Itching in the ears: causes, diagnosis

The desire to scratch the ear is not so rare. We almost immediately realize it involuntarily, sometimes without even giving importance to this action. Most often such a reaction is caused by a piece of wax, which came to the very edge of the ear canal. It is quite acceptable to remove it with a fingertip, after which the discomfort immediately passes. But sometimes itching in the ears becomes compulsive, is felt deep inside, accompanied by ear stuffiness and causes constant discomfort. These are already pathological signs. Do not try to eliminate them with the use of cotton swabs or other devices, independently wash the ear with a stream of water from a large syringe. Such methods can only aggravate the situation and even lose hearing. It is necessary to consult a doctor and find out the origin of the discomfort.

Epidemiology

WHO statistics show that more than 5% of the world's population is recognized as disabled due to acquired hearing loss or total hearing loss from causes, the vast majority of which could have been prevented. Otitis media - external and middle ear - accounts for more than a third of all cases of ear disease, while fungal lesions account for a quarter. Periodically about 5% of the population of different ages seek treatment for wax plug removal worldwide. In addition, the ear can itch and from other causes. So the problem is quite widespread.

Causes of the itchy ears

Our ears have special glands (ceruminous glands) that secrete wax, a light brown substance that is a natural lubricant and has a protective function. Sulfur protects the ear canal from drying out, with it is eliminated dust, dirt, water droplets, various microorganisms and even small insects. Settling on the lubricant, they do not penetrate further, but gradually move towards the exit, which is facilitated by chewing, swallowing, talking. It is this lump of wax lingering at the edge that can occasionally be felt as itching at the entrance to the ear canal. But everything that happens within the natural self-cleaning usually does not irritate us. But annoying itching deep in the ear canal, from which it is impossible to get rid of and abstract, brings considerable inconvenience.

The reasons for this can be very different. For example, impaired production of ear lubricant. To the fact that wax accumulates intensively in the ears, clogging the ear canals, forming wax plugs and causing itching, leads to its excessive secretion and / or insufficiently effective self-cleaning, in the risk group of development of which are people who use hearing aids, who do not remove earphones from the ears, the elderly, as well as - those who like to regularly clean their ears with cotton swabs. In addition, an anatomical feature such as a narrowed or deviated ear canal also contributes to wax buildup, even if it is secreted normally.

Low wax production leads to drying of the ear canal epithelium, the formation of microcracks in it, which in itself can cause discomfort, and in addition and increase the risk of infection.

The most common infection that causes itching in the ear is fungus. The outer part of the ear canal is most often affected. In humans, otomycosis is mostly caused by fungi of the genus Aspergillus (aspergillosis of the ear) [1] and Candida (candidiasis of the ear). Other pathogens are much less common. You can get infected by contaminated water, scratching the ear with dirty hands or with a hard object (match, hairpin). Fungal pathogens live with us everywhere, so trauma to the epithelium of the ear canal, the presence of microcracks in it significantly increase the likelihood of infection, especially in combination with massive invasion. Often mycosis occurs after prolonged treatment with antibacterial ear drops against the background of destruction of beneficial bacterial microflora. [2]

Infectious agents have not only fungal origin, but also bacterial, viral. Often there is itching in the ear after otitis media, which occurred as a complication of influenza, acute respiratory viral infection, sore throat, maxillary sinusitis. It can be a symptom of rye - infection of the facial skin in the ear area by β-hemolytic streptococcus-A. [3]

Persons with reduced immunity are most susceptible to contracting various infections.

Allergies or contact dermatitis, it can occur in patients with non-infectious dermatoses (psoriasis, eczema).

Chronic systemic diseases can manifest with symptoms such as itchy ears. Dryness of the skin surface in the ear canal occurs in people with reduced thyroid function. Disorder of hormonal balance entails disturbances in the work of other organs and, accordingly, metabolism.

Xerosis may indicate diabetes mellitus. In this disease, the skin dries out due to trophic disorders caused by intoxication associated with hyperglycemia. The excretory organs cannot cope with the utilization of toxins, and the skin is involved in this process.

Itching in the ears, the body can signal a deficiency of vitamins and mineral substances, which happens after prolonged compliance with dietary restrictions in the diet.

Often it is itching in the ears that is the most noticeable and distressing manifestation of the early onset of intoxication. The accumulation of toxins in the skin and the desire to scratch in the ear can be provoked by chronic renal and/or hepatic failure.

Parasitic infestations, such as giardiasis complicated by dyskinesia or inflammation of the bile ducts, can also manifest this symptom.

