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Preauricular abscess

For 2 weeks I have been dealing with a very painful abscess on my ear, where after alot of research and several trips to a local medical clinic and ER, I have found that what I have is an abscess in the Preauricular pit/sinus.

I have been given 3 rounds of antibiotics, one of which I am still taking (Clindamyacin). I have yet to see any improvement from taking the antibiotics, so I went to the ER yesterday where they attempted to do and Incision and Drainage procedure. Some of the abscess was soft, but a large part of it in the middle was still hard... ??? With making an incision, the doctor was able to squeeze a good portion of the abscess out... but there is still a fairly large sized lump there. There has been no drainage coming from the incision since she did this.
I still have some tenderness down the side of my cheek, as well as some puffiness up into my scalp area as well.

I can say that by doing what she did, it did relieve alot of pressure and pain that I was having, but I still am having to take pain relievers to reduce the swelling and continued discomfort.
She instructed me to continue finishing out the anitbiotic I am now taking, and that it should dry up anything left in the abscess, as she said that at the point it was beforehand that no antibiotic would be able to get rid of it alone without I&D procedure being performed.

I am still very concerned, and am thinking of contacting an Ear, Nose and Throat physician about this bc I just feel like a regular physician does not know much about preauricular pits/sinuses, as I have had to educate every physician I have seen thusfar for treatment bc they had no idea what those little holes in the tops of my ears were. I get the feeling that they do not know the complications that can arise from the condition, and that has me worried that if the swelling continues that more serious problems are going to develop.

Has anyone else had this problem?

21 Responses
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Avatar universal
Just returned from the er for treatment of yet another abcess on my scalp-I have been getting these on and off for the past four months-cause unknown-and primarily behind my ear lobe and along my hair line. The first two I had treated required them to be lanced opened with some drainage but a hardness as well. Was prescribed Keflex and Bactrum which does seem to be effective over time.  I have discovered a product called PRID which is a natural homeopathic drawing salve which works wonders-The key to  getting these to heal is for them to drain, as long as they continue to drain, which the PRID facilitates the eventually heal. The one I have been dealing with the last couple of weeks requires antibiotic as well. Try using warm compresses and if you can bear it sterilize a straight pin or needle and poke a small hole to allow the puss to drain out-Instant relief when that pressure is alleved and also will help it to heal faster. I have found using peroxide or neosporin are ineffective  as they seem to heal the surface skin and end up making the infection worse by not allowing it to drain. Hang in there-They are awful, painful and hurt.  Keep your hair clean, avoid dyes or harsh chemical treatments, buy a new hairbrush each time it happens too-one doctor said it was some type of Staph infection which can be picked up anywhere and everywhere.  TRY the PRID-$5 at walmart -apply a dab to a small bandage with q-tip and cover the abscess, do this daily-it may take a couple days but IT WORKS
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Avatar universal
can you plz give me his details at
zsm_55***@****
thanks plz
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Avatar universal
Hello Friends

I am here to ask you my doubts regarding PAS. I have a 5 year old daughter and she has recurring PAS infection. The first infection was when she was 2 years old and we treated it with antibiotics. ENT told us that she will need a surgery if the infection comes frequently and it can be done once she completed 5 years. She gets infection every 3 months and we treat with anti-biotics. Now we are planning to do the surgery. But still we are worried about the surgery and its consequences. Some people get infection even after surgery. Also a mark will be there on the face.I  Am also worried about giving anastasia for my child.

1. Will there be any problems if we don't do surgery and treat it with antibiotics?

2. Will the chance for infection be low once my child has grown-up.?
3. Is there any ways to prevent infection. ?
4. Why some people with the hole on the ear don't get infections?
5. Is there any solution for preauricular sinus infection in Homeopathy or Ayurveda?


Can anyone please help me out. I am waiting for a quick reply.

