Quick Answers
A lump behind the ear can have many different causes, including:
– Swollen lymph nodes from an infection or inflammation
– Cysts, such as sebaceous cysts
– Lipomas or fat deposits
– Abscesses from a bacterial infection
– Salivary gland problems, like blocked salivary ducts
– Rarely, a lump could be a sign of cancer, like a lymphoma or salivary gland tumor
Most lumps behind the ear are harmless, but it’s important to have them evaluated by a doctor to determine the exact cause. Some lumps will go away on their own, while others may need drainage or surgical removal. Prompt medical attention is recommended if the lump is painful, persists, or continues to grow.
What Causes a Lump Behind the Ear?
There are various possible causes for lumps that form behind the ear:
Swollen Lymph Nodes
Lymph nodes are small glands that filter lymph fluid and help fight infection. There is a group of lymph nodes known as the posterior auricular lymph nodes located under the skin behind the ear. When the lymph nodes swell due to an infection, inflammation, or cancer, it can cause a noticeable lump.
Common causes of swollen lymph nodes behind the ear include:
– Viral or bacterial infections of the ear, face, scalp, or throat, like ear infections, sinusitis, tonsillitis, or colds
– Skin infections around the ear like cellulitis or abscesses
– Inflammation of the ear canal (otitis externa)
– Dental infections of the teeth, gums, or mouth
– Cancer, such as lymphoma, which may cause painful, firm lymph nodes
Lymph nodes can sometimes remain swollen long after an infection is gone. Usually swollen lymph nodes will go away on their own within a few weeks. Warm compresses can help speed up drainage and healing. If the nodes stay enlarged for over 2-4 weeks, see a doctor to determine if other testing is needed.
Cysts
Cysts are closed sacs that can fill with pus, blood, or other fluids. There are various types of cysts that can develop behind the ear:
Sebaceous cysts – These cysts are formed by blocked oil glands in the skin. They create smooth, movable lumps and are often painless.
Epidermoid cysts – These cysts develop from skin cells and also create painless, mobile masses.
Pilar cysts – These cysts originate from hair follicles that have become blocked. They form firm bumps that can sometimes be tender.
Cysts are very common and mostly harmless. Often they require no treatment unless they grow very large, rupture, or become infected, in which case they may need to be drained or surgically removed.
Lipomas
A lipoma is a benign fatty tumor that forms a soft, doughy lump under the skin. They are usually painless and harmless. Lipomas can form anywhere on the body where fat is stored, including behind the ears. Surgical removal may be done for cosmetic reasons but is not medically necessary in most cases.
Abscesses
An abscess is a collection of pus that builds up within surrounding inflammation and swelling. Abscesses can happen when infections spread to tissues under the skin. Common causes behind the ear include:
– Middle ear infections (otitis media) that spread
– Infected epidermoid or pilar cysts
– Folliculitis (infection of hair follicles)
– Complications of piercings
Abscesses are often red, warm, and very tender. Treatment involves draining the pus, along with antibiotic therapy.
Salivary Gland Problems
The parotid glands are the major salivary glands located just below and in front of the ears. When salivary ducts become blocked, it can lead to a salivary gland lump.
Causes of blockages include:
– Salivary stones – mineral deposits that form inside the glands
– Duct strictures – narrowing of the ducts
– Dehydration – which causes thickened saliva
– Tumors – both cancerous and benign
Swelling of the salivary glands is called sialadenitis. The lump may be painful initially and worsen while eating. Massaging and hydrating the glands can help manage the blockage in some cases, but sometimes surgery is required for removal of stones or tumors.
Rare Causes
In rare cases, a lump behind the ear could be a sign of cancer. Cancers found near the ear include:
– Parotid gland tumors – Tumors in the salivary glands are usually benign but can sometimes be cancerous.
– Non-Hodgkin’s lymphoma – Lymph nodes may swell if cancer cells spread.
– Squamous cell carcinoma – Ear skin cancer spreading to lymph nodes.
– Chondrosarcoma – A cartilage cancer, more often seen in the jawbone.
Any lump that persists, especially if hard and fixed in place, warrants medical investigation. Swollen painful nodes and growths should also be evaluated quickly.
