Irritation behind the ears from wearing face masks with ear loops is inevitable during the COVID-19 Pandemic. Doctors, nurses, dentists, dental hygienists and others that have worked for years wearing face masks know about this problem. Now everyone is getting a chance to experience it and the problem won’t go away until the COVID-19 Pandemic is over. You need to understand why this happens, what some of the unusual causes are and how to prevent the skin from developing a fissure or large sore.
Why ear loop masks cause pain behind the ears
The elastic creates pressure and that alone can cause pain. But, the fold behind the ear is home to some more unique problems that put it at high risk for problems from the ear loops that secure your face mask.
The fold behind the ear is prone to seborrheic dermatitis. Seborrhea can reside quietly in this fold until the fold is injured or traumatized. The seborrhea creates inflammation and weakness of the skin, making it fragile and prone to breakdown.
If you have a history of sensitivity, soreness and crust in the fold behind your ear, you may have seborrhea. Treat it by washing the area with a dandruff shampoo. Gently remove any crust with a wash cloth in the shower. Apply non-prescription clotrimazole cream to help the dermatitis clear. If that does not help heal the skin doctors sometimes use a little non-prescription 1% hydrocortisone for a few days to speed resolution of the dermatitis. If the skin does not heal in a few weeks it’s time to ask for help from you physician.
Granuloma fissuratum is a sore that classically develops behind the ear due to the mechanical trauma and pressure from the earpiece of your glasses or hearing aid. We can now add face mask ear loops to the causes. Granuloma fissuratum is the presence of a stubborn sore that heaps up in the crease behind the ear and has a tender split or fissure in the middle. Treatment involves avoiding the trauma, which allows the skin to heal. Granuloma fissuratum is also called acanthoma fissuratum
Chondrodermatitis nodularis helicis is another frustrating non-healing sore that happens on the ear secondary to mechanical pressure. It usually manifests as a sore on the top of the ear but can happen anywhere on the cartilaginous ear. It starts because the underlying cartledge festers up and out of the overlying skin. Again, the process starts from trauma such as pressure from sleeping on the ear. It is a frustrating problem to fix and it’s best to avoid it by limiting trauma to the ear.
Another cause of inflammation and discomfort in the fold behind the ear due to ear loops is elastic contact allergy. Yep, you can be allergic to the chemicals that make up elastic. The fold behind the ear is exposed to elastic for long periods of time when wearing face masks with ear loops. The skin is thin and elastic chemicals will enter the skin putting you at risk for becoming allergic. Washing elastic, bleaching it and drying it in the drier increases the amount of elastic chemicals that leach out of elastic due to laundry care. There will be some itching involved in the allergic reaction. Treatment will necessitate avoidance of elastic exposure. Once allergic to elastic, all elastic will potentially cause a rash over time. It’s best to limit elastic exposure to only what is necessary.
By Cynthia Bailey MD on May 14, 2020
Post Updated on: May 14, 2020