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Avatar universal
I had one for years! And I do mean years, close to four or five before it finally popped on its own. I tried to see my GP and have it drained, but she told me it was a cyst and nothing to worry about, so I didn't. I guess I was lucky, mine didn't hurt until about two weeks before it popped. I am guilty of poking and prodding on it constantly during those two weeks, and it was the worst smelling thing I have even endured when it did pop, but that was about five years ago. Just tonight I discovered a new one forming, but again, there's not any real pain, so I may not worry about it. I never took antibiotics for the first, never went back to the doctor after she told me there was no chance it could be cancerous. Am I odd? It seems everyone else has a bunch of trouble with theirs...
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Avatar universal
I can sympathise with you all. I too am currently suffering with an abscess on my left ear lobe/where it joins my head. The whole area is hugely swollen and extremely painful. I have been prescribed antibiotics only (Flucloxacillin). And am making my own concoction of pain relief up!
I visited a doctor who told me it would needed draining ASAP and then sent me round to A&E.
After an age in A&E and UTC it was decided that apparently "if it was anywhere else on your body - armpit,groin etc we would drain it - however ears are funny things and we get more of them wrong than we do right - which means you're likely to either end up with a rugby players ear or deaf!" So they sent me on my way for it to work its way out " naturally on its own"

Does anyone know how long this is likely to last?
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Avatar universal
i had also the same case. its located on my upper right earlobe. i have it when im still young but my doctor gave me antibiotics and its whoa, immediately gone. but when im in secondary my friend notice it again. because im afraid of operations i decided not to consult it from any docs because i know its not dangerous but when i go to the salon, the stylist saw it and recommended me her doctor because she also have the same case before. without any second thoughts i went to the doctor and he find out that its non dangerous so he did the so called I&D. unfortunately i went back for several times of drainage. the mass was still going and going. its not yet gone. a big disappointment cause i almost spent my savings but my problem is still here and the worst its painful compared before. but we have the same meds. i am taking cloxacillin before but he replaced it with climdamycin. how this can be totally removed?
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Avatar universal
i have also a pre auricular sinus infection and i have it  for almost a month already. i have been seeing an ENT MD for this one and they advised me to have I&D to relieve the pressure, pain and for for proper healing, but unfortunately, due to too much pressure and my carelessness it ruptured on its own. I've been taking clinamycin (dalacin C) for almost 2weeks now coz my doctor advised me to take it for that span of time. i think clindamycin works  best for ear infection coz it deeply penetrates (as what my doctor told me) in the ear. My doctr prescribed me a mupirocin its an ointment to prevent bacterial in the surface.
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Avatar universal
Hi , i am 18, i live in Sydney Australia, i had problems with preauricular sinuses too. i had 3 operations all three were unsuccessful, these things are a massive headache if not taken care of and treated the right ways. If the infections happen to come back again and keep coming back then i would advise you to take Keflex to stop the infections as soon as it starts the first little signs of infections (it helped me alot with stopping the infections). Recently on the 4th of December i had a successful operation done and it is now all cleared up. i advise if you are going to have a operation on this problem, then have it operated by a surgeon that has operated on these problems and make sure he has alot of experience. My last operation was operated by a professor in sinuses and i think that if you live in Australia and are willing to get rid of them problems then you should see this guy.
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Avatar universal
All I can say is I have struggled with this all my life. I am now 27 yrs old. I just had a recurrent infection. It usually forms an abscess behind my ear cos the pit was sewn shut by the Dr during the first surgery.This last episode was the last straw. Went to my ENT Dr's office to schedule 2nd surgery on monday. Surgery was supposed to be for tmro but cos abscess poped today. Dr said we have to cancel surgery till further notice. Said since its been recurring for many years. It will be hard to find all the tracts due to scar tissue. He prefers to operate while i have the huge abscess ( dont understand the logic behind this). Is this not when the infection is active???
Brief or not so brief History:
I was born with the hole on my right ear. As a little girl who grew up in Africa I remember asking myself wat in the world was the "Stinky" liquid that came out of my ear. I would like to describe the smell as similar to  rotten fish. The worst part of it is the internal itch and tingling( like there is water dripping inside) inside the hole became unbearable. I just could not get to the itch. So one day in 1996 I remember the day very vividly I was playing and then it started to itch internally so bad. I tried rubbing my external ear to soothe the itch but the stinky fluid came out again and the itch and tingling became more intense.and then finally I rushed and grabbed a match stick and i broke it down to the "perfect size" and stuck it in the hole and omg it felt so good. I still remember the feeling till this day. However, my bliss was short lived and it broke inside the hole. Fast forward story: parents very upset abt match stick.Had guilty feelings for years that i had brought this on my self. Had surgery, got another abscess flare up a wk after surgery (1996) and that has been my life eversince. I get this stuff like 4- 5 times a yr, it lasts for exactly 5 days and then i have to get a I&D or pop it myself cos antibiotics DO NOT WORK. It wil deft be back unless the whole sac and sinus tract is COMPLETELY removed. I think i still have some of the tract in my ear. I feel tingling and then I know that i am about to have another flare up cos I think wat happens is that the fluid builds up and since my hole is shut it has no where to come out from. Hence the excruciating head pressure. The pain is HORRIFIC. on a scale of 1 to 10. I told my bf 9.8 . 