Swelling Behind the Ears Symptoms, Causes & Common Questions

Swimmer's ear (otitis externa)

Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.

It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.

Most susceptible are children, because they have narrower ear canals that do not drain well.

Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.

Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.

Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.

Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.

Rarity: Common

Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving

Urgency: Primary care doctor

Wart

Warts, also called common warts or verrucae, are small, rough, rounded growths on the top layer of the skin. They may appear singly or in clusters.

Common warts are caused by the human papilloma virus (HPV) and are contagious through direct contact, especially through a break in the skin. They may spread from one place on the body to another simply through touch.

Anyone can get warts but they are most common in anyone with a weakened immune system, as from illness or chemotherapy. Children and teenagers are also susceptible to warts.

Warts often first appear on the hands and fingers, especially near the nails or after any injury to the skin. This is why biting fingernails is a risk factor for warts.

Warts are benign, meaning they are not cancerous. But they can be unsightly and interfere with normal use of the hands, so treatment is often beneficial.

Diagnosis is made through physical examination. Warts in children sometimes go away without treatment, but otherwise most warts can be easily removed in a doctor's office.

Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

• Pain or discomfort in the muscles controlling the TMJ.
• Dislocation or injury to the jawbone.
• Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Skin cyst

A cyst is a small sac or lump, filled with fluid, air, fat, or other material, that begins to grow somewhere in the body for no apparent reason. A skin cyst is one that forms just beneath the skin.

It's believed that skin cysts form around trapped keratin cells – the cells that form the relatively tough outer layer of the skin.

These cysts are not contagious.

Anyone can get a skin cyst, but they are most common in those who are over age 18, have acne, or have injured the skin.

Symptoms include the appearance of a small, rounded lump under the skin. Cysts are normally painless unless infected, when they will be reddened and sore and contain pus.

Diagnosis is made through physical examination. A small cyst can be left alone, though if it is unsightly or large enough to interfere with movement it can be removed in a simple procedure done in a doctor's office. An infected cyst must be treated so that the infection does not spread.

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Pimple

Pimples are also called comedones, spots, blemishes, or "zits." Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.

Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.

Most susceptible are teenagers from about ages 13 to 17.

Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.

Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.

Diagnosis is made through physical examination.

Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.

Lymph node inflammation behind the ear

There are lymph nodes behind the ear. Lymph nodes are where your immune cells live, and when they become enlarged, it could be from a nearby infection, immune response, or even backlog of blood.

You should see your primary care doctor tomorrow for a sick visit. There, the doctor can look at what could explain the enlarged node behind your ear.

Rarity: Common

Top Symptoms: pain behind the ear, swelling behind the ears

Symptoms that always occur with lymph node inflammation behind the ear: swelling behind the ears

Urgency: Primary care doctor

Lipoma

Lipoma is a word that translates as "fatty tumor," but a lipoma is not cancer. It is simply a growth of fat between the muscle layer and the skin above it.

The exact cause is not known. The condition does run in families and is associated with other unusual syndromes such as adiposis dolorosa, which is similar. Lipomas most often appear after age 40.

Symptoms include a soft, easily moveable lump beneath the skin, about two inches across. A lipoma is painless unless its growth is irritating the nerves around it. They are most often found on the back, neck, and abdomen, and sometimes the arms and upper legs.

It is a good idea to have any new or unusual growth checked by a medical provider, just to make certain it is benign.

Diagnosis is made through physical examination, biopsy, and imaging such as ultrasound or CT scan.

Most of the time, treatment is not necessary unless the lipoma is unsightly or is interfering with other structures. It can be removed through surgery or liposuction.

Chronic inflammation of the salivary gland (parotitis)

The parotid glands are large salivary glands that sit inside each cheek, over the jaw in front of each ear. Chronic recurrent parotitis is a condition that causes repeated cycles of swelling in these glands, causing swelling and occasionally dry mouth or a strange taste.

You should visit your primary care physician for a thorough physical exam. The doctor may remove fluid from the gland to check for signs of infection, and perform imaging with an X-Ray or Ultrasound to figure out the cause of the recurrent inflammation. Treatment may involve prescription medication, or, in rare cases, surgery.

Rarity: Ultra rare

Top Symptoms: jaw pain, moderate fever, swollen jaw, dry mouth, swelling behind the ears

Symptoms that always occur with chronic inflammation of the salivary gland (parotitis): swollen jaw

Urgency: Primary care doctor

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Branchial cleft anomaly

A branchial cleft anomaly (abnormality) is a mass of unusual tissues within the neck. These tissues may form fluid-filled pockets called cysts, or they may form passages (called fistulas) that drain to an opening in the skin.

You should visit your primary care physician who will perform a thorough physical exam. Branchial cleft anomalies are usually treated with surgery, and it is important to check for any infection.

Rarity: Ultra rare

Top Symptoms: shortness of breath, neck bump, painful neck lump, trouble swallowing, swollen neck

Symptoms that never occur with branchial cleft anomaly: bleeding from the ear

Urgency: Primary care doctor

Will the swelling behind my ear go away on its own?

It depends. If your swelling is due to abnormal cell growth, it might stay the same, grow, or shrink. If it is caused by infection, it might go away on its own as your body fights the infection or might go away with some over-the-counter anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin). If the infection has caused a collection of pus (an abscess) to form, it might go away but typically this requires draining by a medical professional. Any swelling that persists or worsens over time should be seen by a medical provider.

Why is the swelling behind my ear painful?

Swelling caused by infection may be painful because the body’s immune response is reacting to the infection, and one of the symptoms of this reaction is pain to alert you that something is wrong. If the swelling is due to trauma, the pain you’re feeling is most likely the aftermath of the damage to the area in and around the area of swelling. If your pain doesn’t get any better or gets worse, seek the attention of a medical provider. If your swelling appears after trauma (like bumping your head) and is associated with severe pain or a headache, you should be immediately evaluated by a medical professional.

Why is the swelling behind my ear getting worse?

Your swelling may be getting worse as fluid or blood collects in and around the area of the swelling. If the swelling is due to trauma, it should decrease over time. A swelling due to infection may grow as pus collects under the skin or as lymph nodes enlarge in reaction to the infection. Swelling may also worsen if abnormal cells or protein (like keratin) are building up. These cells can either be cancerous or non-cancerous. A swelling that is growing rapidly in size, persistently grows, or is associated with a change in color or shape should be medically evaluated.

Can swelling behind the ear be life-threatening?

Usually, swelling behind the ear is not life-threatening and may resolve on its own or with simple medications like antibiotics for an infection. Sometimes, however, swelling behind the ear can indicate a serious infection of the mastoid, the bone behind the ear. Infection of the mastoid, called mastoiditis, is dangerous because it can spread to the brain [6]. If your swelling is associated with severe pain, high fever, headache and/or confusion, you should seek medical evaluation without delay.

Can swelling behind the ear be due to an ear infection?

Yes. Ear infections are a common cause of swelling behind the ear as the middle ear (the part of your ear canal behind the eardrum) is connected to the bone and area behind the ear. The lymph nodes that exist behind the ear can also grow during an ear infection and appear as small swellings behind the ear.

Questions your doctor may ask about swelling behind the ears

• Any fever today or during the last week?
• Is there anything coming from your ear(s)?
• Do you use a hearing aid or wear earplugs?
• Have you ever been diagnosed with diabetes?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.