The ear canal is dark and hard to see into without special tools like an otoscope. Any indication that something unusual is in there, such as unidentified spots, can set off alarm bells. Some causes of spots are not unusual, but others can lead to more health problems if not taken care of. Note that while an audiologist can look inside the canal, you have to go to a doctor for any medical treatment.
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The ear canal is the opening in your ear. It is actually divided into two parts structurally; one is skin over cartilage and the other is skin over bone. The cartilage portion of the canal is closest to the pinna, or the big flap of skin and cartilage you call your ear. This is the section where earwax is produced, and it also contains tiny hairs that, along with the earwax, catch debris and help move out shedding skin cells as part of a process called epithelial migration. The bony portion leads to the tympanic membrane, or your eardrum. On the other side of the membrane is your middle ear, which contains three bones that help transmit sound vibrations.
Spots in the ear canal can have a number of causes, not all of which are serious, but they can be annoying at the very least. One basic cause is irritation. If you’ve been scratching around the canal with a cotton swab or other implement, you can scratch and injure the very thin skin, resulting in red patches. It is possible for these spots to become infected, so get irritation checked out to ensure you don’t have an infection.
The spots may also be cysts; these are tougher to diagnose because they may be due to an infection or to something happening in the jaw just under the ear. Furuncles or boils can spontaneously appear. MedlinePlus, an online resource of the National Institutes of Health, notes that these sometimes go away on their own, but they can be very painful, become infected and burst open. Don’t handle these by yourself; get confirmation from your doctor regarding treatment, because a furuncle or boil can become worse.
Spots in the ear canal also can be an indication of a more systemic problem. A condition called seborrheic dermatitis can leave reddish spots in the ear canal and on other parts of your body, such as the scalp and eyebrows. This is an itchy condition that looks like severe dandruff, with scaly dead skin over red spots. It does not necessarily appear in all these spots at the same time. Treatment may include antifungals, although no one cure has been discovered.
Don’t use cotton swabs or stick anything in your ear canal. The canal is small enough so that even a tiny cotton swab can shove earwax back into the far portion of the canal, which doesn’t have those hair cells that move out wax and debris. You can also irritate the inside of the canal, leading to more spots. More alarming is the risk of the item getting shoved down into and through the tympanic membrane or eardrum. If your arm is bumped, say by an opening door, or if you slip while you have a swab in your ear canal, you can rip the membrane open, causing a hearing loss. It’s also possible to damage the bones of the middle ear and invite infection.