10 I would have been sobbing loudly. I havnt slept in 3 days( I literally slept sitting up in bed), missed 2 days of work.  Feel relief after it popped while i was at work today. I have a gaping hole behind my ear. From my observation, I think the build up fluid never stops.  I feel bad for kids who have to go thru this! Srry for the long story. Finally there are others out there who can relate!
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Avatar universal
i am also experiencing the same thing as yours..at the moment the pain is life hell..it caused me stiff neck and burning pain makes me feel sooo uncomfortable.i went to see a EENT doctor 2 days ago and prescribed Proxco med and advised me to have warm compress.i did not buy the prescribed meds because before i came to see her i am already taking antibiotics so i decided not to buy the meds she prescribed and continue taking the antibiotic i started taking..until now it is still panful and it feels like its getting worst..i already had a lot of research in the internets and almost all of the articles iv read is to have a I&D which i am sooooo scared to do..huhuhuhu what am i gonna do now?
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Avatar universal
Wel, i also ones had an i&d at d back of my ear bt afta abt 6 months anoda pop up, wich d doc. said it wil b best 2 hav surgery wich i had, nd up til nw i'm stil havin recurrent pre auricular abscesses. I'm scared 2 go 2 d dr. Because of anoda i&d or surgery. What shld i do plz?
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Avatar universal
Several years ago, I had a severe infection in one of my preauricular pits.  It was swollen and spreading to my face and neck.  Touching it was extremely painful.  At first it was red, then turned a gradual purple.  I was on antibiotics, none of which worked.  I had to rush to the ENT, who at age 80, had to take cultures to determine the best treatment. Because of the pressure from the infection, there was concern that it may cause blindness, so he had to excise it.  I guess it is called the I&D procedure.  Extremely painful, the process definitely relieved the pressure and took a few days to drain through this tiny rubber tube.  Fortunately, it healed and caused no problems until NOW, 4 years later.  It has grown in size. I went to another ENT who said we have to excise it. I was concerned because it continues to swell yet is not painful to the touch, yet.  The ENT, whom I am seeing on a fairly regular basis for another issue, keeps insisting on removing it.  What is the cost for this procedure?  What is the success rate of it not recurring? What is the likelihood of scarring or nerve damage?  Any comments would be appreciated.  Currently, I am on cefprozil, and while I thought it was working the first few days, the cyst/abscess continues to grow.
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Avatar universal
I am 21 and have had the worse year of my life. I had a lump on my chest between my breast for about six years, never thought nothing of it because the doctor told me it was just fatty tissue.... one morning i woke up and the lump spread to my breast and became extremely painful. I went to the hospital, was put on antibiotics and still the pain got worse and the hardening increased almost all the way up to my neck, two days after going to the er and being on antibiotics, i went to my doctor and she put me on another anitbiotic and said there was nothing she could do because it wasnt to the surface yet, but she said she could try.... I just wanted it gone so i said ok,,, she put a needle in me and said crap im not getting anything... at that point she sent me home and told me to put warm compresses on my chest. She said THERE IS NOTHING THAT I CAN DO to prevent it and i had to deal with it.... I THINK NOT!!!!  I would like to know, what in the body do we have to much of or not enough of that causes an abcess to occur. is there anything that i eat that can help or make it worse, anything i drink.... does the amount of water intake make a difference?????????? please help me
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Avatar universal
Hi, i had to add my comments, i have one preauricular pit either side of my ears and had terrible abcess in my right one which ment i had to go into hospital in Feb 09 have it drained then went back into hospital in the May to have them closed up. 12 months later i had abcess again in right one and had antibiotics which helped it to poped where the stitches had been.I had to go back to ENT who told me they might never  hea lproperly  and i would be best to have more surgery. my appointment is on 26th of this month and i have just delt with another bout of infection in my right one again. but the ENT said it could happen again even with the surgery.. so i wouldnt bother to have surgery if you dont have any trouble with them leave well alone.
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Avatar universal
I just wanted to let you know that I understand what you are going through. I had 3 surgeries on my preauricular pit between the ages of 5-10 (I'm 26 now), and I've dealt with 2 infections (1 when I was 23, another infection at 25). I'm actually dealing with one at the present time, which is why I started googling information/forums on this particular area.