Otocariasis - ear mite infestation is uncommon in our climate zone. A person cannot get infected from those mites that parasitize in the ears of cats and dogs. The human ear mite is an insect brought most often from a trip to Asian countries (India, Thailand and others), where small parasites wait for their victims, lurking on fruits and vegetables, tree leaves. In our latitudes there are larger mites, but it is impossible to completely exclude their penetration into the ear, as well as any other insect, such as an ant. Although this does not happen too often.

Demodex is a mite that parasitizes the sebaceous glands (Demodex brevis) and hair follicles (Demodex folliculorum) of the facial skin, but can also settle at the entrance to the ear canal and cause itching in the ear drum. This parasite feeds on sebum and prefers areas of skin that are abundantly supplied with sebaceous glands. The ears are not, so the desire to scratch them is unlikely to be the first symptom of demodectic disease.

Itching in the ear from a mosquito or other bloodsucker bite is not uncommon. It is doubtful that the insect will fly deep into the ear, but its bite can cause an allergy, and it will itch not only in the place of the bite from the outside, but deep in the ear canal.

Itching in the ears may appear in neurological diseases. Its psychogenic nature is assumed, if the examination does not indicate pathological changes associated with infection, inflammatory processes, trauma, no flaking or wax plugs are found in the ears.

Acute respiratory viral infections are accompanied by a cough and runny nose. However, itching in the ears with a cold (as we often call acute respiratory viral infections) is also possible. The ear, throat and nose are closely related, not without reason they are treated by the same specialist. The ear canal is rich in reflexogenic receptors. In many people there is the trigger of the cough reflex, it is they who start coughing when they try to "dig" deep into the ear. The inverse relationship can be traced back to colds: if you cough, you get an itch in your ear.

A runny nose also leads to a stuffy and itchy ear canal. Swelling and accumulation of mucus in the nasal passages and sinuses squeezes the Eustachian tube that connects the nasopharynx and middle ear, resulting in discomfort. In addition, a cold increases the production of protective secretion in the ear, the immune system reacts by enlarging the nasopharyngeal lymph nodes, which also contributes to stuffy and itchy ears.

It is already clear that the risk factors for itching in the ear can be varied, as well as the pathogenesis of this symptom, so get rid of excruciating discomfort will help to understand the nature of its occurrence, for which it is necessary to consult a specialist. After all, without qualified diagnosis and treatment, many diseases can lead to deterioration of hearing up to its complete loss.

Symptoms of the itchy ears

A constant desire to scratch in the ear canal, usually accompanied by other manifestations - ringing in the ears, noise, stuffiness, soreness, hearing loss, is a serious reason for examination in a medical institution, because such symptoms can manifest themselves in various pathologies. Only a specialist can accurately answer the question about the cause of discomfort.

Nevertheless, the first signs of trouble can suggest in which direction it is advisable to look for the cause of unpleasant sensations.

Constant strong itching of the ears outside, perhaps, indicates an allergic reaction to contact with a new shampoo, a cap of inappropriate material, new hair dye, poorly rinsed bedding, a bite of a bloodsucking insect. Such symptoms at the end of a sunny day spent outdoors can indicate that you have burned skin on your ears, and if the day was windy - and weathered. You can also get frostbite on your ears, and in a warm room they will start to itch. In addition to itching, other symptoms will appear, in particular, skin hyperemia and swelling. Allergies can be more than just contact allergies. Skin itching anywhere can occur from an unfamiliar food or medication.

If you are constantly in a dry environment and drink little water, your skin will start to dry out. Your ears may itch more because they are usually unprotected and, apart from the dryness of the room, are exposed to unfavorable environmental influences. In this case, it is unlikely that the skin on the ears will "burn", unless you brush them. Rather there will be peeling, the skin will become thin and "parchment". In addition, when dehydrated, you will often be thirsty.

Itching outside the ear canal, combined with a feeling of swelling and some local hyperthermia, may be the first sign of otitis externa ("swimmer's ear"). Usually, when dirty, bacteria-infected water is ingested, one ear is affected where the epithelium has been damaged, but bilateral inflammation of the external auditory canal is also possible. External otitis media is not always of infectious origin. Inflammation may develop after chlorinated pool water enters the ear (as a reaction to the presence of chlorine). Prolonged bathing, cold air on land can cause general hypothermia, which in sum ends up with otitis externa. As the disease progresses, there may be some hearing loss, hyperthermia and soreness.

