Swelling behind the ear


Swelling in the ear can have many causes, but in most cases it shouldn't be a cause for concern. In most cases, it is inflamed, enlarged lymph nodes in the head and neck area that suddenly become palpable. They can be slightly tender on pressure, but usually resolve within a few days. Other common causes include a blocked sebum gland (atheroma) or a benign fatty tumor (lipoma), which can appear anywhere in the body.

These swellings on the ear are usually round, not tender and can usually be moved. Caution is advised if there is a painful swelling in the area of ​​the bone behind the ear that is temporally related to a cold and leads to headache and earache.
This can indicate inflammation of the mastoid process (mastoiditis) and should always be treated by a doctor.

Cervical cysts, which are usually congenital and harmless, but should be surgically removed as a precaution to avoid complications, are rare and more likely to occur on the neck.

If there were injuries or small wounds behind the ear beforehand, they can become infected and an abscess can form. Abscesses show up as painful, fluctuating swellings behind the ear, and can be accompanied by malaise and fever.
Skin tumors or lymph node cancer are rare causes of ear swelling.
Swelling behind the ear is usually harmless. However, if you experience severe pain or if the swelling has increased in size, this should always be clarified by a doctor.

Read more about this under: Swelling - what's behind it?


The causes of swelling behind the ear are numerous. It is primarily important to distinguish whether it is a painful swelling or a painless swelling. Painful swellings usually indicate inflammation.

The most common and harmless cause of painful swelling behind the ear is inflamed lymph nodes. In the head and neck area there are numerous small lymph node stations that can swell and become palpable as part of a cold, tonsillitis (see symptoms of tonsillitis), otitis media (see symptoms of otitis media) or toothache. Most of them are sensitive to pressure or tend to be tender and can be moved easily.

As soon as the infection has receded, the lymph node swelling also recedes. Common pathogens for respiratory infections are various viruses such as adeno, rhino and influenza viruses.
But the Epstein-Barr virus, the causative agent of Pfeiffer's glandular fever, can also cause painful swelling of the lymph nodes behind the ear and in the neck area.

Bacterial pathogens, such as streptococci, can also cause tonsillitis, which can be accompanied by swelling of the lymph nodes behind the ear. Mumps infection - a viral inflammation of the parotid glands that occurs mainly in children - is rare today, but still possible. But too little drinking can result in the formation of salivary stones, which lead to swelling of the parotid gland and pain in the parotid gland.

It leads to painful swelling behind the ear, earache, high fever, and fatigue. Since a vaccination against mumps is possible today, this clinical picture is rarely observed today.

Other causes of painful swelling behind the ear include abscesses. Abscesses are collections of pus under the skin that can be caused by inflamed sebum glands or infected wounds. They are associated with severe pain, malaise and occasionally with a fever and must always be treated by a doctor.

Read more on the topic: Abscess on the ear

A relatively common cause of painful swelling of the bone behind the ear, especially in children and adolescents, is mastoiditis - an inflammation of the mastoid process.
It usually develops from a delayed, inadequately treated otitis media and is associated with severe ear pain, fever and deterioration in hearing.

Read more on the topic: Mastoiditis such as bump

Causes of painless swellings behind the ear can be clogged sebum glands (atheroma, colloquially known as groats or benign fat swellings (lipomas).

Read more on the topic: Groats bags
Atheromas are mostly perceived as small, firm "bumps" that cannot be moved and usually do not cause pain.

Lipomas, on the other hand, are usually small, soft "lumps", easy to move and also painless. They can be surgically removed for cosmetic reasons or if they become too large and cause discomfort.

Read more on the topic: Remove lipoma

Other causes of painless swelling behind the ear can include skin tumors or cancer of the lymph glands. One should always be careful if the swelling suddenly appears and increases in size quickly, is coarse, cannot be moved and there are accompanying symptoms such as fever, night sweats or an unwanted, severe weight loss. To be on the safe side, long-term swelling behind the ear should always be clarified by a doctor.


Depending on the cause of the swelling behind the ear, there may be pain in the area of ​​the swelling, but also headaches, ear pain or painful movements of the head. Fever or malaise can also occur in the case of mastoiditis or an abscess.

However, swelling behind the ear can also be completely symptom-free and only noticeable through the swelling.

Please also read: Pus in the ear


To clarify the swelling behind the ear, the doctor will first ask a few general questions, for example whether you have recently had a cold or whether you have pain or other complaints.

