What Type of Skin Cancer Appears on the Ear?

Ear cancer is rare and usually starts out as skin cancer that develops on the outer ear, ear canal, or skin surrounding the ear. If left untreated, skin cancer on the ear can spread to the inner ear, as well as to the temporal bone, facial nerves, and beyond. Early treatment is important, and the first sign of ear cancer is usually an abnormal growth on the outer ear. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer that develop on or around the ear. 

Types of Skin Cancer on the Ear

The two most common types of skin cancer on the ear are basal cell carcinoma and squamous cell carcinoma. Melanoma is also possible but much rarer.

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 types of growths are usually slow-growing and rarely spread past their primary site. If left untreated, however, the tumor can spread to the temporal bone, inner ear, and surrounding areas. Most cases are caught early and can be completely removed. 

Squamous Cell Cancer

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. It occurs 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. 

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; they produce pigment in the skin.

While serious, melanoma is usually curable when caught early. The five-year survival rate is 99% when caught in its earliest stage. 

Signs and Symptoms 

Cancers of the ear almost always start out as skin cancer. Early signs include a scaly patch of skin around the ear or tiny white bumps on the outer ear. If left untreated, cancer can spread to other areas of the body 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. The most common signs of squamous cell carcinoma on or in the ear are ear pain and discharge. Hearing loss may be noted as well. 

Basal cell carcinoma usually appears as open sores, pink growths, red patches, or shiny bumps. About half of individuals 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. 

Squamous cell carcinoma growths typically look like scaly patches of skin and open lesions. The patches are usually rough and thickened; they may look like warts. The open sore may bleed and crust over, and it never heals completely. 

Melanoma usually presents as a brown or black growth that resembles a mole. These growths typically have an abnormal shape without defined borders. Most start out tan, brown, or black, and can change to red, white, or blue as it grows and spreads. The growth will change over time, so it is crucial to keep an eye on any new moles or markings that develop on the ear. 

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 otorrhea (ear drainage) 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 (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 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. Take frequent breaks indoors or in the shade. Wear sun-protective clothing, especially a hat that shields your ears from the sun. 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. 

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 could also help you catch early signs of cancer and treat it right away. 

A Word From Verywell 

Ear cancer is rare, so it’s possible to overlook or ignore it. Squamous cell carcinoma of the ear is often misdiagnosed. Symptoms like pain and discharge can be mistaken for an ear infection and treated with antibiotic drops, delaying necessary treatment and worsening the prognosis. Be aware of any growths on or around the ear and watch them for changes. Don’t hesitate to see your healthcare provider if you develop scaly patches of skin, new growths or bleeding. While ear cancer is very rare, it’s treatable when caught early.