Very small cysts continuing to appear on Ears. Can’t find cause!

Question

I am 185 lb early 20’s male. I do not have acne, but I do have cysts that are appearing in my outer ears. It is ramping up and they are very small but it went from 1-2 to 5-6 between the left and right ear and I’m wondering if accutane or any other medicine out there could potentially help this issue. Previously I had a small one drained and they believed that it was potentially sebaceous but unsure.

Anna Chacon, MD, FAAD · Answer

Thank you for your question. Recurrent small cysts on the outer ears can be frustrating, especially when they continue to appear without an obvious trigger. Even in patients without acne, this is something that can happen.

Based on your description, the most common possibilities include sebaceous (epidermoid) cysts, blocked oil glands, or a localized form of follicular occlusion in the ear skin. The skin of the ears has oil glands but limited space, so when ducts become blocked, small cysts can form repeatedly. Friction from earbuds, headphones, helmets, or even frequent touching can contribute, even if it’s not always obvious.

Regarding Accutane (isotretinoin): while it can be very effective for severe or widespread acne and cystic conditions, it is not usually the first-line treatment for small, localized cysts on the ears—especially in someone without acne. Accutane is a systemic medication with significant monitoring requirements, and the risk–benefit ratio often doesn’t favor its use for a limited area like this unless other treatments have clearly failed or the condition becomes more extensive.

Other medical approaches may be more appropriate, such as topical or oral antibiotics, anti-inflammatory treatments, or procedural management (for example, targeted drainage or removal of the cyst wall if they are truly recurrent sebaceous cysts). Identifying and minimizing contributing factors—like pressure, occlusion, or skin irritation—can also make a meaningful difference.

The good news is that this type of issue is usually manageable once the exact cause is clarified. While it can take some trial and adjustment, most patients are able to significantly reduce or stop new cyst formation with the right approach.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Very small cysts continuing to appear on Ears. Can’t find cause!

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