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Smell Behind Ears: Diabetes-Related or Something Else?

Medically reviewed by Sarika Chaudhari, M.D., Ph.D.
Written by Emily Wagner, M.S.
Posted on August 18, 2023

Have you ever scratched your ear and caught a whiff of an unusual or just plain bad smell? Sweat, oil, and bacteria can all collect in this area, giving it a sweaty, unpleasant odor. The skin in and around your ear produces sweat and oil, which can mix with bacteria and create an environment where smelly things can form. So, sometimes you might notice a not-so-pleasant scent when you scratch your ear or touch that area.

In some cases, your type 2 diabetes may also be to blame. In this article, we’ll cover how the smell behind your ears could be related to your blood glucose (blood sugar) level, along with other potential causes. For the most part, this odor is harmless and can be managed with hygiene and skin care.

Diabetes and the Smell Behind Your Ears

Did you start to sweat more after you developed diabetes? This isn’t a coincidence — your body now has a harder time controlling your sweat glands. High blood sugar levels from diabetes can also cause neuropathy (nerve damage). When the nerves that control your sweat glands are damaged, you may experience excessive sweating.

You may also start sweating if your blood sugar is too low, known as hypoglycemia. Your blood sugar levels can drop after taking diabetes medication or skipping a meal. If you’re sweating a lot from neuropathy or hypoglycemia, the skin behind your ears can start to smell. The sweat itself does not smell, but the action of skin bacteria with the sweat causes the smell.

According to the American Academy of Dermatology Association, people with diabetes are also at a higher risk of skin infections. In addition to painful, swollen skin or rashes, skin infections can also leak a smelly discharge. In diabetes, infections may be difficult to control. If you think you have a skin infection behind your ear, make an appointment with your doctor immediately before it gets worse.

Fruity-Smelling Body Odor and Diabetes

Another symptom to keep an eye — or a nose — out for is sweet-smelling or fruity body odor. This scent is a sign of diabetic ketoacidosis (DKA), a complication in people with very high blood glucose levels from diabetes. In type 2 diabetes, your cells have trouble using insulin properly. Insulin is a vital hormone that helps your cells take in sugar from your blood to use as energy.

In DKA, your cells can’t get enough glucose, so they start breaking down fat for energy instead. The breakdown of fat releases chemicals known as ketones, which make your blood acidic and give your skin and breath a fruity smell.

DKA is a medical emergency — one warning sign is a sweet- or fruity-smelling odor. Other signs of DKA to be aware of include:

  • Stomach pain, nausea, and vomiting
  • Shortness of breath
  • Extreme thirst
  • Frequent urination
  • Tiredness or weakness

If you begin experiencing any of these signs of DKA, you’ll need to seek medical attention immediately. You’ll be treated with insulin and fluids to bring your blood sugar levels down.

Other Reasons the Skin Behind Your Ears Smells Unpleasant

When researching why the skin behind your ears might smell, it’s easy to find scary or inaccurate information. While your type 2 diabetes may play a role to some extent, chances are the smell you’re noticing comes from your skin’s normal secretions.

Here are three other reasons why the skin behind your ears smells.

Buildup of Sweat, Oils, and Dirt

You have sweat glands all over your body, including behind your ears. The sweat and oils from your skin and scalp are easily trapped in this area, where they can mix with dead skin cells, dirt, hair products, and even soap or shampoo from your latest shower. Together, the mixture of these substances makes for an unpleasant smell.

Without a mirror and regular checking, you may not even notice any buildup behind your ears until you rub the area or smell it. Personal hygiene and lifestyle changes often help cure the problem in most cases. Washing your skin regularly with warm water and soap and rinsing thoroughly helps remove sweat, oils, and dead skin cells.

Sweat, oils, and dirt can also collect where your glasses sit behind your ears. Be sure to wipe down the arms of your glasses regularly with a clean cloth or wipe to remove any buildup.

Ear Infections

Ear infections aren’t just painful — they can also be responsible for foul smells coming from your ears. Bacteria and fungi can grow in your ear canal and outer ear, causing smelly fluid or earwax to leak from your ear.

If you’ve been experiencing ear pain, a feeling of pressure or fullness behind your ear, or fluid leaking from your ear, it’s time to make an appointment with your health care provider. Fluid can also be a sign of a ruptured eardrum, which your doctor can take a look at. They’ll prescribe medicated eardrops or antibiotics to treat an infection.

Ear piercings can also become infected if they’re not properly cleaned. Signs of an infected piercing include:

  • Discolored, warm, swollen skin
  • Itching or pain around the piercing
  • Bleeding
  • Yellow, green, or white pus that may have an unpleasant smell

Be sure to clean your piercings with a sterile saline solution throughout the day. You can also apply an over-the-counter antibiotic ointment to help clear the infection. If your symptoms don’t improve after a few days, it’s a good idea to call your doctor.

Seborrheic Dermatitis

Do you have a scaly rash or greasy buildup on your scalp, on your face, or around your ears? This is known as seborrheic dermatitis, a type of eczema that may be contributing to your ear smell.

Your skin contains sebaceous glands that secrete sebum, an oily substance that creates a protective and hydrating layer. Sebaceous glands are found nearly everywhere on the body, but they’re more concentrated on the scalp and face. If you have seborrheic dermatitis affecting your ears, you may have:

  • Dry, flaking skin
  • Oozing from the skin inside or behind your ears
  • Raised crusts
  • Skin cracking

On its own, seborrheic dermatitis usually doesn’t cause a bad smell. However, if you pick at or scratch the rash or scales around your ears, you may develop an infection. People with seborrheic dermatitis react to a specific yeast found on their skin, which can lead to fungal infections that give off a cheesy smell.

If you notice an unusual smell from inside or behind your ears, along with pain, itching, or discoloration, talk to your doctor. They’ll prescribe an antifungal cream for you to apply directly to your skin.

An odd or not-so-pleasant smell behind your ears can come from various reasons, like things related to diabetes or other hidden factors. It’s essential to keep things clean and consider sweat, oil, and germs that might gather there, as they can lead to a smelly situation. If you’re bothered by the odor sticking around or are experiencing other issues, it’s a good idea to talk to a doctor. They can figure out why it’s happening and guide you on what steps to take next.

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DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, more than 132,000 members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Have you noticed an unpleasant smell behind your ears? Do you think it’s related to your type 2 diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on August 18, 2023
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Sarika Chaudhari, M.D., Ph.D. completed her medical school and residency training in clinical physiology at Government Medical College, Nagpur, India. Learn more about her here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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