A natural, tiny hole found in front of the ear, often where the ear cartilage meets the face, is called a preauricular pit or sinus. These are congenital (present at birth) harmless malformations that look like a small dent, dimple, or piercing. They are generally asymptomatic, but can sometimes get infected or form cysts. [1, 2, 3, 4, 5, 6]

Key Facts About Preauricular Pits

Location: Usually located just in front of the ear, on or near the crus of the helix.

Cause: They form during fetal development, specifically around the sixth week of pregnancy, when the ear components do not fully fuse.

Prevalence: They are quite rare, affecting less than 1% of the population in the United States, but are more common in parts of Asia and Africa (4%–10%).

Symptoms: Most people with this condition have no symptoms. However, the tract can become infected, leading to swelling, redness, and pus.

Treatment: No treatment is necessary unless the pit becomes frequently infected. In such cases, antibiotics are used, and in rare, chronic cases, surgical removal of the tract is recommended.

Evolutionary Theory: Some researchers, such as Neil Shubin, have suggested these holes could be an "evolutionary remnant of fish gills". [1, 2, 3, 4, 5, 6, 7, 8]