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Child having petechial rash on ear lobes. Reason?

Aug 2013
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Answered by

ENT Specialist
Practicing since : 1996
Answered : 1025 Questions
Hello, My 7.5 yr old daughter gets petechiae rash on her ear lobes every now and then. Its only on her ear lobes and nowhere else on her body. She has been getting them for the last 5 years. She had general blood work done twice with normal results. She is otherwise healthy. I noticed that she sometimes wakes up in the morning with this petechial rash on her ear lobes. Could she just have more superficial capillaries in that area, and from rubbing at night in her sleep, she gets this?
Thanks in advance
Posted Wed, 13 Nov 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sriram Nathan 1 hour later
Brief Answer:
Nothing to worry about

Detailed Answer:
Hello and welcome to Health care magic,

I am Dr Sriram Nathan an ENT surgeon and I shall try to help you out with your problem.

At the offset let me assure you that since the ear lobes are the only place where your daughter gets the rash and since they go away from time to time, you have nothing to worry about.

Furthermore since the blood tests were also normal, that again points out to a harmless phenomenon.

Just for your consideration, you may adhere to these:
1. Ear lobes are very delicate structures so that even a minor trauma such as a pillow or bed which is hard can cause these rashes. So make sure that she is not turning or putting much pressure on her lobes when she is sleeping.

2. Make sure her pillows and mattress are very soft and not the hard ones

3. Make sure that when she is sleeping she removes all her ear rings if she has any so that they do not cause any pressure induced trauma. Also if her ears are pierced then use only pure gold non reactive ear rings. If her ears are not pierced then you do not have to worry about this.

4. Let her not get exposed to extremes of cold and heat and her face and ear should never be in the direct blast of the AC or the fan

5. You may also get a soft velvet pad which she can use to cover her ear and ear lobes especially when she sleeps

6. Apply a moistening lotion such as vaseline when she goes to sleep and see if that helps

7. I am also assuming that she is presently not on any medication like pain killers or steroids which are also associated with these rashes

8. Laslty and most importantly, do not rub or meddle with the ear lobes as you rightly assumed and as I mentioned earlier, they are very sensitive structures.

Finally, if the rash is definitely having a cylce of coming and going then you have nothing to worry about. However if the rash stays on permanently and comes in other areas and or comes more frequently then you must consult both your ENT as well as your dermatologist.

Hope your doubts are clear and I will be happy to help you out if you have any more doubts


Dr Sriram Nathan
Above answer was peer-reviewed by
Follow-up: Child having petechial rash on ear lobes. Reason? 49 minutes later
Hello Dr,
Thank you so much for your detailed response.
So if I understand it correctly, some people can just have more delicate ear lobes than others. Because non of us in the family have this issue, just her.
Also how can I make sure she is not applying much pressure on her ear lobes at night. Any recommendations?
She has no earrings so thats not an issue. She is also not on any meds. I am pharmacist myself and am very careful about giving her any meds.
As for cold and heat - her hair and head do sweat at night, could this heat make petechiae come out?
You also mentioned velvet pad to cover her ear. Can you please tell me in more detail how to do it? I will also try vaseline.
Answered by Dr. Sriram Nathan 13 minutes later
Brief Answer:
do not worry

Detailed Answer:
Hello again,

You have undestood correctly that her ear lobes are little more sensitive that others. Even in normal people, ear lobes are sensitive to minor trauma which can be due to physical injury and also temperature changes.

In your daughters case, as you rightly understood she may be a little more sensitive

The sweating of the hair and head in children is normal because they have a fast developing brain and they do get more metabolism and hence the sweating.
The sweating can also cause the rash secondarily so make sure that at least whenever you can the sweat does not collect in the ear lobe area.

You can do cleaning of the sweat with a clean soft and moist cloth. But generally it is recomnended to keep the ear lobe as dry as possible.

I mentioned velvet as it is a very soft material. You can use any soft material to cover her ears including wool so that when she turns in her sleep she does not cause any pressure to the ear lobe.

Finally everyone is different and special so this problem may not run in the family but a detailed history of your family including any minor bleeding problem or problems like gout or arthritis can be very helpful and give us valuable insights on her condition.

But do not worry about these and try to perform the measure I have suggested and I am sure she will become better when she grows and her ear lobes get better.

Hope your doubts are clear and you may ask any more doubts that you may have


Dr Sriram Nathan
Above answer was peer-reviewed by
Follow-up: Child having petechial rash on ear lobes. Reason? 46 minutes later
Thank you again!
I will follow all your recommendations.
One last thing, if this was related to something systemic, like lupus, etc. she would desplay other symptoms by now as well, right?
Answered by Dr. Sriram Nathan 3 minutes later
Brief Answer:
your welcome

Detailed Answer:
Hello again,

You are welcome and I am sure that she will get better over time

And also you are right in understanding that if this was systemic it would either show up in the blood work you did earlier or also in that there will be other signs all over the body.

Hence like I mentioned before, since it is localised only to the ear lobe you have nothing to worry about

take care then


Dr Sriram Nathan
Above answer was peer-reviewed by
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