Constant or frequent itching in the ear is not only annoying, but usually has serious causes. They require a clear diagnosis in order to be treated efficiently afterwards.
What is itching in the ear?
The first intuitive reaction to annoying itching in the ear is usually to try to relieve the itching with the little finger or by means of a cotton swab. The first intuitive reaction to an annoying itch in the ear is usually to try to relieve the itch with your little finger or with a cotton swab. And this is exactly what should not happen! The external auditory canal is lined by very delicate skin and can easily be injured by a fingernail or cotton swab. This, in turn, encourages new infections. The use of a cotton swab is also discouraged because it is more likely to clog the ear canal. The earwax (cerumen) pushes together and forms a plug just in front of the eardrum, which (temporarily) significantly reduces hearing. It goes without saying that pencils or paper clips are prohibited as “treatment tools” because of the considerable risk of injury.
Causes
Constant or frequent itching in the ear can have various causes. Often, inflammation is found in the ear canal, which may have resulted from small injuries in the ear canal. Small injuries form the entry ports for bacteria or fungi, which cannot always be kept sufficiently “in check” by the immune system. In these cases, parallel to itching, there is usually also a feeling of pressure in the ear and ear pain. In the further course it can come to the formation of pus, which flows out of the ear with an unpleasant odor. Other causes for the annoying itching in the ear can lie in underlying diseases such as neurodermatitis or psoriasis, if the external auditory canal or the auricle is affected. Allergic reactions to the use of incompatible shampoos, hair sprays or cosmetics can also trigger a lasting itch. Similar allergic reactions can even be caused by earrings if they contain nickel in the case of a nickel allergy. Occasional itching in the ear usually has harmless causes such as dried earwax or simply a particularly stressful situation.
Diseases with this symptom
- Ear infection
- Allergy
- Ear canal inflammation
- Neurodermatitis
- Diabetes mellitus
- Skin fungus
- Psoriasis
- Nickel allergy
- Eczema
Diagnosis and course
A reliable diagnosis requires a thorough history (initial examination) to clarify possible causes of annoying itching in the ear. By means of an ear microscope (technical term: otoscope), it can be clarified fairly reliably whether inflammatory processes caused by bacterial or fungal infection play a role in the external auditory canal. If an inflammation of the external auditory canal and possibly also of the eardrum is diagnosed, it is usually manifested not only by an annoying itch but also by diffuse pain when chewing or when pulling on the auricle. It is also important to answer the question of whether the affected person has diabetes. Diabetes can lead to a significantly more severe course of inflammation in the external auditory canal. Likewise, neurodermatitis or psoriasis can usually be detected, especially if a tendency to these two diseases was evident in the course of the medical history or if corresponding symptoms have already occurred on other parts of the body. In suspected cases of allergic reactions, it should be carefully clarified whether rigorous discontinuation of the shampoos and cosmetics used can provide relief. If skin reactions have also been observed in other areas of the face, neck or scalp, the suspicion of allergic reactions has been substantiated. In case of doubt, allergy tests for groups of substances contained in the shampoos and cosmetics used must be performed by the specialist (ENT physician).
Complications
An itch in the ear can occur due to various underlying diseases. If left untreated, the diseases can lead to various complications. Because of the constant itching, scratching can cause sores that can become infected. As a result, the ear swells and hurts.One of the most common causes of itching in the ear is inflammation of the external auditory canal (otitis externa), which is often triggered by pathogens or an allergic reaction. If the inflammation is not treated, it can spread to the surrounding soft tissues and infect other structures. Often, this also affects the eardrum, which can rupture. Severe pain and impaired hearing are the resulting consequences. In the worst cases, in addition to the soft tissues, the bone with the base of the skull can also be affected, and this can be destroyed due to the infection. In addition, there may be dysfunction of the nerves, especially those responsible for the facial muscles and the sense of hearing and balance. These cases are most common in diabetics and the elderly. Another possibility for an itchy ear is when there is no or hardly any ear wax (cerumen). Normally, this has the task of moistening the ear and protecting it from infection. If less is present, the ear is more at risk for infection and inflammation.
When should you go to the doctor?
