Blackheads in the ear
back to main page
Blackheads in the ear are a colloquial term for open comedones located within the auricle or the external auditory canal. These are non-inflammatory lesions formed due to the clogging of the hair follicle opening by excess sebum, exfoliated skin cells, and impurities. The dark coloration of a blackhead is not due to "dirt," but rather the oxidation of melanin and lipids upon contact with air. The ear area, although often neglected in daily care, contains numerous sebaceous glands, which promotes the formation of these lesions. Blackheads in the ear are usually a cosmetic issue; however, improper handling can lead to inflammation, folliculitis, or a boil in the ear canal.
Blackheads in the ear – what is it?
The formation of blackheads in the ear area is the result of disrupted keratinization of the follicular opening (hyperkeratosis) and excessive sebum production (seborrhoea). The key factors in the pathogenesis include:
- Overactivity of the sebaceous glands – hormonally regulated (androgens), intensified during puberty, stress, and insulin resistance.
- Abnormal shedding of the epidermis – retention of corneocytes leads to the formation of a keratin plug.
- Mechanical factors – pressure from earphones, hearing aids, hats, helmets.
- Excessive occlusion of the skin – use of greasy products around the ear, hair cosmetics flowing onto the auricle.
- Inadequate hygiene of this area or conversely – overly aggressive cleansing leading to reactive seborrhea.
- Skin microbiome – colonization by Cutibacterium acnes may promote the transition from a non-inflammatory to an inflammatory lesion.
Additionally, in the external auditory canal, there are ceruminous glands, producing earwax. Excess earwax can mix with sebum and shed skin cells, forming masses resembling blackheads.
Risk factors include:
- oily and acne-prone skin,
- hyperandrogenism,
- use of comedogenic hair cosmetics,
- chronic stress and a high glycemic index diet.
Blackheads in the ear – how to remove
The procedure should be adapted to the location of the change – different rules apply within the auricle and others in the ear canal.
1. Dermatological and cosmetological procedures (auricle)
- Keratolytic preparations:
- salicylic acid 1–2% (lipophilic, penetrates the sebum plug),
- topical retinoids (adapalene, tretinoin – regulate keratinization),
- azelaic acid (comedolytic and antibacterial action).
- Medical peels with salicylic or mandelic acid – performed locally in office conditions.
- Manual extraction (controlled) – conducted by a qualified specialist, maintaining aseptic principles.
- High-tech cleansing – e.g., cavitation peeling or water microdermabrasion on the auricle.
2. Changes in the ear canal
Changes located deep in the ear canal require:
- ENT consultation,
- possible removal under visual control (otoscope),
- exclusion of a furuncle in the ear canal.
Self-manipulation in the ear canal can lead to:
- epithelial damage,
- secondary bacterial infection,
- swelling and severe pain,
- in extreme cases – perforation of the eardrum.
3. Prevention
- regular, gentle cleaning of the auricle,
- avoiding greasy cosmetics in this area,
- hygiene of headphones and hearing aids,
- use of sebum-regulating preparations for acne-prone skin.
Blackheads in the ear – extraction
Squeezing blackheads in the ear is the most common but not recommended method of dealing with them. In the area of the auricle, improper technique can lead to:
- damage to the wall of the hair follicle,
- transformation of the blackhead into an inflammatory papule,
- formation of an abscess or boil,
- hypertrophic scarring (rare, but possible if predisposed).
In the ear canal, squeezing is particularly dangerous due to:
- the thin, highly innervated skin,
- limited anatomical space,
- risk of sudden development of external ear infection.
If the lesion:
- is painful,
- grows rapidly,
- is accompanied by swelling and redness,
- causes a feeling of ear blockage,
it is necessary to urgently consult a doctor.
Blackheads in the ear are a non-inflammatory change resulting from keratinization disorders and seborrhea. In most cases, they are of a cosmetic nature, but improper removal can lead to infectious complications. Treatment should focus on regulating keratinization and controlling sebum production rather than mechanical squeezing.