Determining Origin and treatment

[Cheryl_L]

My question concerns the area on and around the ear lobes (pierced ears), on side of cheek, and behind the ear. This is the only area affected by skin growths that begin as an acne-like infection, usually about one per year.  

The problem is, unlike an acne breakout, these lumps do not go away over time. They change to a large (pea size) hardened nodule, or stay an active lump that produces a thick white excretion.

There are currently 3 on the left ear over five years old, and four on the right ear (two new this year).

The last dermatologist visited merely looked at them, and prescribed 250 mg of antibiotic and said to stop scratching them.
(This particular doctor was sub standard on many levels, and I no longer see him.)

Are these acne scars, or possibly an allergic reaction to some metals?  Fat deposits?

I would like to know if there is a more advanced diagnosis and removal treatment available, possibly from a cosmetic surgeon or laser technician, or a new chemical process to remove them.  These are becoming a disfigurement on otherwise good 40 year old skin.  Thanks.  

[Alan Rockoff, MD]

It sounds as though you are describing epidermoid ("sebaceous") cysts.  They can occur anywhere, but are especially common around the earlobes.  As usual, no cause is known, so no prevention is available.  If a particular one is large and obtrusive, a plastic surgeon would be your best bet for removal, but it's often better to leave them alone, as the scar may be worse than the cyst.  The white stuff that comes out is dead skin tissue, usually not pus.

Best.

Dr. Rockoff

[Cheryl_L]

Dear Dr Roloff,

Thank you for clearing up my concerns, if not my skin.  Your reply was most valuable to me, in that, I did not want to waste time and money on another dermatoligist.  I will seek out an effective plastic surgeon to go over this. I have lived for years with my hair hanging over these nodules. I think the scars would be easier to live with then these cysts.


I am very pleased with this forum, and will report back on progress, for others benefit.

With much appreciation,

Cheryl L