An itchy ear usually indicates a middle ear infection, which definitely requires medical attention. However, at the first signs of such an inflammation, it is not mandatory to see a doctor. For the time being, the affected person can of course also resort to home remedies or to the medicine cabinet to get the inflammation under control. Anti-inflammatory agents such as chamomile are a very effective remedy at this point. However, if there is no significant improvement after one or two days, a doctor should be consulted immediately. In the case of a simple middle ear infection, a visit to the family doctor is sufficient. Of course, an ENT specialist can also be consulted as an alternative, but the treatment or the medication to be prescribed will probably not differ. As a rule, the affected person is given an antibiotic to inhibit the inflammation. Supplementary painkillers may also be prescribed, but these can be purchased from the doctor without a prescription. As a general rule, home remedies and medications can be taken on your own at the beginning of a middle ear infection. However, if there is no improvement after a short time, a visit to the doctor should not be put off. Otherwise, the inflammation can worsen considerably, so that it may even come to the formation of pus.
Treatment and therapy
If inflammation is diagnosed, the external auditory canal is thoroughly cleaned and possibly treated with a cortisone-containing agent. In addition, specific antibiotics are administered in the case of a bacterial infection, and appropriate antifungal agents are administered in the case of a fungal infection. Alternatively, instead of the cortisone-containing agent, chamomile tea (cold) can be carefully introduced into the ear canal as an antibacterial agent. If there is an allergy to certain classes of substances in shampoos or cosmetics, it is strongly recommended to discontinue the agents immediately. Possibly, alternative shampoos, soaps and cosmetics can be used that do not contain any of the specific allergens. In the case of a pronounced allergy, desensitization may be helpful.
Outlook and prognosis
An itchy ear is associated with impending inflammation in most cases. However, a visit to the doctor is not necessary until the itching becomes a constant and severe pain. Medical advice should also be sought in the case of a purulent discharge, as this clinical picture should be treated urgently with appropriate medication. If the itching occurs immediately after eating certain foods, this may be a sign of an allergic reaction. Going to the doctor is highly advisable at this point, because allergy therapy can provide a quick and uncomplicated remedy. Another cause of severe itching in the ear canal is foreign bodies in the ear. Insects or other small animals can get into the inner ear and cause the said itching due to their movements. Bacterial infections and inflammations can be caused by foreign bodies and animals very quickly. In this case, an ENT specialist must be consulted urgently. With appropriate aids, the ENT doctor can remove the animal or foreign body. In general: If a strong itching exists over a longer period of time, a doctor should definitely be consulted.The cause must be found out and treated accordingly.
Prevention
The best measures to prevent itching in the ear are omissions. The external auditory canal has small cilia that, for example, slowly transport the produced earwax to the outside. Therefore, cleaning the ear canal with cotton swabs or other means is unnecessary. Cleaning the ear canal with shampoos or soap is also counterproductive, because an acidic environment is created in the healthy ear canal, which would be severely disturbed by such measures. If earplugs or earphones are worn frequently or permanently, it is recommended to clean them more often with an alcoholic or antibacterial solution to prevent bacterial infections.
What you can do yourself
If the ear itches, it is not necessary to go directly to a doctor. Various home remedies and methods relieve the itching and address the causes. First, the ears should be carefully rinsed with water to flush out possible foreign bodies. The ear canals themselves should be professionally rinsed or superficially cleaned with warm water. Cotton swabs should be avoided due to the risk of injury. If the itching is due to an inflammation of the ear canal, cotton swabs soaked in high-proof [alcohol] can be placed in the auricle. After repeated application, the itching should decrease and any swelling in the ear canal should subside. If there is a fungal infestation, antifungal solutions or ointments containing cortisone are recommended. A natural alternative is chamomile tea. Ear oil or ear candles can also be applied to reduce itching in the ear. In case of allergy, the most effective remedy is prevention. Itching can be avoided by sealing the ears with absorbent cotton or an earplug before showering (if allergic to shampoo) or swimming (if allergic to chlorine). If the itching can no longer be managed with conventional home remedies and measures, a visit to an ear, nose and throat specialist is recommended.
