Why Are My Ears Burning?

A hot or burning sensation in the ears affects most people at one time or another. It may be a sign of a medical condition or mean nothing at all. Ears can become red and hot suddenly due to strong emotional responses (such as blushing), or turn red as a result of ear infections, skin infections, allergic reactions, hormonal changes, and rare conditions like red ear syndrome (RES).

Where and how you experience hot ears can provide clues about what is happening. Is the problem with one ear or both? Are your ears physically hot, or is there a burning sensation? Are your ears hot and itchy, or are there other symptoms such as a fever or nasal allergy?

This article explains the possible causes of hot ears and describes the symptoms and conditions that require treatment by a healthcare provider.

Sunburn

Sunburn is one of the most common reasons your ears might feel hot or burn. Many people do not realize that this vulnerable, sensitive skin needs UV protection. It can be easy to forget to apply sunscreen—especially if your ears are partially covered by your hair.

If you get a sunburn on your ears, it will feel similar to how it would feel if you got burned anywhere on your body. In addition to pain and burning, a sunburn on your ears can cause:

• Redness and swelling
• Blistering 
• Itchy, peeling skin days after a burn

Treatment

Most sunburns heal on their own within a few days to a week. Treating a mild sunburn can include gently applying cool, wet compresses to painful areas, taking an over-the-counter (OTC) pain reliever, and using a gentle, fragrance-free moisturizer, aloe vera salve, or 1% hydrocortisone cream. Avoiding the sun while you heal will eliminate further pain and skin damage.

Allergic Reaction

A skin allergy (or contact dermatitis) may be another reason that your ears might be burning. This can happen if you are exposed to allergens such as:

• Plants
• Insect bites
• Personal care products (shampoos, conditioners, cosmetics, perfumes, etc.)
• Adhesives
• Latex
• Topical creams 
• Jewelry

Nickel-plated jewelry is a common allergen for people who have pierced ears. A skin allergy may cause hives, redness, itching, and burning. Some people experience swelling, and the ear can also feel hot to the touch.

Treatment

The main treatment for contact dermatitis is stopping and preventing exposure to the allergen. For example, if you react to a piece of jewelry, you would need to stop wearing it.

Mild allergic reactions will typically resolve once you remove the allergen. In some cases, you might need to see your healthcare provider or a dermatologist. They may prescribe you a medicated cream to help your skin heal.

Facial Flushing

Blushing or flushing of the face, neck, and upper chest is a common physiological response to strong emotions, like anger or embarrassment. Sudden emotional reddening is due to increased blood flow.

Flushing can also affect the ears. When a person experiences a powerful emotion, their ears may get red and feel hot to the touch. They may also feel a burning sensation.

Other causes of facial flushing include:

• Drinking alcohol
• Some prescription medications
• Physical activity
• Eating spicy or hot foods
• Extreme temperature swings 

You are also more likely to experience facial flushing if you have certain conditions. Flushing may be seen in people who:

• Have rosacea
• Are going through menopause
• Have Cushing’s syndrome
• Have carcinoid syndrome (associated with tumors of the small intestine, colon, appendix, and lungs)
• Have an illness that causes high fever 

Treatment

Flushing is a normal bodily response and it does not need to be treated. You can sometimes prevent or lessen the response by avoiding triggers, such as alcohol or temperature extremes.

Ear Infection

An ear infection can also cause pain and a burning sensation to the outer ear depending on the severity and type of infection you have.

Middle ear infections are a common type of ear infection. The symptoms of an ear infection include:

• Ear pain
• Fatigue
• A sensation of fullness in the ear
• Muffled hearing
• Nasal congestion
• Loss of appetite
• Fluid drainage from the ear 

Treatment

Ear infections often go away without treatment but there are some things that you can do to alleviate your symptoms, such as:

• Applying a warm compress to the affected ear
• Using OTC ear drops
• Taking OTC pain medication 

Ear infections that do not get better on their own or get worse need to be treated by a healthcare provider. You might need antibiotics to clear up the infection.

Red Ear Syndrome

Red ear syndrome is a poorly understood condition that typically produces one-sided ear reddening and burning, but can affect both ears also. The burning and redness can last up to several hours, and attacks happen on and off repeatedly.

