A lump on the ear is a common localized swelling or mass that develops on or just under the skin of the external ear. While the majority of these growths are benign, they can still cause concern or discomfort. Understanding the origin of the lump—whether it arises from the skin, glandular tissue, or deeper structures like cartilage—provides insight into its nature. This article informs readers about the various causes of ear lumps; however, it is not a substitute for professional medical guidance, and any new or changing growth should be evaluated by a healthcare provider.
Lumps Arising from Skin and Glands
Many common ear lumps originate from the superficial layers of the skin or the oil-producing glands beneath them. The most frequently encountered type is the epidermoid cyst, often incorrectly referred to as a sebaceous cyst. These masses form when epidermal cells become trapped beneath the skin’s surface, multiplying and secreting keratin, a thick, cheese-like material. Epidermoid cysts typically present as soft, movable, dome-shaped lumps that may have a small, visible pore at the center.
True sebaceous cysts are rarer and develop directly from a blocked sebaceous gland, which secretes sebum, an oily substance that lubricates the skin. When these cysts or a hair follicle become blocked, it can lead to folliculitis or acne, appearing as smaller, tender, red bumps. If bacteria enter the area, these issues can progress into an abscess—a painful, warm, and red pocket of pus requiring drainage and antibiotics.
These growths are usually confined to the skin layer or just beneath it. While they are not inherently serious, inflammation or infection can cause rapid growth, pain, and tenderness. Applying a warm compress can sometimes encourage drainage of a small, uninfected lump, but attempting to squeeze or rupture a cyst is discouraged due to the risk of inflammation and infection.
Bumps Caused by Injury or Chronic Irritation
Other types of ear lumps result from trauma or ongoing physical stress, often involving the underlying cartilage structure. Keloids are a form of exaggerated scar tissue that develops after skin injury, most commonly following ear piercing or minor surgical procedures. Unlike typical raised scars, keloids extend beyond the boundaries of the original wound, presenting as firm, rubbery, often itchy or painful nodules that can grow quite large.
A different trauma-related lump is Chondrodermatitis Nodularis Helicis (CNH), a painful, inflammatory nodule that typically forms on the helix or antihelix, the curved parts of the outer ear cartilage. CNH is thought to result from chronic pressure, such as habitually sleeping on one side, or from sun damage, leading to compromised blood flow to the cartilage. The resulting nodule is usually small, between four and six millimeters, and is exquisitely tender to the touch, often disrupting sleep.
Blunt force trauma to the ear, common in contact sports, can cause an auricular hematoma, where blood collects between the skin and the cartilage. Because the cartilage receives nutrients from the overlying skin via the perichondrium, this separation disrupts the blood supply. If the pooled blood is not promptly drained, the cartilage can die and be replaced by fibrous tissue, leading to the permanent disfigurement known as “cauliflower ear.” Immediate drainage and application of a compression dressing are necessary, ideally within six hours of the injury, to prevent this long-term deformity.
Signals That Require Medical Evaluation
While most ear lumps are benign, certain characteristics warrant immediate professional medical evaluation. A lump that is fixed to the underlying tissue, does not move freely, is firm to the touch, or exceeds 1.5 centimeters in size should be seen by a doctor. Concerning signs also include changes in the overlying skin, such as ulceration, bleeding, or a non-healing sore.
Systemic symptoms accompanying an ear lump, including sudden hearing loss, weight loss, fever, or night sweats, suggest a possibility beyond a localized skin issue. In rare instances, a lump may represent a serious condition, such as basal cell or squamous cell carcinoma, which are types of skin cancer. These malignancies often appear as a pearly nodule or a persistent, scaly patch, especially on the sun-exposed outer ear.
Less common benign causes include lipomas, which are soft, painless, and movable deposits of mature fat cells. Another possibility is a gouty tophus, which are hard, chalky accumulations of uric acid crystals that can form in the cartilage in people with chronic, untreated gout. A doctor will typically begin with a visual and physical examination, and if malignancy is suspected, they may order imaging or perform a biopsy for a definitive diagnosis.