Does ethical egoism promote narcissism and insensitivity to others?

People often suggest that ethical egoism -- such as that advocated by Ayn Rand -- promotes unfriendly if not hostile behavior toward other people. Ultimately, the egoist cares for himself above everything else, perhaps to the point that the thoughts and feelings of others aren't even noticed or of concern. The problem seems to be exacerbated by a commitment to moral absolutes and moral judgment. Do such philosophic principles incline a person to be self-absorbed, insensitive, hostile, unkind, or otherwise unpleasant to others? How can egoists take care not to fall into these traps?