Then he will take a closer look at the swelling, feel it and apply it to his consistency and Movability check. If necessary, an ultrasound can also be carried out.
If mastoiditis is suspected, he will also examine the ear and eardrum more closely with the help of an otoscope.
If the suspicion of mastoiditis is confirmed, an admission to the hospital is usually necessary, where blood is drawn and inflammation levels are checked and a smear is taken from the ear, which is examined for possible pathogens.

If necessary, an X-ray or CT can also be performed to confirm the diagnosis and detect complications, such as melted bone, at an early stage.
In the case of small children, however, X-rays or CT scans are mostly avoided due to the radiation exposure. In the event of a positive result, therapy with Antibiotics started, in some cases surgical treatment is also necessary.

In the case of atheroma or lipoma, one can wait or do a surgical excision. In the case of a swollen lymph node, the neighboring and other large lymph node stations are also examined and, if necessary, a blood sample is taken.
If there are no other abnormalities, a spontaneous decline can be awaited.

Should the swelling indicate any Skin tumor behind the ear, referral to a dermatological or ENT clinic is usually necessary for further clarification and tissue examination.

Swelling of the neck

A swelling in the neck usually indicates a harmless enlargement of the lymph nodes, as part of a cold or tonsillitis.
Usually the swelling will go away on its own. Another, less common, reason for a swelling of the neck can be a congenital neck cyst, which contains fluid and mucus and can easily become infected, for example as a result of a cold. After the infection has subsided, the cyst usually recedes again.

However, the neck cyst can also form an opening in the skin and weep it - it is then called a neck fistula.
In rare cases, the cervical cysts can become so infected that an abscess forms, which can be accompanied by severe pain, fever, and difficulty swallowing.
Neck cysts are inherently harmless, but they can become infected and are often cosmetically bothersome. They are usually removed surgically.

Read more on the subject at: Throat fistula

Swelling of the bone

A common cause of swelling behind the ear, especially around the bone, is Mastoiditis Inflammation of the mastoid process. The mastoid process lies behind the ear and is directly connected to the tympanic cavity.

Mastoiditis usually develops as a direct consequence of a postponed or inadequately treated one Otitis media and is very common in children and adolescents. It is usually accompanied by severe ear pain, constant, throbbing Pain on the mastoid process, Hearing impairment, Exhaustion and fever.
In addition, a clear, doughy swelling can be felt behind the ear, which can even push the ear down. As a result, the auricle usually sticks out. A purulent fluid can also drain from the ear canal.

Swelling in the child

The most common cause of swelling behind the ear in children is also inflamed, enlarged lymph nodes, which occur, for example, as part of a cold or tonsillitis, or mastoiditis, as a result of Otitis media.

An otitis media can also start out as a swelling of the lymph nodes behind the ear. Congenital neck cysts that can be felt as a swelling on the neck are rare.

Pain / headache

A swelling behind the ear can also be with a headache accompanied.
If the lymph nodes in the head area are greatly enlarged and inflamed, this can lead to painful head movements, but also lead to headaches as part of the inflammation.

Mastoiditis also often leads to fever, fatigue, severe ear pain and headache, as well as tenderness in the area of ​​the mastoid process. Atheroma too, if very large, can cause painful head movements or a headache if it becomes infected.

Swelling behind the ear with a cold

A cold often causes painful enlargement and inflammation of the lymph nodes. It can also lead to otitis media, which is accompanied by severe ear pain and headaches.

A heavy one flu (see Symptoms of the flu) can also lead to painful enlargement of the lymph nodes, headache and limb aches and fatigue.
If swelling occurs behind the ear as part of a cold, it usually disappears by itself after the cold has subsided.


Swelling behind the ear caused by enlarged lymph nodes from a cold does not require special treatment. Can be symptomatic anti-inflammatory drugs (for example Ibuprofen, or Paracetamol) can be taken.
In addition, attention should be paid to bed rest and adequate drinking.

In the case of otitis media, decongestant nasal sprays should always be used and pain relievers should be taken if necessary. Sometimes you can stop taking Antibiotics to be necessary.

If you have mastoiditis, you should definitely go to a clinic. Antibiotics are usually administered there, often intravenously for children. Sometimes surgery may be necessary.

If the cause of the swelling behind the ear is a lipoma, an atheroma or a neck cyst, these can be surgically removed. An abscess usually has to be punctured and drained through a drain and treated with antibiotics.