Dr. Priyanka Kuri, Consultant – Dermatology,Aster Whitefield Hospital

Usually,​‍​‌‍​‍‌​‍​‌‍​‍‌ you put on earbuds when you want to focus, while traveling, or simply to separate yourself
from the rest of the world, but if you cram them in your ears all day, your ears (and the skin around
them) might not be so fortunate. Here’s a safe, somewhat scientific glance at how prolonged use of
earbuds can lead to skin issues, what the reasons are, and some easy fixes that you will actually ​‍​‌‍​‍‌​‍​‌‍​‍‌use.
What can go wrong?

1. “Ear acne” (acne mechanica). The continual pressure, friction and trapped sweat caused by
   earbuds could result in clogged pores and the appearance of pimples or small bumps in and around
   the ear – the same condition athletes get from tightly fitting helmets or straps. This is a prominently
   described skin reaction known as acne mechanica. (Mills, classic description; practical overview).
2. Allergic contact dermatitis. Some earbuds may contain plastics, adhesives, metals (including gold
   plating), acrylates or other chemicals that could induce allergic eczema – redness, itching, flaking, or
   blistering in the area where the device is in contact with the skin. There have been documented
   instances confirmed by patch tests in the literature of dermatology linking allergic reactions in-ear
   devices.
3. Infections (bacterial or fungal). Earbuds, particularly the in-ear type, cause a warm, slightly humid
   microenvironment. In humid seasons (think monsoon), it is an ideal place for bacteria and fungi to
   grow – and some studies indicate that different earset users have different patterns of
   bacterial/fungal growth in their ear canals. This can cause otitis externa (infection of the outer ear)
   or, in the case of pimples, the sudden appearance of infected flare-ups.
4. Irritation resulting from grime and sweat. Dirt, sebum (skin oil), product residues (hair spray,
   perfumes) and dead skin taken from a dirty earbud are being returned to your skin each time you
   put them on – thus, the risk of blocked pores and irritation is doubled.

Why does this happen?
There are tiny hair follicles and oil glands on the skin of your body. The friction caused by a close-
fitting earbud, along with heat and trapped moisture, works to encourage oil and dead skin to come
together and also bacteria to flourish – this is a cause of inflamed bumps. If you are allergic to a
certain material, even limited contact may cause the immune system to react and the resulting
dermatitis will be very bad and last for a long time. Moreover, if the ear canal is warm and humid
(and you use earbuds during rainy days), microbes that are usually on the skin can multiply too much
and bring about infections.

Who is more likely to experience problems?

• The ones who wear in-ear buds for many hours without a break (full-time office workers,
  commuters, gamers).
• Those who sweat a lot (while exercising and using in-ear devices).
• People with sensitive skin, eczema, and known contact allergies.
• The ones who don’t clean their earbuds regularly or use cheap, untested earbuds.
• In humid times, the number of infections increases when moisture is trapped.

Honestly fixes that you can do right now

• Don’t wear them continuously for long hours. Where possible, remove earbuds every 60–90
  minutes, and give your ears breathing breaks.
• Keep your earbuds clean on a daily basis. According to manufacturer’s instructions, wipe the tips
  with alcohol swabs or mild soap and water; regularly change silicone tips.
• Change the style. If in-ear tips irritate you, consider over-the-ear or open-back headphones that
  eliminate trapped moisture and reduce friction.
• Don’t use earbuds during heavy rainfall or after a heavy sweat without cleaning. Moisture
  facilitates infections.
• Be alert for symptoms. If you experience red, itchy, and flaky skin that is persistent, stop using the
  device and consult a dermatologist – patch testing can pinpoint the exact allergens.
• Opt for good quality products. Lower-priced knockoffs may have undeclared metals or chemicals
  that can cause dermatitis. Consider the brands that are transparent about the materials they use.

When to see a doctor
When​‍​‌‍​‍‌​‍​‌‍​‍‌ the pain of an ear sore is intolerable, if the ear starts to produce pus, the infection expands,
bleeds, or after you have removed earbuds and given a gentle care treatment for a few days the
condition has not improved, then it is necessary to see a doctor without a doubt. There is a
possibility that infections of the outer ear as well as allergic dermatitis, can be treated with
medications, both topical and ​‍​‌‍​‍‌​‍​‌‍​‍‌oral.
Bottom line

Earbuds are not bad; actually, they are quite handy. Yet, if you wear them all day long without taking
breaks or cleaning your ears and the earbuds, then you make them a perfect place for bacteria to
multiply and a place for your skin to be damaged by the friction. A little care (cleaning, breaks, style
choices) can go a long way in keeping your ears comfortable and your skin free from ​‍​‌‍​‍‌​‍​‌‍​‍‌‍‌‍‍‌‍‌‍‍‌blemishes.