When to See a Doctor
It’s a good idea to have a doctor assess any unexplained lump behind your ear, even if it is small or painless. See a doctor promptly if you notice any of the following:
– The lump is larger than 1 cm (0.4 inches)
– It has been present for over 2 weeks without shrinking
– It is red, inflamed, or tender
– You have swelling in multiple nodes behind both ears
– You develop a fever or unexplained weight loss
– The lump is hard, doesn’t move easily, and is fixed in place
– It continues to grow larger
– It does not go away on its own
A doctor can examine the lump and determine if imaging tests or biopsy are recommended to identify the cause. This is important to guide appropriate treatment.
Self-care Tips
While waiting for your medical appointment, some self-care tips include:
– Apply a warm compress to promote drainage and healing if it is swollen and inflamed. Avoid heat if redness or tenderness increases.
– Use an OTC pain reliever like acetaminophen if the lump is sore.
– Avoid picking at or trying to pop cysts or lymph nodes. This can worsen infections.
– Drink plenty of fluids and use gum or hard candy to promote saliva flow if the parotid glands are affected. Massage in front of the ears can also help.
– Practice good hygiene to prevent infections that could cause swollen nodes.
Seeking prompt medical attention is strongly advised if symptoms persist or worsen. Try not to panic as in most cases, lumps behind the ear are benign.
Diagnosing Lumps Behind the Ear
If you discover a lump behind your ear, there are some common tests your doctor may use to diagnose the cause:
Physical exam
Your doctor will closely inspect and palpate the lump, noting characteristics like:
– Location – is it centrally located behind the ear or more toward the jaw/neck?
– Size – how large is the mass?
– Shape and borders – are the edges well-defined?
– Texture – is it soft, firm, or fluctuant with liquid? Does it feel like a cyst, node or tumor?
– Mobility – is it fixed or movable when touched?
– Tenderness – is it painful when pressed?
This can help determine if it seems like a cyst, swollen node, or tumorous growth. Signs of infection like redness, warmth and pus will also be assessed.
Medical history
Your doctor will ask about risk factors, associated symptoms, and duration of the lump. Let them know if you have any history of cancer.
Imaging tests
If cancer is suspected, your doctor may order imaging like CT, MRI, or PET scan to evaluate the size, location, and possible spread of growths.
Ultrasound can also allow visualization of cysts, nodes, and tumors. It can guide needle aspiration if draining fluid for analysis.
Biopsy
A biopsy involves taking a small sample of cells from the lump to examine under a microscope. This can confirm if cancer is present. Fine needle aspiration or surgical biopsy may be done.
Blood tests
Blood tests are unable to directly diagnose the lump, but they can detect markers of infection or possibly cancer. Complete blood count, sedimentation rate, and LDH levels may be checked.
Cytopathology can also analyze any drained fluid for bacterial, cancerous, or other abnormal cells.
Treatment for Lumps Behind the Ear
Treatment will depend on identifying the specific cause of the lump behind your ear:
Swollen lymph nodes
– Infections – Antibiotics will be prescribed if a bacterial infection is the cause. This helps resolve the swelling.
– Persistent swelling – If swelling lasts longer than 1-2 months, a biopsy may be done to rule out cancer.
– No cause found – Expectant observation is recommended if no cause found but nodes aren’t worrisome.
Cysts
– Drainage – A needle may drain fluid from larger cysts at risk of infection. This provides relief but recurrence is common.
– Surgery – Removal is an option if the cyst is unsightly, painful, or repeatedly fills. This prevents recurrence.
Lipomas
– Observation – Most are harmless and can be left alone if small and non-bothersome.
– Surgical removal – An option for larger lipomas or those causing pain or cosmetic concerns.
Abscesses
– Incision and drainage – Making a small cut to release the pus provides immediate relief.
– Antibiotics – Oral antibiotics combat the bacterial infection and prevent reaccumulation.
– Warm compresses – Applying heat aids drainage and healing.
Salivary gland obstruction
– Hydration and massage – This may help relieve obstruction and swelling in some cases. Hard candy or gum stimulates saliva flow.
– Prescription drugs – Medications can help manage chronic swelling and inflammation.
– Surgery – Operative procedures like stone removal or tumor resection may be required for certain blockages.
Cancer
– Biopsy – A definite diagnosis is required to determine appropriate cancer treatment.
– Surgery – Operation to remove cancerous growths and lymph nodes.
– Radiation therapy – High energy beams target and destroy cancer cells.
– Chemotherapy – Cancer-killing medicines are prescribed to shrink growths.
