What Causes a Lump in Front of the Ear?
What is a lump in front of the ear?
The area in front of your ear is near complex structures that help with everything from the feeling in your face to eating food. Because of this, many things can cause a lump here.
For example, lymph nodes, which are part of the immune system, are located in the head and neck area—including on the side of the face in front of the ear. They can swell when you’re fighting an infection.
Growths in the muscle, soft tissue, and nerves in front of the ear, and inflammation can cause hard lumps.
A lump in front of the ear can be painful. If you have a lump, it’s important to get it looked at. New lumps anywhere on the body may be a sign of a benign tumor or cancer.
Treatment ranges from over-the-counter pain relievers to surgical removal, radiation, and chemotherapy depending on the cause of the lump.
1. Swollen lymph node
If the bump in the ear is a swollen lymph node, the lymph node itself is not infected. It is swollen because there is an infection somewhere in the ear or the mouth. The lymph nodes in front of the ear drain this area of the body. —Dr. Lauren Levy
- Marble- to golf ball-sized lump under the skin
Lymph nodes are home to the cells of the body that fight infection. When you have an infection, lymph nodes swell up because they are working overtime.
The lymph nodes in front of the ear are called the preauricular lymph nodes. When there is an infection of the outer part of the ear, the mouth (due to a dental infection), or in the salivary gland, these lymph nodes may become swollen and painful.
In rare cases, a swollen lymph node in this area can be a sign of a blood cancer (like lymphoma or leukemia) or a head and neck cancer (such as squamous cell carcinoma of the throat or mouth).
See your doctor if your lymph node does not resolve in 1 to 2 weeks, or the lump is fixed to surrounding tissue (not mobile) and not painful.
- Small pink or red bump
- White pus, yellow-white keratin (whitehead), or black keratin (blackhead) in the center
- May have pain
Pimples are also called comedones, spots, blemishes, acne, or zits. They are small pockets in the skin filled with dead skin cells, bacteria, oil, and white blood cells (the cause of pus). They usually occur around puberty, but adults can get pimples as well.
There are many different kinds of pimples. Blackheads (open comedones) are small bumps with a black center, caused by the exposure of keratin (the top layer of skin) to air. In whiteheads (closed comedones), which are small white bumps, the keratin has not been exposed to air.
Cyst-like acne lesions are painful, red, angry-looking bumps on the skin. They form when there is a lot of inflammation in the skin. Pus forms from the white blood cells that are in the oil (sebaceous) gland.
There are many options for treating pimples, depending on the type of acne that you have. You can try a combination of topical over-the-counter (OTC) medications and acne cleansers. Or you can see a dermatologist who can prescribe a combination of creams and acne washes, and sometimes oral medications.
Avoid foods high in sugar or simple starches. Wash your face daily with gentle non-comedogenic products, which means they are less likely to clog oil glands. Look for makeup labeled non-comedogenic as well.
3. Skin cyst
- Skin-colored or red bump
- Marble to golf ball-sized lump
- A central opening
- Oozing pus or white cheese-like material (keratin)
A cyst is a small sac or lump filled with fluid, air, fat, or other material. The most common cyst is an epidermal inclusion cyst. They range from the size of a marble to a golf ball. There may be a central opening on the cyst that oozes keratin (pus)—a white cheese-like material—when it is infected.
Cysts are not contagious and are usually painless, but they can become infected or inflamed. Then they become red, tender, and feel warm to the touch. They are often very painful and pus may flow out of the cyst. In rare cases, you may run a fever when it is infected.
If the cyst can’t be seen or doesn’t bother you, treatment isn’t necessary. If you don’t like how the cyst looks or it's large enough to interfere with movement, your doctor can remove it during a simple office procedure called an excision.
If the cyst becomes infected, your doctor may cut and drain it. Antibiotics are necessary. Your doctor may also inject steroids (Kenalog) into the infected cyst to calm the inflammation and reduce pain.
- Skin-colored, marble-sized bump under the skin
- Usually not painful
A lipoma is a “fatty tumor”—a noncancerous growth of fat between the muscle and the skin. Lipomas are usually not painful unless they grow very large and irritate a nerve. Doctors don’t know why they occur, but they often run in families.
A lipoma doesn’t usually need to be treated. But if it bothers you, is growing, or is causing pain, your doctor can remove it with surgery or liposuction.
5. Skin abscess
- Red, pus-filled bump, ½ cm to 2cm in diameter
A skin abscess is a large pocket of pus that has formed just beneath the skin. Usually, bacteria (staphylococcus aureus) enters the skin from a small cut or scratch and then multiplies. Picking a pimple can also introduce the bacteria. The body fights the infection with white blood cells, which kill some of the bacteria while also forming pus within the remaining cavity.
A small abscess may heal on its own. But your doctor may need to drain the abscess to clean out the pus. This will help relieve the pain. They will probably prescribe an antibiotic.
If an abscess is not treated, it can grow and the bacteria can spread through the bloodstream, which is dangerous. Fever, body aches, and chills are signs that the infection has spread.
