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Painful earlobe lumps could develop in the course of different diseases. Most commonly, they are seen in young adults who have a sensitive skin and tend to develop acne on their face, chest or upper back. Technically, they are developed due to secretions and clogging of follicles which is called acne when it happens on the face. When outflow of the gland is clogged, the secretions start to accumulate and thanks to the overgrowth of bacteria (present all over the normal skin) in ample food (secretions), a local area of infection and inflammation develops. It hurts when it is touched and occasionally it opens up to excrete puss. Eventually they get resolved and become limited by the normal body reaction but they might stay for a long time as tiny palpable nodules in the earlobe before they fully disappear.

It is also possible that these lumps develop as a result of bacterial overgrowth within a cyst like structure especially in people whose skin become colonized by bacteria that disturb the normal bacteria flora. This bacterial overgrowth is not related to hygiene as these people have a genetic susceptibility to such overgrowth. In most cases, bacterial overgrowth does not form true cyst but might require the same management i.e. trying to drain and squeeze the contents out and antibiotic treatment. Sometimes, these cysts shrink and become small thanks to our body's defensive mechanisms when no further action might be necessary. Certain cysts may contain non-infectious cells and be primarily filled with squamous cells.

A lump may also develop after manipulation or trauma. It could also develop as a reaction to a foreign body or metals (e.g. earring). It is sometimes seen following a piercing in some people who have sensitive skin to trauma. These people tend to build up extra tissue in response to the trauma which is commonly not painful. They could be carefully removed for cosmetic reasons but extra care and some topical treatments are necessary to stop additional regrowth.

Certain systemic diseases may also create earlobe lumps but they are often presented with other symptoms which makes the diagnosis simple to a trained physician. Rheumatologic diseases can cause accumulation of some metabolic products in the external ear and the earlobe. Lipid disorders also lead to accumulations in the skin including the earlobe. Another group of rheumatologic diseases involve cartilages in the children that might produce a painful lump. All these diseases are uncommon and they are presented with a set of other symptoms.

Skin cancer might develop on the ear especially in the aged population. These lesions are usually painless but might become painful when they are manipulated. They require close examination by a dermatologist and a biopsy is required so don't forget to see your doctor if you develop a persistent painful ear lump.

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