Erysipelas of the ear: what should you know?

Ear erysipelas is a bacterial infection of the skin and superficial lymphatic vessels around the outer ear. The pinna may become bright red, hot, swollen, and tender, sometimes with a distinct border. Fever or feeling unwell can accompany the skin changes. Redness of the ear can also come from cartilage infection, an abscess, dermatitis, or an allergic reaction, so appearance alone cannot identify the cause. Do not put creams, drops, or objects into the ear canal unless a clinician recommends them.

Arrange prompt medical review and describe when the redness began, whether it is spreading, and whether there was a piercing, scratch, bite, eczema flare, or wound. Keep the area clean and dry, avoid pressure from headphones or jewellery, and do not scratch or squeeze swollen skin. Use only medicines recommended for you. If antibiotics are prescribed, take them as directed and report a rash, breathing difficulty, or other suspected reaction urgently. General information on Antibiotics For Skin Infection can help you prepare for the consultation.

Seek same-day assessment for a red, painful, hot, or swollen ear, particularly with fever, discharge, worsening pain, or redness extending onto the face. Get emergency help for confusion, faintness, severe weakness, breathing trouble, or rapidly worsening swelling. Urgent review is also appropriate if the ear becomes very painful, the outer ear changes shape, hearing changes, or the infection follows a piercing or injury. Do not wait for home care to show whether a potentially deeper infection is present.

Is the ear canal or cartilage involved, or is the infection limited to the skin? What treatment and follow-up do I need? Which changes should prompt an emergency review?