Lump Behind Ear: 7 Possible Causes (& When to Worry)

A lump behind the ear can result from common issues like acne, swollen lymph nodes, or a sebaceous cyst. It may also indicate other conditions such as a lipoma, keloid, or dermoid cyst.

Generally, a lump or small bump in this area does not cause pain, itching, or discomfort. However, cases involving inflammation or ear infections may present with symptoms like pain, fever, redness, and headaches.

If the lump causes pain, takes a long time to go away, or grows larger, it is important to see a primary care physician, dermatologist, or pediatrician. A doctor can identify the cause and recommend the appropriate treatment.

Why is there a lump behind my ear?

Common causes of a lump behind the ear include:

1. Swollen lymph nodes

A lump behind the ear often indicates a swollen lymph node, which is an enlargement of the glands that usually signals an infection or inflammation. It can also be caused by autoimmune diseases, certain medications, or, in rare cases, cancer.

Swollen lymph nodes may or may not be painful and typically last between 3 and 30 days. However, if the lump continues to grow, lasts longer than 30 days, or is accompanied by weight loss, fever, night sweats, or itchy skin, it is important to see a doctor for proper treatment.

What to do: You should consult a primary care physician to evaluate the cause of the swelling and determine if treatment is necessary. The doctor may recommend rest and hydration, the use of pain relievers, anti-inflammatories, or antibiotics, or potentially surgery.

2. Acne

With acne, skin pores can become blocked by excess sebum produced by sebaceous glands, forming a pimple that creates a painful lump behind the ear. Although less common, acne can specifically affect the skin in this region, leading to a lump that usually disappears on its own.

What to do: Acne treatment should be guided by a dermatologist. They may prescribe medications such as antibiotics, anti-inflammatories, retinoids, or oral contraceptives for women. Other treatments a doctor might recommend include radiofrequency, phototherapy, laser therapy, chemical peels, or corticosteroid injections directly into the acne lesion.

3. Sebaceous cyst

Another possible cause of a lump behind the ear is a sebaceous cyst, a round lump that forms under the skin. These are usually soft to the touch, painless, measure a few centimeters, and can appear anywhere on the body.

If the cyst becomes inflamed, it can cause symptoms such as pain, redness, increased heat in the area, tenderness, and pus formation.

What to do: A sebaceous cyst is generally not serious. A dermatologist may simply recommend applying a warm compress to the area for 15 minutes to encourage the cyst to drain on its own. However, if there is inflammation or infection, the doctor may perform drainage or surgery and prescribe antibiotics.

4. Mastoiditis

A lump behind the ear may indicate mastoiditis, an infection of the bone located directly behind the ear. This condition can occur if an ear infection is not treated properly.

While more common in children, mastoiditis can affect people of any age and may be accompanied by symptoms like ear pain, fever, redness, heat, swelling, and increased sensitivity at the site.

What to do: If mastoiditis is suspected, it is important to consult an otolaryngologist (ENT), primary care physician, or pediatrician immediately. The doctor will perform a full evaluation and prescribe appropriate treatment, which usually involves intravenous (IV) antibiotics for about two weeks. In severe cases, treatment may involve surgery to drain ear secretions or remove the infected part of the bone.

5. Lipoma

A lipoma is a type of benign fatty tumor that can create a lump behind the ear. It generally does not cause pain or other symptoms.

However, larger lipomas can press on or block surrounding tissue, causing pain and signs of inflammation, such as redness or warmth in the area.

What to do: Treatment is usually not necessary for a lipoma. However, if it causes cosmetic concerns, is very large, or leads to pain and difficulty with daily tasks, a doctor can remove it via liposuction or surgery.

6. Keloid

A lump behind the ear can be a keloid, a type of scar that develops due to abnormal healing after skin inflammation or trauma. Keloids often present as irregular, shiny, hairless scars that can feel either firm or soft.

What to do: Treating a keloid is not always necessary. However, a dermatologist can treat it if the keloid causes cosmetic distress, pain, or a burning sensation.

The doctor may suggest using silicone-based ointments or gels, such as Kelo-cote, Mederma, or Celacyn. Additionally, the doctor might administer corticosteroid injections or perform cryotherapy, laser therapy, radiation therapy, or surgery. Learn more about keloid treatment and the options your doctor can recommend.

7. Dermoid cyst

Although rare in this location, a dermoid cyst is a possible cause of a painless lump behind the ear. It is a type of benign tumor that grows slowly. If complications arise, it can cause pain and discharge.

What to do: You should consult a primary care physician or dermatologist to confirm if the lump is a dermoid cyst. If necessary, the doctor will perform surgery to remove it.

When to worry

It is recommended to go to the doctor if the lump appears suddenly, is fixed (ie. doesn't move when palpated), does not resolve, or presents with other signs and symptoms such as:

• Pain and redness;
• Increase in size;
• Releases pus or other fluid;
• Difficulty moving the head or neck;
• Difficulty swallowing.

In these cases, the doctor can inspect and palpate the lump, and assess any other symptoms (like fever and chills, which may indicate an infection). If the lump is painful, it may be a sign of an abscess or a pimple.

Treatment depends largely on the cause of the lump, which can disappear without any treatment or require antibiotics or surgical intervention.