Psoriasis of the ear: how to alleviate it?

The psoriasis is a skin disease that affects a fairly high number of people. It can appear in anyone, at any age.

This skin disease is characterised by red, scaly patches that cover specific parts of the body. These can be a source of itching and irritation, with the intensity varying from one individual to another. They appear following a skin inflammation caused by a failure of the immune system. T lymphocytes produce inflammatory molecules (cytokines Il-17, Il-22, TNF-alpha, among others). These stimulate the proliferation of keratinocytes. The renewal period of these cells, normally three weeks, then becomes three days. This results in an accumulation of immature keratinocytes on the skin surface, increasing the thickness of the outer layer (the cornea). This is referred to as hyperkeratosis.

Ear psoriasis presents itself just like any other form of classic psoriasis. It can appear solely on the lobe, or it can affect the pinna, the back, or even the inside of the ear. It is precisely this situation that makes ear psoriasis particularly troublesome. The plaques are hard to reach, which complicates the act of scratching them for relief. Moreover, it becomes difficult, if not impossible, to wear earphones, a headset, earplugs, or even a hearing aid. The scales that fall into the ear can even reach the eardrum and block the auditory canal, which can lead to partial deafness.

As of now, curing psoriasis is impossible. Indeed, there is no remedy that can completely eradicate the disease. However, certain methods can be used to alleviate the symptoms. To limit the spread of inflammation, it is recommended to use a treatment containing dermocorticoid ingredients such as cortisone. Applied topically, they help soothe the skin by combating inflammation. They inhibit the transcription factor NF-kB by activating the transcription of the IkB gene, thus providing anti-inflammatory effects. Dermocorticoids are available in the form of ointment, lotion, or cream.

To remove plaques and slow their progression and appearance, it is recommended to use treatments based on vitamin D derivatives. These vitamin D analogues, such as calcipotriol or calcitriol, are anti-proliferative, meaning they combat the excessive multiplication of certain skin cells. Therefore, they act against hyperkeratosis.

Phototherapy can also be considered for treating ear psoriasis. This is a method of treating skin conditions that utilises ultraviolet rays. There are two types of phototherapy: PUVA therapy, which exposes the patient in a cabin to UVA rays, and the UVB phototherapy , which uses ultraviolet rays closer to those emitted by the sun.

To avoid further irritating the skin, it is advisable to use soap-free cleansing gels with a neutral pH that will not irritate the skin. As for the hair, a shampoo containing salicylic acid can be used twice a week alternately with a mild shampoo. Indeed, this active ingredient has keratolytic properties that help to remove dead skin cells. The hydration of the ears should not be neglected. For this, it is appropriate to use a moisturising cream or lotion every day that will create a protective film on the surface of the skin and fight against flaking.

If you suffer from psoriasis of the ear, it is advisable not to use cotton swabs. These can push the crusts of dead skin towards the eardrum and promote the obstruction of the auditory canal.

LEBRUN-VIGNES B. & al. Dermocorticoïdes. Ann Dermatol Venereol (2004).

SAURAT J. & al. Psoriasis. Dermatologie et infections sexuellement transmissibles (2016).