– Immunotherapy – Medications boost the immune system to fight cancer.
Home Remedies for Lumps Behind the Ear
There are some home remedies that may provide relief for swollen and painful lumps behind the ear while waiting to see a doctor:
– Warm compress – Place a warm washcloth on the lump for 10-15 minutes 2-3 times a day to encourage circulation and drainage of fluid or infections. Avoid direct heat on open skin or rashes.
– Cool compress – For fresh injuries or swollen cysts causing pain, a cold pack wrapped in a towel may help reduce inflammation. Apply for 10 minutes a few times a day.
– Pain relievers – OTC nonsteroidal anti-inflammatory drugs like ibuprofen or acetaminophen can alleviate pain and discomfort. Avoid aspirin for children.
– Lymphatic massage – Use small circular motions to gently massage the area behind the ear toward the neck. Repeat 2-3 times per day to promote lymph drainage.
– Stay hydrated – Drink plenty of water to thin secretions and prevent salivary gland blockages.
– Saline rinse – Rinsing the nasal passages with a saltwater solution helps clear congestion and drainage that can cause swollen nodes.
– Proper hygiene – Keep ears, throat, and facial areas clean to avoid infections leading to enlarged nodes.
– Healthy lifestyle – Eat a balanced diet, exercise regularly, quit smoking, and manage stress to support your immune system.
However, home remedies should not be used as a substitute for medical care. It’s important to see a doctor to determine if any testing or treatment is needed for the lump.
When to Seek Emergency Care
In most cases, a lump behind the ear does not constitute a medical emergency. However, you should seek prompt emergency care if:
– Difficulty breathing – The airway becomes obstructed or breathing is impaired.
– Facial drooping – There is sudden one-sided facial muscle weakness.
– Rupture – You observe pus or blood draining from the lump.
– Rapid enlargement – The lump grows substantially larger in just a few hours or days.
– Abscess – The lump becomes extremely painful, warm and tender, signaling a localized infection.
– Loss of consciousness – You faint due to inflammation putting pressure on the brain.
– High fever – Temperature above 101°F, especially with headache or neck stiffness.
– Multiple lumps – Swelling rapidly develops behind both ears and down the neck.
– History of cancer – You have had a previous cancer that could spread to lymph nodes.
Seek emergency care if any of these more concerning symptoms accompany a new lump behind your ear. Call 911 or go to the nearest ER to receive rapid treatment intervention if warranted.
Preventing Lumps Behind the Ear
While not all lumps can be prevented, there are some measures you can take to lower your risks:
– Practice good hygiene – Keep your ears clean and avoid sticking cotton swabs or fingers inside the canal.
– Treat infections promptly – Take a full course of any prescribed antibiotics.
– Protect hearing – Use earplugs around loud noise to prevent ear damage.
– Wear sunscreen – Protect ears from sun exposure that can lead to skin cancers.
– Eat healthy – Consume a diet rich in antioxidants through fruits and vegetables to support immunity.
– Stay hydrated – Drink plenty of fluids and limit alcohol, which can dehydrate salivary glands.
– Don’t smoke – Avoid smoking and secondhand smoke, which impair immunity.
– Manage stress – Find healthy ways to cope with stress like exercise, meditation, or speaking with friends. Chronic stress can depress the immune system.
– Get cancer screenings – Follow guidelines for screenings like mammograms that can detect cancers early.
– Avoid trauma – Prevent sports, work, or other injuries that could cause hematomas and swelling.
See your doctor at the first sign of any lump to identify high-risk abnormalities. Prompt treatment leads to better outcomes.
Conclusion
Discovering a lump behind the ear can be concerning. However, in most instances, these lumps are benign. Common causes include swollen lymph nodes, cysts, lipomas, and salivary gland issues. Still, it is important to see a doctor for an accurate diagnosis, especially if the lump persists, changes, or becomes painful.
Blood tests, imaging, and biopsy help identify whether cancer is a possibility. Treatment will depend on the cause but may include antibiotics, drainage, medication, or surgery. Warm compresses, pain relief, massage, and hydration can help manage symptoms at home. Seek emergency care for breathing difficulties, sudden weakness, discharge, or rapid enlargement. While benign lumps may recur, addressing high-risk symptoms leads to better health outcomes. Stay vigilant and follow up with your doctor if you notice any lumps.
