Seborrheic Dermatitis
It is characterized by the flaking of dry skin or buildup of waxy dead skin cells as well as redness and inflammation. It may arise due to climatic changes, stress, fatigue, neurological conditions, or even yeast infections. Individuals with Parkinson's disease, epilepsy, or AIDS are more susceptible to the development of seborrheic dermatitis.

Treatment: Skin diagnosis and dermatological investigations help to confirm the diagnosis of this condition. Topical creams and lotions containing corticosteroids like hydrocortisone and betamethasone may be prescribed to reduce the itching and discomfort. Antifungal agents like ketoconazole and ciclopirox may be prescribed in case of yeast infections.

Medical intervention is extremely important to determine the etiology and course of treatment for a lump behind the ear. Especially so, if it appears all of a sudden without any justifiable reason, and is painful or continues to increase in size.

Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for professional medical advice.