What Does Skin Cancer of the Ear Look Like?
Skin cancer can affect the ear lobe, ear rim, and outside of the ear canal
Medically reviewed by Casey Gallagher, MD
Skin cancer of the ear can develop on the outer ear, ear canal, or skin surrounding the ear. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer that develop on or around the ear.
These types of cancer may begin as scaly or red patches of skin, bumps, sores, or growths. In the early stages, they can be easily treated with surgery. Untreated cancers can spread to the inner ear, as well as to the temporal bone, facial nerves, and beyond. Melanoma is more likely to spread than other types of skin cancer.
This article explores the various types of skin cancer that can appear on the ear, how they are treated, and what the prognosis is.
Related: The Anatomy of the Ear
Verywell / Jiaqi Zhou
Symptoms of Skin Cancer of the Ear
Cancers of the ear almost always start out as skin cancer. The two most common types of skin cancer on the ear are basal cell carcinoma and squamous cell carcinoma. Basal cell and squamous cell skin cancer on the ear are usually not serious if caught early.
It is also possible to develop melanoma skin cancer on your ear, but this is much rarer.
Squamous Cell Carcinoma
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.
Squamous cell carcinoma occurs on the ear 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.
Squamous cell carcinoma can cause the following symptoms:
Scaly patches of skin that are rough and thickened and may look like warts
Open lesions that bleed, crust over, and never heal completely
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 lesions are usually slow-growing and rarely spread past their primary site. Still, it is possible for untreated basal cell carcinomas to spread to the temporal bone, inner ear, and surrounding areas. Most cases are caught early and can be completely removed.
Basal cell carcinoma may look like one or more of the following:
Open sores
Pink growths
Red patches
Shiny bumps
About half of people 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.
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 which produce pigment in the skin. While serious, melanoma is usually curable when caught early. The five-year survival rate is 98% when caught in its earliest stage.
Melanoma usually presents as a tan, brown, or black growth that resembles a mole. These growths typically have the following characteristics:
An abnormal shape without defined borders
An asymmetrical shape
Color that is patchy or does not appear uniform
Grows and changes over time
Is larger than a pencil eraser
Color that may change to red, white, or blue as it grows and spreads
Because melanomas can grow quickly, it is crucial to keep an eye on any new moles or markings that develop on the ear or elsewhere on the body.
Learn More: Everything You Need to Know About Melanoma Treatment
Symptoms That Can Mean the Cancer Has Spread
If left untreated, skin cancer on the ear can spread 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.
Can skin cancer on your ear spread to your brain?
It is possible for any skin cancer—even nonmelanoma cancer—to spread to other parts of the body, including the brain. This is why it's important to see a healthcare provider for any new lesion that appears on your skin.
Basal and squamous cell carcinomas do not spread as quickly as melanoma. If you have melanoma, signs that it has spread may include symptoms like:
Lesions that appear on other areas of skin
Swollen lymph nodes
Feeling unwell or fatigued
Unexplained weight loss
Unexplained pain
Fluid build-up in the abdomen
Don’t Ignore Scaly Skin
The most common type of ear skin cancer, squamous cell carcinoma, often presents as a dry, scaly patch of skin. The skin may feel rough and thicker than the surrounding skin on the ear.
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 an associated 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.
Learn More: The ABCDEs of Skin Cancer
Diagnosis
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 can help you catch early signs of cancer so it can be treated right away.
See a healthcare provider any time you find a new lesion on your skin. Though it's uncommon for basal and squamous cell carcinomas to spread, it is still possible, so these lesions should always be removed by a healthcare provider.
A diagnosis of skin cancer is typically made following a biopsy of the lesion. This is done with a small sample of tissue taken from the abnormal skin. A pathologist can identify cancer by looking at the sample under a microscope.
If cancer is identified, your healthcare provider may recommend additional tests such as an MRI or CT scan. These tests can determine if the cancer has spread, and if so, what stage it is in. Your healthcare provider will use the results of these tests to develop a treatment plan.
Treatment
The most common type of treatment for ear cancer is surgery to remove the growth completely. If caught early, your dermatologist may be able to remove it with one of the following options:
Excision
Curettage and electrodesiccation
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).
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.
Chronic inflammation 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 (middle 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 (HPV) 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. Wear sun-protective clothing, especially a hat that shields your ears from the sun, and take frequent breaks in the shade or indoors.
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.
Learn More: How to Choose a Natural Sunscreen
Related: Wearable UV Sensors for Sun Protection
Prognosis
Melanoma is the most dangerous type of cancer that can appear on the ear. The five-year survival rate for melanoma varies depending on the stage at diagnosis:
Stage 1: 98%
Stage 2: 90%
Stage 3: 70%
Stage 4: 10%
Other types of skin cancer have much better prognoses. Squamous cell carcinoma in the external auditory canal that has not spread to the bone has a 94.8% five-year survival rate. Once the cancer has spread to the point of causing facial weakness, the prognosis is much poorer: 19.1%.
For people with basal cell carcinoma that has spread to the temporal bone or external auditory canal, the five-year survival rate is 78%.
Summary
Skin cancer on the ear is most likely to be squamous or basal cell carcinoma. Melanoma is also possible, but much less common.
Skin cancer on the ear can spread over time and cause problems like ear pain and hearing loss. This is why it's important to have any new lesion on the ear or elsewhere on the skin examined by a healthcare provider.
A healthcare provider can remove the lesion, have it tested for cancer, and develop a treatment plan if the cancer has spread. When caught early, skin cancer on the ear has a good prognosis.
Read the original article on Verywell Health.
