I have an unpleasant odor behind my right earlobe. I'm not sure how to get rid of it. It seems to be where my ear is pierced. I haven't worn earrings in a long time. When I did wear them, my ear would get sore and pus would come out. I would be grateful for any suggestions.

Jacquie

The smell is almost certainly due to chronic bacterial infection of the skin-lined channel created by the piercing. Pain and purulence (pus drainage) were signs that you had an acute bacterial infection of this skin. In a medical sense, "acute" means "recent onset," while "chronic" means "long-lasting." Acute infections of skin tend to be aggressive and worrisome, while chronic infections are just plain annoying.

Bacteria thrive in tight, wet, warm spaces. The tiny channel that exists within a piercing is just such a space. The amazing thing is that piercings do not become infected more often. It is important that the initial piercing be performed using sterile technique and that the fresh piercing be kept as clean as possible. During the healing phase, it's a good idea to clean the posts with rubbing alcohol before inserting them.

Metal allergy is another potential problem. By using earrings that are made from relatively inert metals (such as gold), one can minimize the risk of sensitivity to the metal itself. For example, nickel allergy can interfere with the comfortable use of certain earrings.

What should you do with your earlobe now? You could try cleaning it frequently with warm soapy water, perhaps twice a day, followed by topical application of an over-the-counter antibiotic ointment. Unfortunately, most over-the-counter antibiotic ointments contain neomycin, and roughly 15 percent of the population will have a bad skin reaction to neomycin! If you can find an over-the-counter antibiotic ointment that contains only bacitracin, this would be a better choice (assuming, of course, that you are not allergic to bacitracin).

If this doesn't work, there is a stronger topical antibiotic that might work called mupirocin, but this is a prescription drug. You would need to see a doctor about the problem -- which is a good idea in any case, if the conservative steps outlined in the previous paragraph do not solve your problem.

Oral antibiotics may be effective, but this strikes me as being overly aggressive. After all, oral antibiotics are not without risk. (The common risks include development of allergy to the antibiotic, diarrhea, and oral or vaginal yeast infection.)

Worst-case scenario: If all else fails, your doctor may need to cut out the tissue immediately surrounding the piercing. This procedure could be done in the office, using a local anesthetic.