Types of Skin Cancer on the Ear
The two most common types of skin cancer on the ear are basal cell carcinoma and squamous cell carcinoma. Melanoma is also possible but much rarer.
Basal Cell Carcinoma
Basal cell carcinoma is the most common type of skin cancer and the second most common to appear on the ear. Basal cell carcinoma begins in the basal cells, which are located in the top layer of the skin. These types of growths are usually slow-growing and rarely spread past their primary site. If left untreated, however, the tumor can spread to the temporal bone, inner ear, and surrounding areas. Most cases are caught early and can be completely removed.
Squamous Cell Cancer
Squamous cell carcinoma is the second most common type of skin cancer but the most common type of skin cancer on the ear. Squamous cell skin cancer on the ear is still rare, accounting for just 0.2% of all face and neck cancer diagnoses. It occurs when the squamous cells on the skin around the ear become damaged and start to grow at an out-of-control rate. Squamous cell skin cancer is more serious than basal cell carcinoma because of its ability to spread.
Melanoma
Melanoma of the ear is rare and a much more serious diagnosis than basal cell or squamous cell carcinoma. Melanoma is more likely to spread to surrounding tissues on the face, making it more dangerous than other types of skin cancer. Melanoma begins in cells called melanocytes; they produce pigment in the skin. While serious, melanoma is usually curable when caught early. The five-year survival rate is 99% when caught in its earliest stage.
Signs and Symptoms
Cancers of the ear almost always start out as skin cancer. Early signs include a scaly patch of skin around the ear or tiny white bumps on the outer ear. If left untreated, cancer can spread to other areas of the body and cause serious symptoms like hearing loss, ear pain, and blood or drainage from the ear. Facial weakness and paralysis can also occur once the cancer spreads. The most common signs of squamous cell carcinoma on or in the ear are ear pain and discharge. Hearing loss may be noted as well.
Basal cell carcinoma usually appears as open sores, pink growths, red patches, or shiny bumps. About half of individuals with darker skin have pigmented lesions that appear brown or black. Over time, the growths may bleed or ooze. A sore that never seems to heal could also be a sign of basal cell carcinoma.
Squamous cell carcinoma growths typically look like scaly patches of skin and open lesions. The patches are usually rough and thickened; they may look like warts. The open sore may bleed and crust over, and it never heals completely.
Melanoma usually presents as a brown or black growth that resembles a mole. These growths typically have an abnormal shape without defined borders. Most start out tan, brown, or black, and can change to red, white, or blue as it grows and spreads. The growth will change over time, so it is crucial to keep an eye on any new moles or markings that develop on the ear.
Risk Factors
Ear cancer is rare, so most people who have the risk factors will never develop it. It’s helpful to know what the risk factors are, though, in order to be mindful of any abnormal skin growths around the ear. The most common risk factor is exposure to ultraviolet (UV) rays from the sun or tanning beds.
These growths differ from dry or sensitive skin because they don’t improve with moisturizers and are sometimes painful. They often crust over and bleed or ooze, and never fully heal. A skin cancer lesion could also appear as a new scar without the injury.
A precancerous lesion, known as actinic keratosis, also appears as a red, scaly patch of skin. It often presents on sun-exposed areas of the face like the ears. Early treatment of these growths can prevent them from turning into cancer.
Chronic otorrhea (ear drainage) and cholesteatoma (abnormal noncancerous skin growth) within the external auditory canal and middle ear are also associated risk factors. Ear cancer is also commonly found in people with chronic otitis media (ear infections).
Other risk factors include:
Fair skin Old age Male sex Exposure to arsenic and other chemicals Radiation exposure Previous skin cancer, especially on the face Chronic skin inflammation Light treatments for psoriasis Weakened immune system Human papillomavirus infection Smoking
Prevention
The best way to prevent skin cancer on the ear (or any area of the body) is to avoid and protect yourself from harmful UV rays from the sun or a tanning bed. When spending time outdoors, be mindful of how you’re taking care of your skin. Take frequent breaks indoors or in the shade. Wear sun-protective clothing, especially a hat that shields your ears from the sun. When applying sunscreen, be vigilant about rubbing it into the skin on and around your ears. These places are often forgotten, and can put you at higher risk of developing skin cancer. Look for a sunscreen that is at least SPF 30 or higher and reapply often.
Excision Curettage and electrodesiccation Mohs surgery
If cancer has spread to the surrounding tissues, more invasive surgery may be required. Radiation is usually required after surgery to ensure that all cancer cells have been removed; radiation therapy typically lasts about six weeks.
Your surgeon and oncologist will determine how much tissue needs to be removed based on how advanced your cancer is. When some or all of the outer ear is removed, a soft tissue flap is used to help the wound heal. A plastic surgeon may be needed to help with reconstruction. Other types of surgeries involve removing the ear canal and eardrum or the surrounding lymph nodes, if needed. Hearing aids and cochlear implants can be used to cope with hearing loss after surgery.
Depending on the type of cancer, if surgery or radiation cannot cure it, your oncologist may prescribe Keytruda (pembrolizumab).
To detect ear cancer as soon as possible, monitor your outer ear and the surrounding skin for changes like dry, scaly patches or a sore that never seems to heal. Bleeding or discharge from the ear is also a warning sign. An annual skin check with a dermatologist could also help you catch early signs of cancer and treat it right away.
A Word From Verywell
Ear cancer is rare, so it’s possible to overlook or ignore it. Squamous cell carcinoma of the ear is often misdiagnosed. Symptoms like pain and discharge can be mistaken for an ear infection and treated with antibiotic drops, delaying necessary treatment and worsening the prognosis. Be aware of any growths on or around the ear and watch them for changes. Don’t hesitate to see your healthcare provider if you develop scaly patches of skin, new growths or bleeding. While ear cancer is very rare, it’s treatable when caught early.
