If you’ve ever woken up with a sore ear after a night of sleeping on your side, congratulations—you’ve experienced the condition nicknamed pillow ear. Though it sounds a bit silly, it’s a real thing, says Alison Boucher, M.D., a dermatologist at Henry Ford Health. And in some people, it can lead to pain and even open sores on the ear.
But it doesn’t have to. Dr. Boucher explains what causes pillow ear, who is at risk and how to prevent the condition from giving you trouble.
Chondrodermatitis Nodularis Helicis
Most of the outer ear is made of cartilage, a rigid but flexible tissue that gives the ear structure. But cartilage doesn’t have its own blood supply. Blood vessels bring nutrients to the overlying skin, but no blood flows through the cartilage itself.
“Ears have a very delicate blood supply, and compression cuts off that blood flow very easily,” Dr. Boucher explains. “That means ears are especially susceptible to irritation and inflammation.”
Repeated pressure on the ear—such as sleeping on the same side, night after night—can cause inflammation and pain. This can lead to the formation of a hard bump, usually on the outer rim of the ear. The condition is officially known as chondrodermatitis nodularis helicis.
It’s common for the skin atop that bump to break down, Dr. Boucher says, forming a sore that won’t heal. “That can put them at risk for infections, which can further inflame the cartilage,” she adds.
Unfortunately, the limited blood flow to the cartilage means the ear is slow to heal from injuries, including swelling and sores related to pillow ear. That lack of blood flow is also why cartilage piercings take longer to heal than piercings to the fleshy lower lobe of the ear.
Dermatology at Henry Ford
Unsurprisingly, people who sleep on their side are most at risk of developing pillow ear. The condition tends to be more common in older adults, who are at risk of developing problems with circulation as they age. “Smoking also increases your risk, since tobacco use damages blood vessels and increases inflammation,” Dr. Boucher notes.
Preventing Pillow Ear
Sleeping on your back or your other side is an obvious way to take the pressure off your ear. Unfortunately, changing sleeping positions is often easier said than done—especially when you’re sound asleep.
If you’re a committed side sleeper, here’s what you can do to avoid pillow ear or prevent it from becoming a bigger problem.
- Change your pillow: Special donut-shaped pillows that have a hole for your ear are often marketed as “piercing pillows,” since they can help ease pressure on the ear while you heal from an ear piercing. But they’re great for pillow ear, too.
- Rethink jewelry: An earring can put extra pressure on the delicate tissue of your ear, especially if you have a piercing in the cartilage. Consider removing piercings at night.
- Go earplug-free: Pillow ear usually affects the outer rim of the upper ear, so it may not be affected by earplugs or earbuds. Still, any cartilage in the ear can become uncomfortable from pillow pressure, and removing earplugs might help. “If you’re missing the noise-canceling effect from the earplugs, you might try sleeping with a white noise machine instead,” Dr. Boucher says.
- Treat wounds: If you develop an open sore on your ear, use petroleum jelly to soothe tender skin and provide a barrier, Dr. Boucher recommends. “There are also things we can try in the office, such as steroid injections, to help calm the inflammation in the ear,” she adds.
- See your doctor: Pillow ear isn’t the only cause of sores on the outer portion of the ear. Ears are also a common spot for skin cancer, since they’re frequently exposed to the sun (and can be forgotten when you apply sunscreen). “Any sore on the ear that doesn’t seem to be healing should be examined by a doctor to rule out skin cancer,” Dr. Boucher says.
Since ears are slow to heal, it might take a few weeks to notice pillow ear improving, especially if you’ve developed a hard nodule or a sore. But a few simple bedtime tweaks will help keep pillow ear from becoming a pain.
Reviewed by Alison Boucher, M.D., a dermatologist at Henry Ford Health. Dr. Boucher sees patients at Henry Ford Medical Center-Plymouth, Henry Ford Medical Center-Farmington Road and Henry Ford Medical Center-New Center One in Detroit.
