What causes pain behind the ear when pressed, and what should be done about it?

Generally, pain when pressing behind the ear may be caused by local pressure or skin tension, cold exposure, external otitis, postauricular lymphadenitis, or infected sebaceous cysts. It is recommended to seek medical attention promptly to determine the underlying cause and, under a doctor's guidance, improve symptoms through general care, medication, or other treatments. A detailed analysis is as follows:

1. Local pressure or pulling: Long-term side sleeping that presses on the area behind the ear, or tightly tying hair that pulls the skin, can lead to soft tissue injury, causing noticeable pain upon pressing. Adjust sleeping posture immediately to avoid one-sided pressure, loosen tight hairbands, and apply a warm towel to the area behind the ear for 10 minutes to promote local blood circulation and relieve discomfort.

2. Cold exposure: The skin behind the ear is thin and rich in blood vessels; direct exposure to cold wind can easily cause local muscle spasms, resulting in tenderness when pressed. Wear earmuffs or scarves to keep warm, stay away from drafts, drink plenty of warm water, and avoid prolonged cold exposure that may worsen symptoms.

3. External otitis: Bacterial infection of the external auditory canal causes inflammation, with pain radiating to the area behind the ear. Pressure behind the ear intensifies the pain, often accompanied by itching inside the ear and increased ear discharge. Patients should follow medical advice to use medications such as ofloxacin ear drops, cefradine capsules, and Pudilan anti-inflammatory tablets, and avoid digging into the ear canal with fingers or cotton swabs.

4. Postauricular lymphadenitis: Infections from areas such as the throat or mouth may spread to the lymph nodes behind the ear, causing lymph node swelling and significant tenderness upon palpation. Patients should take medications as directed by a physician, such as amoxicillin capsules, cefixime dispersible tablets, or roxithromycin capsules, while also actively treating the primary infection sites in the throat or mouth.

5. Infected sebaceous cyst: Blockage of sebaceous glands behind the ear leads to cyst formation, which becomes red, swollen, and painful upon secondary infection, with severe tenderness on pressure. In early infection stages, medications are used to control inflammation. After stabilization, surgical excision of the sebaceous cyst—including removal of the cyst and affected tissues—is performed to prevent recurrence.

In daily life, maintain cleanliness of the skin behind the ears and dry the area thoroughly after washing hair. Avoid frequently touching or squeezing the region, eat a light diet avoiding spicy and irritating foods, maintain regular sleep patterns, enhance immunity, and reduce the likelihood of discomfort.