Painful or painless lump behind the ear: what does it mean?

Discover what causes lumps behind the ear
Last update on Jul, 04, 2024
Dr. Tom Tedeschi

Reviewed by

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

Lump behind the ear: Causes and remedies

Sometimes small lumps appear on the back of our ears, causing discomfort or itching. Lumps behind the ear can be the result of inflammation or infection. In certain conditions like mastoiditis, middle ear infections or mumps, ear lumps are often associated with pain. In this article, you'll learn all there is to know about lumps behind the ear. If you'd like to find out more about your hearing health, please consult a hearing care professional at Miracle-Ear

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Lumps behind the ear with pain

Lumps behind the ear accompanied by pain can indicate various underlying issues, ranging from infections to inflammatory conditions. Painful lumps are often associated with swollen lymph nodes, which can occur due to infections in the ear,  scalp, or throat.

These lumps may also result from abscesses, which are pockets of pus caused by bacterial infections. In some cases, painful lumps behind the ear could signal more serious conditions such as mastoiditis, an infection of the mastoid bone behind the ear. Seeking prompt medical attention is crucial to determine the cause of the pain and initiate appropriate treatment to alleviate discomfort and prevent complications.

Painless lumps behind the ear

Painless lumps behind the ear are commonly benign and may not cause immediate concern. These lumps often include swollen lymph nodes that enlarge in response to infections or immune system activity. Lipomas, which are non-cancerous growths of fatty tissue, can also present as painless lumps.

Occasionally, painless lumps behind the ear may indicate sebaceous cysts, which are sacs filled with keratin and oil. While painless lumps are usually harmless, it's important to monitor them for any changes in size, shape, or texture. Consulting a healthcare professional for an evaluation can provide peace of mind and ensure appropriate management if needed.

Why do I have a lump behind my ear? Possible causes

In most cases, lumps behind the ears are harmless. They are rarely a sign of a dangerous or life-threatening problem. Several conditions can cause knots, bumps, or lumps behind the ears, including:

A lump behind or near the ear is also one of the symptoms of acute external otitis, associated with pain, fever and yellow discharge. The swelling is localized in and may affect the outer ear or ear canal.

Parotitis is a viral infection that manifests itself with painful enlargement of the parotid glands and lump behind the ear. When this occurs, the swelling can extend in front of and below the ear, up to the lower portion of the jaw or face.

A lump behind the ear can be a symptom of mastoiditis, especially when the swelling appears in children. 

Mastoiditis is an inflammatory process of the mastoid bone (a large bone behind the ear), which causes intense pain with a lump and swelling in or around the ear. Other symptoms of this condition are ear discomfort, fever, drainage, headache and redness of the ear. If you have these symptoms, it is important to visit a doctor promptly for evaluation and treatment options.

Epidermal cysts are small, fluid-filled sacs that can appear anywhere on the skin and are often caused by blocked skin glands. One of the most common types are sebaceous cysts, which are often seen on the head, neck and back. These result from clogged sebaceous glands that produce oily secretions that lubricate the skin. 

The epidermal cyst can vary in size, they are usually harmless and no intervention is needed. In some cases epidermal cysts can become infected resulting in red, painful and larger cysts. If this occurs, they can be treated by a healthcare professional. 

Inflamed and swollen lymph nodes are one of the most common reasons for a lump to develop behind the ear. They are the body's reaction to bacteria and viruses. The lymph nodes behind the ear are called posterior auricular lymph nodes, and if they become swollen, they usually feel like small, painless lumps behind the ear that are very small in size.

They are usually caused by a skin or ear infection in that area (such as otitis media). Most of the time they are painless and return to their normal size in 2-3 weeks. If they start to become painful, you should visit a doctor to receive a full diagnosis and support.

Lipomas are harmless lumps of fat that develop under the skin and can appear anywhere on the body. They vary in size. Some are small and often unnoticeable while others can be pea-sized, soft and movable.. These larger lumps are usually between 2-3 cm in diameter and painless. It can be quite tricky to distinguish lipomas from an epidermal cyst as both can surface in any area where there is fatty tissue, but compared to a skin cyst, lipomas are usually found deeper in the skin and feel much softer.

