Swelling of the ear can have many causes, but most should not be a cause for concern. In most cases, they are inflamed, enlarged lymph nodes in the head / neck area, which suddenly become palpable. They can be mildly painful, but usually form within a few days. Other common causes may be a congested sebaceous gland (atheroma) or a benign fat swelling (lipoma) that can occur anywhere in the body.

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

Rarely, and more commonly on the neck, are cervical cysts, which are usually innate and harmless, but should be surgically removed as a precaution to avoid complications.

If there are injuries or small wounds behind the ear, they may become inflamed and an abscess may form. Abscesses appear as painful, fluctuating swellings behind the ear, and can be associated with malaise and fever.
Rare causes of ear swelling are skin tumors or lymph node cancer.
Swelling behind the ear is usually harmless. However, if severe pain occurs, or if an increase in the size of the swelling is noticed, this should always be clarified by a doctor.


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

The most common and harmless cause of painful swelling behind the ear is inflamed lymph nodes. In the head / neck area, there are numerous small lymph node stations that can swell in the context of a cold, tonsillitis (see Symptoms of tonsillitis), otitis media (see Symptoms of otitis media) or even toothache and palpation. Mostly they are pressure sensitive to painful and can be moved well.

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

Bacterial pathogens, such as streptococci, can also cause tonsillitis, which can accompany lymph node swelling behind the ear. Nowadays rare, but still possible, is the mumps infection - a viral inflammation of the parotid glands, which occurs especially in children. But too little drinking saliva stones can form, leading to parotid gland swelling and pain in the parotid gland.

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

Other causes of painful swelling behind the ear are, for example, abscesses. Abscesses are pus build-ups under the skin, which can arise due to inflamed sebaceous glands or infected wounds. They are associated with severe pain, discomfort, and occasionally fever and must always be treated by a doctor.

A relatively common cause, especially in children and adolescents for a painful swelling of the bone behind the ear, is the mastoiditis - an inflammation of the mastoid.
It usually develops from a delayed, not sufficiently treated, otitis media and is associated with severe ear pain, fever and a deterioration in hearing.

Causes of painless swelling behind the ear can be blocked sebaceous glands (atheroma, colloquially grits pouches or benign fatty tumors (lipomas).

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

Other causes of painless swelling behind the ear can also be skin cancers or lymph node cancer. You should always be vigilant when the swelling occurs suddenly and rapidly increases in size, is coarse, not shiftable and has concomitant symptoms such as fever, night sweats or an unwanted, severe weight loss. For safety reasons, existing swellings 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. Also, fever or malaise may occur in the case of mastoiditis or abscess.

However, a swelling behind the ear can also be completely asymptomatic and only noticeable by the swelling.


For the exact clarification of the swelling behind the ear, the doctor will first ask some general questions, for example, whether there was a recent cold or whether there is pain or other complaints.

Then he will look at the swelling more closely, scan it and check its consistency and mobility. Optionally, an ultrasound can be performed.
In case of suspected mastoiditis, he will also examine the ear and the eardrum with the help of an otoscope.
If the suspicion of mastoiditis is confirmed, it is usually necessary to be hospitalized, where blood is collected and checked for signs of inflammation, and a swab taken from the ear is examined for possible pathogens.

Optionally, an X-ray or a CT scan may also be performed to help diagnose and detect complications such as bone fusions early on.
In small children, however, due to the radiation exposure is usually dispensed to the X-ray or CT images. In the case of a positive finding, treatment with antibiotics is usually started, in some cases also an operative treatment is necessary.

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

If the swelling is evidence of a skin tumor behind the ear, is usually a briefing in a dermatological or ENT-medical clinic for further clarification and histological examination necessary.

Swelling on the neck

A swelling on the neck usually speaks for a harmless enlargement of the lymph nodes, as part of a cold or tonsillitis.
Mostly, the swelling forms by itself back. Another rare cause of neck swelling, however, may be an inborn cervical cyst, which contains fluid and mucus and can easily inflame, for example as part of a cold. After the infection has resolved, the cyst usually also forms again.

However, the cervical cyst can also form an opening in the skin and wet it - it is called a neck fistula.
In rare cases, the cervical cysts may become so inflamed that it forms an abscess, which may be accompanied by severe pain, fever, and difficulty in swallowing.
Cervical cysts are not dangerous in themselves, but can inflame and are often cosmetically disturbing. Usually they are surgically removed.

Swelling on the bone

A common cause of swelling behind the ear, especially in the area of ​​the bone, is mastoiditis - an inflammation of the mastoid. The mastoid lies behind the ear and is directly connected to the tympanic cavity.

Mastoiditis usually arises as a direct result of delayed or inadequately treated otitis media and is very common in children and adolescents. It is usually accompanied by severe ear pain, constant, throbbing pain on the mastoid, hearing impairment, fatigue and fever.
In addition, behind the ear a distinct, doughy swelling can be felt, which can even push the ear down. As a result, the auricle usually stands out. A purulent fluid can also drain from the ear canal.

Swelling in the child

The most common cause of behind-the-ear swelling in the child is also inflamed, enlarged lymph nodes, such as those associated with a cold or tonsillitis, or mastoiditis resulting from middle ear infection.

Also a middle ear inflammation can make itself noticeable at the beginning over a lymph node swelling behind the ear. Rare are congenital cysts, which can be felt as a swelling on the neck.

Pain / headache

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

Mastoiditis also often leads to fever, fatigue, severe ear and headache, and pressure pain in the area of ​​the mastoid. Even an atheroma, when it is very large, can cause painful head movements or headaches when it becomes inflamed.

Swelling behind the ear in case of a cold

A cold often leads to painful enlargement and inflammation of lymph nodes. It can also cause middle ear inflammation, which is accompanied by severe ear pain and headache.

Severe influenza (see symptoms of influenza) can also lead to painful enlargement of the lymph nodes, headache and body aches and fatigue.
If it comes in the context of a cold to a swelling behind the ear, so it forms after the fall of the cold mostly by itself back.


Swelling behind the ear, caused by enlarged lymph nodes as part of a cold, does not require special treatment. Symptoms may include anti-inflammatory drugs (for example, ibuprofen, or paracetamol).
In addition, attention should be paid to bed rest and adequate drinking.

In the case of middle ear inflammation always decongestant nasal sprays should be used, as well as painkillers should be taken if necessary. Sometimes taking antibiotics may be necessary.

If mastoiditis is present, a clinic should definitely be visited. Antibiotics are usually administered there, often intravenously in children. Sometimes surgery may be necessary.

If the cause of the swelling behind the ear is a lipoma, an atheroma or a cervical cyst, these can be removed surgically. An abscess usually needs to be punctured and drained via drainage and treated with antibiotics.

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