What happened to the hard lump that you had? Did it ever go away? How are you doing now? With my past 2 infections, I took antibiotics (Augmentin) and my abcess (underneath the incision site from my previous surgeries) popped on its own. This process took about a 1 week.

Right now, my GP is prescribing me something else and we're going to see how the week goes. I'm keeping a hot towel on it when I can -- this is what helped the abcess to burst on its own last time. I also have an appointment with an ENT next week . . . though I know, he's just going to tell me they have to do an I&D, which I would like to avoid.  
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Avatar universal
so the aspiration didnt work....
i switch docs and this one did an I&D.........
unfortunately i had to go back a few days later to get another I&D
now most has drained out but i can feel a hard lump.......
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Avatar universal
i went to the ENT doc today for mine. He simply stuck a needle into the infected/swollen area and drew out the infection. it was not a pleasant experience, but at least it didnt take too long. under a minute i would say. he then bandaged me and prescribed some antibiotic(pills) to take and one pain killer med.
he suggested surgery to close the hole up. he described it as skin that was suppose to grow as a straight line at birth but instead folded in.
i havent decided as yet.

hope this helps out
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Avatar universal
Thanks for your replies :)

After all was said and done, I had an I&D. I think this was the worst experience that I have ever had! But was relieved from alot of discomfort in the end. There was still alot of stuff left that the dr couldnt get out, but was told that it would drain out on its own. The following day after I had the I&D, I applied a hot rag to the area and within 15 minutes it began draining constantly. By the end of the day, it was almost all completely drained out.
Sweet relief! ;)

I havent had any problems with it since then, except I notice that I now have developed a small bump down below the preauricular sinus.. which I think they call a tag or something.

I hope that you are doing better now, sime_on :)
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Avatar universal
Reply to post by Kimmy72-

I have been dealing with pain and swelling of my right ear over the past week, and after alot of research and several trips to a number of medical centres, I also realised the small hole present on my right external ear is a preauricular sinus/pit.

Upon my first visit to the GP(where my ear was not yet swollen but was very itchy, with alot of discharge and peculiar smell present), I was prescribed antibiotics(Ibilex) to treat my ear. I also had a sore throat which I thought was associated with my ear itching/swelling but the doctor said to just take the antibiotics to clear up my nose and throat. However, due to my skepticism with the GP's evaluation of my condition, I decided not to buy the prescribed antibiotics with the script I was given. I persisted with the sore throat and swollen ear(constantly applying Dettol antiseptic liquid) until the pain(especially my ear) reached the point that I needed better medicine to relieve my discomfort in my ear and throat. I purchased the antibiotics(Ibilex) 2 days after the initial visit to the GP and started taking them immediately, along with betadine gargle and strepsils to relieve my sore throat.

After 2 days taking Ibilex, my ear did not improve, with pain and swelling increasing. I managed to research some articles on the management of my condition(infected preauricular sinus) on the internet and discovered that my ear swelling was in fact an abscess forming, therefore needing an I&D(incision and drainage) procedure to be undertaken. I attempted to visit another GP this time(one which was open late at night) to undertake this procedure(as the pain in my ear and head was very severe) but it took me 2 GP appointments(through constant persistence that I needed the I&D procedure undertaken) to finally have my ear incised and drained. Once the surgical procedure with local anaesthesia was performed, the pressure and pain on the right side of my head was relieved. If anyone undergoes this I&D procedure, please make sure your doctor/nurse gives you some pain killers(Panadeine or panadeine forte depending on severity of pain) to control the pain after the local anaesthetic has worn off. I have currently changed my course of antibiotics from Ibilex to Flucloxacillin and am resting at home while my ear wound heals. My sore throat is still present but is much more bearable than the pain I experienced from my infected preauricular sinus/pit. I am currently gargling salt water and taking strepsils lozenges to relieve my sore throat.

Here is a good article I discovered while researching my condition-

http://www.****
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242516 tn?1368223905
MEDICAL PROFESSIONAL
OtoHNS_MD has good advice, an ENT can take care of it if it's not getting better.
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Avatar universal
These are fairly common.  If they repeated get infected, they can be surgically removed.  See an ENT MD.  It is likely that the infection would need to be treated with antibiotics prior to any surgery.
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