If they cause discomfort and pain, it is best to have them surgically removed. Lipomas can also be removed by a professional through liposuction using a large syringe and needle.

Acne is a very common skin condition, especially in younger people. The pores and follicles of the skin become clogged with fluids and shed skin cells. This can cause a swelling on the skin that can become infected and inflamed, including behind the ear.

Acne lumps behind the ears may appear black, white or reddish and may surface on the face, neck or back, among other places. When seeking treatment for acne, it is important to see a dermatologist as they will assess your case and prescribe the most suitable treatment.

In some types of cancer, such as lymph gland cancer or leukemia, a lump behind the ear can be the first sign of the disease. If a lump is hard, fixed in place or uneven in shape, it might be a sign that it is cancerous.

It is strongly recommended that you see a doctor if your lump is painful, appears suddenly or is accompanied by other symptoms.

Lump behind the ear

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When shoud you be worried about a lump behind the ear?

Although most lumps behind the ear are completely harmless and will go away in a few weeks without treatment, you should see a doctor if any of the following occur:

  • The lump remains unchanged after 2-3 weeks;
  • The lump is painful or oozing;
  • The lump appears suddenly;
  • The swelling increases in size or shape;
  • The lump does not move or is in a "fixed" position behind the ear;
  • Other symptoms such as fever, malaise, or weight loss are present.

Your doctor will usually diagnose the lump through a simple exam and prescribe treatment, such as antibiotics, if needed. Occasionally, a lump may require further investigation or imaging tests, such as X-rays and MRIs.

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How to get rid of a lump behind the ear: Treatment options

Treatment depends on the cause of the lump behind the ear:

  • Abscess: Some abscesses require simple drainage to remove pus, while others are more complicated and may need to be treated with surgery. Surgical procedures are more likely to include antibiotics due to the chances of infection;
  • Sebaceous cysts: The sebaceous glands produce fluids and sometimes become blocked, thus creating cysts. Most require no treatment, but if they cause soreness or swelling, you should see a doctor;
  • Acne: Most cases can be treated with topical remedies, but for some people acne can be severe and may require specific approaches applied and monitored by a dermatologist;
  • Dermatitis: Lotions or creams are often recommended to help with itching and discomfort. Antifungal agents may also be suggested if there is a yeast infection;
  • Swollen lymph nodes: In this case, the underlying cause of the swelling is treated. This could mean that antibiotics or a biopsy may be needed;
  • Mastoiditis: This must be treated immediately with antibiotics, and in some situations, a procedure is needed to drain the middle ear or remove part of the mastoid bone;
  • Otitis media: This middle ear infection often clears up on its own within 48 hours. With recurrent otitis media, an ear tube is used to drain fluid from the middle ear;
  • Malignant cancer: These growths can be treated with chemotherapy or radiation. The specific treatment depends on the type of cancer and its stage.

While in mild cases, natural remedies may help treat the condition, in severe cases, natural remedies will not solve the problem. When using natural remedies, it is best to keep in mind that they are designed to help the lump disappear faster but not get rid of it entirely by clearing the area and inhibiting the proliferation of bacteria and microbes. 

Some remedies include aloe vera, castor oil and apple cider vinegar application to the area where the lump is present.

Lump behind baby's ear: what to do

Finding a lump behind a baby's ear can cause worry for parents. Typically, a lump in this location on a newborn may stem from enlarged lymph nodes, which often enlarge as the baby's immune system reacts to minor infections or immune responses.

These lumps are usually small, soft, and mobile, and they generally resolve on their own as the underlying issue improves. However, if the lump behind the infant's ear persists, enlarges, or is accompanied by symptoms like fever or fussiness, it's crucial to seek advice from a pediatrician. This ensures any potential serious conditions are ruled out and supports the baby's health and comfort.

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Pea sized lump behind the earlobe with no pain

Finding a small lump behind the earlobe that doesn't cause pain can be worrisome, but it's often harmless. These lumps can arise from different conditions, such as sebaceous cysts, which are benign growths filled with keratin, or swollen lymph nodes responding to an infection nearby. Another possibility is lipomas, which are harmless deposits of fatty tissue that can appear as painless, pea-sized lumps.

