From the Guidelines
For eczema behind the ear, apply a topical corticosteroid cream such as hydrocortisone 1% or a prescription-strength steroid like triamcinolone 0.1% twice daily for 7-10 days to reduce inflammation and itching. Before application, gently clean the area with warm water and pat dry. Apply a thin layer of the medication to the affected skin, being careful not to use too much as the skin behind the ears is thin. This approach is supported by the management guidelines for atopic eczema, which emphasize the use of topical corticosteroids as the mainstay of treatment 1.
After the steroid treatment, maintain the area with a fragrance-free moisturizer like CeraVe, Vanicream, or Eucerin applied 2-3 times daily to prevent flare-ups. Avoid scratching, which can worsen symptoms and lead to infection. Keep the area dry, as moisture can exacerbate eczema. It's also important to avoid provoking factors such as soaps and detergents, which can remove natural lipid from the skin surface, and to use a dispersible cream as a soap substitute 1.
If symptoms persist beyond two weeks, develop signs of infection (increased redness, warmth, pus, or pain), or if the condition frequently recurs, consult a healthcare provider as you may need stronger prescription treatments or to identify potential triggers causing the eczema. Other considerations include the possibility of contact dermatitis, which can be managed by removing the sensitizing agent and applying a topical steroid or other anti-inflammatory topical 1.
Key points to consider in managing eczema behind the ear include:
- Using topical corticosteroids as the first line of treatment
- Maintaining the area with fragrance-free moisturizers
- Avoiding scratching and keeping the area dry
- Identifying and avoiding provoking factors
- Considering the possibility of contact dermatitis and managing it appropriately.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema
- Hydrocortisone (TOP) can be applied to temporarily relieve itching associated with eczema, including behind the ear.
- It is essential to follow the advice and supervision of a doctor for any other uses of this product. 2
From the Research
Eczema Behind the Ear: Treatment Options
To manage eczema behind the ear, various topical treatments can be applied. The choice of treatment depends on the severity of the condition and the individual's response to different therapies.
- Topical anti-inflammatory treatments, such as potent and very potent topical steroids, tacrolimus 0.1%, and ruxolitinib 1.5%, have been ranked among the most effective treatments for improving patient-reported symptoms and clinician-reported signs 3.
- Topical corticosteroids are commonly used to treat eczema, and their potency and formulation can vary. They are available in ointments, creams, lotions, gels, foams, oils, solutions, and shampoos 4.
- The application of topical corticosteroids should be guided by the fingertip unit method, which helps to ensure the correct amount of medication is used. One fingertip unit covers approximately 2% body surface area on an adult 4.
- Local application site reactions, such as skin thinning, can occur with topical corticosteroids, especially with long-term use. However, the risk of skin thinning is lower with short-term use 3, 5.
- Alternative treatments, such as topical calcineurin inhibitors, can be considered for patients who experience adverse effects with topical corticosteroids. However, the relative effectiveness and safety of these treatments compared to topical corticosteroids are uncertain 3, 6.
- New formulations, such as hydroxypropyl methylcellulose (HPMC) lyogel, have been developed to deliver hydrocortisone more effectively and minimize side effects. These formulations have shown promising results in reducing eczematous inflammatory reactions 7.