6. Seborrheic keratosis
- Skin-colored, brown, or black, bumpy growth
- Larger growth over time
- May bleed when traumatized (like shaving over it)
- May itch if inflamed
Seborrheic keratoses are non-cancerous growths that commonly occur on the head, neck, and back. They are skin-colored, brown, or black bumps that feel rough and wart-like. They can occur in clusters and often appear in people over 40.
Seborrheic keratoses can grow with time but they don’t spread throughout the body. They are usually painless but can bleed or become irritated when traumatized or cut. They can also become inflamed and itchy.
No treatment is necessary. However, when the bumps bother you, itch, or bleed, your dermatologist can freeze them with liquid nitrogen (cryotherapy) or shave them off and burn the base so they are less likely to come back.
7. Actinic keratosis
- Pink bump with overlying, sandpaper-like scale
- Absence of pain
Actinic keratoses are precancerous bumps caused by chronic sun damage. They are pink, rough bumps that often occur in groups. They are not painful, but if shaved over can bleed. Left untreated, they can turn into a skin cancer (squamous cell carcinoma).
Your dermatologist can freeze the lesion off with liquid nitrogen (cryotherapy) or apply a topical chemotherapy cream that gets rid of the lesions. If you have been diagnosed with actinic keratosis, you should wear sunscreen on your face every day to prevent more lesions from forming. When you have a lot of them, you need regular skin checks.
8. Skin cancer
People often think that all swollen bumps in front of the ear are cancer. This is not true. Cancer is probably one of the least common causes. Bumps in front of the ear are most likely to be non-cancerous growths like cysts or lymph nodes from an infection or viral syndrome. —Dr. Levy
- A shiny bump that bleeds easily without any trauma
- Painful, red scale
- An ulcer that does not heal
- Rapid lesion growth
Skin cancers do not heal on their own. They can look like a pearly/shiny papule that bleeds easily or a red scaly bump that bleeds. The bump grows over time. It may also look like a cut or an ulcer that does not heal. The area may be painful.
You should see a dermatologist if you think you have skin cancer. Your dermatologist will examine the lesion and take a biopsy, which involves numbing the area and cutting off a small piece to send to a lab for analysis.
The good news is that these skin cancers are highly treatable and curable if caught early, according to the Skin Cancer Foundation. Treatment involves surgery to cut the lesion out.
If you have been diagnosed with skin cancer, wear sunscreen on your face every day. See your dermatologist for skin checks at least twice a year.
Other possible causes
A main sign of mumps—which is very rare nowadays thanks to a vaccine—is a painful lump in front of the ear because the virus affects the parotid gland. —Dr. Levy
A number of conditions may also cause a lump in front of the ear, though these are either rare or a lump in front of the ear is not usually the most noticeable symptom. They include:
When to call the doctor
The causes of lumps in front of the ear vary, so you should see a physician if it does not get better in 1 to 2 weeks. You should also see your doctor if the lump is growing fast, causing pain, bleeding, oozing pus, or is hard and immobile (tight against the surrounding skin).
Should I go to the ER for a lump in front of the ear?
You should go to the emergency department if you have any of these signs of a more serious problem:
- Decreased appetite
- Severe pain interfering with sleep
Many lumps will go away on their own. If the lump is a growth like a cyst, lipoma, or a skin cancer, your doctor will discuss treatment options with you.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) to relieve pain from the lump.
- Warm compresses if the lump is oozing pus
Other treatment options
- Incision and drainage (cutting the lump open) is the treatment for an inflamed cyst.
- Surgery is for removing both benign (lipomas, cysts) and malignant (cancer) growths in front of the ear and other areas of the body.
Dr. Levy is a board certified dermatologist specializing in medical derm with expertise in acne, rosacea, skin cancer, psoriasis, and skin manifestations of rheumatologic disease. Her undergraduate education was completed at the University of Pennsylvania where she graduated summa cum laude and was inducted into the Phi Beta Kappa honors society. She graduated with a distinction in research from the Icahn School of Medicine at Mount Sinai and was inducted into the Alpha Omega Alpha Honor Medical Society. During medical school, she received a one year Doris Duke Clinical Research Fellowship Award. During that time, she investigated imaging techniques for early diagnosis of head and neck cancer. Her training continued with a medical internship at Memorial Sloane Kettering Cancer Center followed by dermatology residency in the Department of Dermatology at Yale University, one of the most prestigious dermatology departments in the country. Following her residency, she worked as a clinical Instructor at Yale School of Medicine. She currently sees patients in New York City and Westport Connecticut and is a Clinical Instructor in the Department of Dermatology at Mount Sinai School of Medicine. She is a Fellow of the American Academy of Dermatology.
Dr. Levy is well published in the field of dermatology having written articles on atopic dermatitis, psoriasis, acne, and skin manifestations of systemic disease. She is an avid lecturer and has been invited to lecture at state wide dermatology meetings. She is the editor of a board review Dermatology textbook.