Triggers for red ear syndrome may include:

• Physical touch
• Chewing
• Hot or cold temperatures
• Neck movement
• Physical exertion 

People can experience red ear syndrome at any age. In addition to ear redness, a person can also have redness in the cheek on the same side. The ear may swell, and, in some cases, the eye on the affected side may water or become irritated.

Treatment

Since little is understood about red ear syndrome, it is unclear what the best treatment for the condition is. People with red ear syndrome might benefit from:

• Elavil, Vanatrip (amitriptyline)
• Sibelius (flunarizine)
• Advil, Motrin (ibuprofen)
• Indocin, Tivorbex (indomethacin)
• Calan, Verap (verapamil)
• Tofranil (imipramine)
• Deseril, Sansert (methysergide)
  
• Botox injections
• Propranolol
• Topical anesthetic
• Cooling of the skin

Erythromelalgia

Erythromelalgia is a rare condition affecting the feet and sometimes the hands. Very rarely, it can also affect the ears. Symptoms can affect one or both sides of the body. 

People with erythromelalgia experience:

• Severe burning pain
• Redness 
• Skin that is hot to the touch 
• Tingling/itching skin 

There’s no definitive known cause for erythromelalgia, but there might be a familial link.

Treatment

Each person with erythromelalgia responds differently to the available treatments; what works well for one person with the condition may not work for someone else.

However, many people with erythromelalgia find cooling is an effective way to soothe their symptoms.

Other treatments include:

• Topical medications such as a lidocaine patch 
• Calcium antagonists
• Magnesium
• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants 
• Gabapentin
• Antihistamines
• Clonazepam
• Misoprostol

Skin Infection

A knick, cut, or bug bite can cause the skin around the outside of the ear to become infected. An infection of the skin around the outer ear is called otitis externa.

Other causes of this type of skin infection include acne, eczema, psoriasis, or an allergic reaction.

An infection of the skin of the ear can cause:

• Redness
• Swelling
• Pain (may feel like a burning sensation)
• Itching
• Pus 
• Fever (if the infection is severe)

Treatment

A skin infection will often go away without treatment. However, if you notice that an infection is getting worse or spreading, you should see a healthcare provider.

Treating a severe skin infection of the ear can be difficult because the ear does not have many blood vessels. When considering treatment, your healthcare provider will need to determine whether the infection is bacterial or fungal. 

Topical ear drops are usually the first-line treatment for a skin infection that involves the outer ear canal. The drops may contain antibiotics or other ingredients such as acetic acid. Oral antibiotics are the last resort for severe infections.

Seborrheic Eczema

Seborrheic eczema (also called seborrheic dermatitis) affects areas of the skin that tend to produce oil, including the face and scalp. It can also affect the ears. It can look like a rash and may produce a burning sensation.

The symptoms of this type of eczema include:

• Redness
• Swelling
• Scaly skin patches 
• Pain and itching

Treatment

The basic treatment for seborrheic eczema involves washing the skin with a zinc cleanser and moisturizing after bathing or showering. 

Medical treatments include topical antifungals or medicated personal hygiene products.

For severe cases of seborrheic dermatitis, a dermatologist may prescribe a topical corticosteroid or calcineurin inhibitor.

Relapsing Polychondritis

Relapsing polychondritis is a rare degenerative disease that primarily affects the cartilage in the body, including the ears.

The main symptoms of relapsing polychondritis include:

• Sudden pain 
• Swelling and tenderness of the ears

The condition can also affect the middle ear, and some people experience hearing loss.

The cause of relapsing polychondritis is not known. However, experts believe that the disease is an autoimmune condition.

Treatment

Treatment for relapsing polychondritis usually involves corticosteroids and OTC pain medications. In very severe cases that involve the heart, a healthcare provider may recommend immunosuppressants.

Summary

There are many causes of hot, burning ears. Sometimes the burning sensation occurs with redness and swelling of the skin of the ears. Emotions and environmental exposure to sunlight or very hot or cold temperatures can cause the ears to burn.

Hot or burning ears are typically not a cause for concern. Cooling the skin or taking OTC pain medication can provide relief, and staying away from triggers is a good way to avoid discomfort. 

Sometimes having burning ears is a sign of an underlying health problem such as an ear infection or autoimmune condition. If the burning is caused by an infection or autoimmune disease, a healthcare provider can prescribe medication to help treat the symptoms.

If your ears are burning and the pain is not getting better or is getting worse, make an appointment with your healthcare provider.