Finding a hard lump behind the ear can be concerning. Many lumps in this area are benign and often resolve on their own. This article provides general information on potential causes of a hard lump behind the ear, helping to offer clarity on a common worry.
Common Explanations for Lumps
Swollen lymph nodes are a frequent reason for a lump behind the ear. These small, bean-shaped glands are part of the immune system, enlarging to filter foreign substances, often in response to infections in the ear, throat, or scalp. During a bacterial or viral infection, such as a cold or ear infection, the posterior auricular lymph nodes can become noticeably swollen and tender. This swelling typically subsides once the underlying infection clears.
A sebaceous cyst is another common cause, forming when a hair follicle or sebaceous gland becomes blocked. This creates a sac filled with keratin or sebum, an oily substance. These cysts are smooth, round, and movable under the skin, usually painless unless inflamed or infected. An infected cyst can appear red, tender, and may discharge fluid or pus.
Lipomas are benign, soft, fatty growths that develop slowly beneath the skin. They are harmless and painless, feeling movable and doughy to the touch. While more common on other parts of the body, they can appear anywhere fat cells are present.
Mastoiditis is a more serious cause: an infection of the mastoid bone. This condition often develops when a middle ear infection goes untreated and spreads to the bone. Symptoms include throbbing ear pain, redness and swelling behind the ear that may cause the ear to stick out, fever, and sometimes discharge from the ear.
Other Potential Causes
Other conditions can also cause a hard lump behind the ear. Benign bone growths, known as osteomas, can form on the skull, including the area behind the ear. These growths are typically hard and painless, often slow-growing, and may not cause symptoms unless they press on surrounding structures or grow large enough to affect hearing.
Salivary gland issues, particularly with the parotid glands, can also manifest as a lump. Swelling in these glands, known as parotitis, can be caused by infections, salivary gland stones, or other conditions. This swelling might be accompanied by pain, fever, or difficulty swallowing.
Though less common, a lump behind the ear can indicate a malignant tumor. These include skin cancers, such as basal cell carcinoma, or cancers affecting the lymphatic system like lymphoma. Malignant lumps are often firm, fixed, and irregularly shaped, growing over time. Salivary gland cancers, though uncommon, can also present as a lump near the ear.
When Professional Medical Advice is Needed
Seek medical evaluation for a lump behind the ear if “red flag” symptoms are present. Professional medical advice is recommended if the lump appears suddenly without an obvious cause, or grows rapidly. Other concerning signs include persistent pain, increasing tenderness, or changes in the skin over the lump, such as redness, warmth, or discharge.
Prompt medical attention is warranted if a lump feels fixed in place, cannot be moved, or is accompanied by fever, unexplained weight loss, or changes in hearing. If a lump persists for more than a few weeks without improvement, even if seemingly harmless, it should be assessed by a healthcare provider.
What to Expect at the Doctor’s Office
When consulting a doctor about a lump behind the ear, the process begins with a thorough physical examination. The provider will feel the lump, assessing its size, texture, mobility, and any tenderness or warmth. They will also inquire about your medical history, including when you first noticed the lump, changes in its appearance, and other symptoms. This detailed history helps narrow down potential causes.
Depending on the initial assessment, the doctor may order diagnostic tests. Blood tests can identify signs of infection or inflammation. Imaging studies, such as ultrasound, CT, or MRI, might visualize the lump’s internal structure and its relationship to surrounding tissues and bone. If a definitive diagnosis is needed, a biopsy may be performed, removing a small tissue sample for microscopic examination.
Treatment varies based on the diagnosis. For infectious causes, antibiotics may be prescribed. Sebaceous cysts or abscesses might require drainage or surgical removal, especially if large, painful, or frequently infected. Lipomas are observed unless they cause discomfort or cosmetic concern, in which case they can be surgically excised. If a malignant condition is identified, a specialist will discuss treatment plans, which could involve surgery, radiation, or chemotherapy.