While these lumps are generally not a cause for concern, it's important to keep an eye on them for any changes in size, shape, or discomfort. Consulting a healthcare provider for a comprehensive evaluation can help rule out any underlying issues and provide peace of mind.

A painful, pea-sized lump behind the earlobe could be due to various causes. These may include:

  • Lymphadenopathy: Swollen lymph nodes due to an infection or inflammation in the nearby area;
  • Sebaceous cyst: A sac filled with keratin and oily fluid, which can become inflamed and painful;
  • Abscess: A localized collection of pus caused by a bacterial infection;
  • Inflammatory skin conditions: Such as folliculitis or acne, which can cause painful bumps;
  • Trauma: Injury or trauma to the area, resulting in a lump.

Sore, firm and hard lumps behind the ear

Painful, firm, and hard lumps can indicate various underlying conditions, each with distinct characteristics:

  • Sore lump: Typically tender to the touch, a sore lump may result from inflammation, infection, or injury. Examples include swollen lymph nodes due to infection or an inflamed sebaceous cyst;
  • Firm lump: Solid and often painless, a firm lump may be caused by conditions such as fibroadenomas in the breast or noncancerous lipomas composed of fat cells;
  • Hard lump: Dense and rigid, a hard lump may raise concerns about cancerous growths like malignant tumors. However, not all hard lumps are cancerous; they can also stem from benign conditions like calcifications or fibrosis.

It's crucial to have any new or concerning lumps examined by a healthcare professional for accurate diagnosis and appropriate management. Depending on the lump's characteristics and associated symptoms, additional tests such as imaging studies or a biopsy may be necessary to determine the cause and establish a treatment plan.

Different positions of lumps behind the ear

A lump around an ear piercing is a common issue many people face. These lumps can form near the pierced area and vary in intensity. Typically, they stem from an infection at the piercing site, causing swelling, redness, and tenderness.

The appearance of a lump near the ear piercing can be concerning due to its size and discomfort. Lumps can also develop at the back of the ear piercing or behind the ear, often as a natural part of the healing process in response to the piercing. It's important to maintain good hygiene around the pierced area and consult a healthcare professional if the lump persists or worsens.

A lump located behind the ear or on the bone nearby can raise concerns due to its location and potential causes. Such lumps may arise from various conditions, including swollen lymph nodes in response to infections or other immune reactions.

They could also be due to cysts, which are sacs filled with fluid or semi-solid material, or benign growths like lipomas composed of fatty tissue. In some cases, a lump in this area could indicate more serious conditions such as a bone tumor or an inflammatory condition affecting the bone.

A lump under the earlobe behind the jaw bone can be concerning due to its location and potential causes. Such lumps may arise from swollen lymph nodes, which commonly enlarge in response to infections or inflammation in the throat, ear, or head and neck area. These lymph nodes are part of the body's immune system and may become palpable when they react to infection.

In some cases, a lump in this area could also be due to a salivary gland infection or a cyst, such as a branchial cleft cyst or an epidermoid cyst. These cysts are sacs filled with fluid or semi-solid material and can sometimes be felt under the skin near the jaw bone and earlobe.

Man with headache and ear pain

Prevention is key

Never underestimate the importance of ear care. Your hearing might depend on it.

A lump behind the ear – FAQs

If the lump is caused by an infection, it may either clear up on its own as your body fights off the infection, or it may go away with some anti-inflammatory medications.

If the infection has caused a collection of pus (an abscess) to form, it may go away, but it usually needs to be drained by a doctor.

A lump behind the ear caused by an infection can be painful because the body's immune response is reacting to the infection, and one of the symptoms of this reaction is pain that warns you that something is wrong. If the lump is due to trauma, the pain you feel is most likely the result of damage around the area of the swelling.

Lumps behind the ear can get worse when fluid or blood collects in and around the area of swelling. If the lump is due to a trauma, it should decrease over time. A lump due to infection can grow when pus builds up under the skin or when lymph nodes swell in response to the infection. Swelling can also get worse if abnormal cells or proteins (such as keratin) build up.

Usually, a lump behind the ear is not particularly dangerous and will go away 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. Mastoid infection, called mastoiditis, is dangerous because it can spread to the brain.

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