The tragus is the small, triangular prominence of cartilage positioned directly in front of the ear canal opening. This structure helps direct sound waves into the ear and acts as a partial guard for the external auditory canal. Experiencing pain when pressing on the tragus is a common symptom that often indicates an issue with the outer ear. The pain occurs because pressing the tragus applies pressure to the ear canal or surrounding inflamed tissue. The underlying causes are usually localized and treatable.
Localized Infections and Inflammation
Otitis Externa
The most frequent reason for tragus pain is inflammation or infection of the ear canal, known as otitis externa. This is often called “Swimmer’s Ear” because retained moisture compromises the skin’s barrier, allowing bacteria to multiply. When the tragus is pressed, the inflamed and swollen skin lining the ear canal is manipulated, causing sharp pain. This specific tenderness is a diagnostic hallmark of otitis externa, distinguishing it from a middle ear infection.
Perichondritis and Cellulitis
A more serious, though less common, cause is perichondritis, an infection of the perichondrium, the tissue surrounding the cartilage. Because the tragus is cartilage, it can be affected. Perichondritis presents with a painful, red, and warm outer ear, often sparing the earlobe which lacks cartilage. If left untreated, the buildup of pus can cut off the blood supply, potentially leading to permanent ear deformity. Cellulitis is a related skin infection that also causes pain and inflammation, but it usually involves the earlobe as well as the upper ear.
Trauma, Piercings, and Skin Irritations
Direct mechanical trauma or irritation to the outer ear structures can trigger pain when the tragus is pressed. Using cotton swabs or other objects to clean or scratch the ear canal is a common form of minor trauma that can break the skin barrier and introduce bacteria. The resulting localized swelling or micro-abrasions become tender when external pressure is applied.
Tragus piercings are a frequent source of localized irritation, especially during the initial healing phase or if improper jewelry is used. Complications can include localized swelling, infection, or constant pressure from the jewelry. Even fully healed piercings can become irritated if the jewelry is bumped or snagged, leading to temporary swelling and sensitivity. Localized skin issues, such as a pimple, cyst, or boil directly on or near the tragus, will also cause pain when pressed. This occurs because the pressure compresses the swollen, inflamed tissue and the nerve endings beneath it.
Pain Originating from External Pressure
Sometimes, the pain felt in the tragus is not due to a problem with the ear itself, but is referred from adjacent structures. The temporomandibular joint (TMJ), which connects the jawbone to the skull, sits immediately in front of the tragus.
Dysfunction of this joint, known as TMJ disorder, is a common source of referred ear pain. Inflammation or strain in the TMJ, often caused by teeth grinding or clenching, can radiate pain to the surrounding area. When pressure is placed on the tragus, it can compress the inflamed joint capsule, causing pain that feels like it originates in the ear.
This type of pain often worsens with jaw movements like chewing, talking, or yawning. Earwax impaction can also create a sensation of pressure and fullness. If the impaction is severe, the constant internal pressure may make the cartilage sensitive to external touch.
Knowing When to Seek Medical Attention
While many causes of tragus pain are minor and resolve with simple care, certain accompanying symptoms signal the need for professional medical evaluation. A fever, indicating a systemic infection, should prompt a consultation. Persistent ear pain that does not improve after 48 hours, or pain that rapidly worsens, suggests a spreading infection requiring prescription treatment. Other red flag symptoms include visible drainage from the ear, especially if it is thick, foul-smelling, or bloody. Swelling that spreads beyond the ear to the neck or face, or a change in hearing, are also reasons to seek prompt medical care.