Xerosis (dry skin) of any etiology, arising from chronic metabolic disorders, may manifest itself as constant severe itching of the outer surface of the ears, including the ear canal. Accompanying symptoms in this case suggest in which organ the pathological process is maturing. Renal itching is accompanied by dull pain in the lower back or just below, dysuric disorders, hepatic - the taste of bitterness in the mouth, nausea, belching with the smell of rotten eggs, yellowish tint of the skin and the sclera of the eyes, heaviness or pain under the right rib, the appearance of brownish liver spots on the skin. Diabetics may experience weakness after meals, thirst, weight changes and visual impairment. Frequent colds and other infections just cling to diabetics. With hypothyroidism, there is swelling of the mucous membranes of the ear, throat and nose and deterioration of their patency, coarsening of the voice, slowness - the patient simply "sleeps on the go", a decrease in all functions - heart rate, motility of the gastrointestinal tract, hypothermia, hypotension, anemia. It is worth noting that with systemic pathologies, itching in the ears can be and will "get" more noticeably than in other places, but the entire surface of the skin will suffer, in addition, the quality of nails and hair will deteriorate. They will lose elasticity and become dull and brittle. About the deterioration of the general state of health will be a reminder of the constantly present weakness.

Psychogenic pruritus may be in one particular place, or it may be observed in several places. The patient may complain of different clinical symptoms, but physical and instrumental examinations and tests usually do not confirm the presence of a pathologic process corresponding to the complaints.

Itching in the throat and ears can be a symptom of nasopharyngeal mycosis. In this case, a whitish plaque is visible in the throat, a sour odor is felt from the mouth, and liquid discharge from the ears may appear. Fungal infection of the throat is also known as fungal sore throat, which can cause sore throat, fever and significant deterioration of the patient's health.

Infection of the mouth, throat and ear can be caused by a variety of pathogens. Most often, infection occurs in water, especially standing water. It is not uncommon to experience itching of the palate and ears. The palate becomes swollen hyperemic or with a whitish plaque, depending on the pathogen. To identify it, it is necessary to take a smear for analysis.

Allergic reaction on the part of the respiratory organs is usually not limited to any one, suffer to some extent all: itching, swelling of the mucous membranes, clear discharge and even an increase in body temperature can be in the complex of manifestations of hypersensitivity reactions.

Sometimes itching in the throat and ears accompanies the onset of acute respiratory viral infections, with dehydration due to dryness itchy skin and mucous membranes in different places, however, such a fairly clear localization suggests that the cause is associated with the lesion of the ENT organs.

Pain and itching in the left ear, right ear, that is, any one ear, at least rules out systemic disease. Most likely it may be acute otitis media, which is often complicated by a previous infectious disease. Intense shooting pain, congestion, and hearing loss are usually felt on one side. Swelling of the ear canal contributes to the accumulation of wax, the secretion of which increases. The ear itches deep inside, attempts to touch it cause increased pain. Acute inflammation of the middle ear in most cases is accompanied by a temperature of 39℃ or more.

Pain and itching in one ear can be symptoms of otomycosis. Itching and stuffiness occurs in the initial stage of the disease. The inflammatory process leads to swelling of the ear canal, degreasing of its surface epithelium, hearing loss. In the acute stage, pain and discharge from the ear with a specific odor, containing sloughing crusts of the epidermis and fragments of fungal mycelium. The lymph nodes under the jaw, clavicles and back of the neck may enlarge. General symptoms such as weakness, sleep disturbances, and hyperthermia may occur.

Pain and itching in one ear can be a consequence of traumatic injury - insect bite, foreign body, age-related vascular disorders, constant unilateral noise exposure, as well as - be psychogenic in nature.

Itching and dryness in the ears, in addition to xerosis described above, accompanying chronic diseases or dehydration, may indicate the initial stage of fungal infection. Fungi, spreading on the skin, contribute to its degreasing, dryness leads to peeling. Later, other signs of mycosis will join, in particular, there will be secretions, through which the body will eliminate dead skin particles and fragments of fungal mycelium from the ear canal.

Itchy ears and flaking can be a symptom of dermatosis - psoriasis, eczema. Seborrheic dermatitis is often localized in the external ear canal and behind-the-ear folds. More often affected and scalp, but sometimes the only manifestation of this disease is otitis externa. The disease is characterized by a long recurrent course. In the warm season, patients usually go into remission, and with the first fall cold weather comes exacerbation. For mild forms are characterized by desquamation, moderate redness and itching. In more severe cases, relapse begins with a rash of small follicles, merging into larger erythema with clear boundaries, round or oval shape, on which are formed fatty thick crusts. The skin itches at the sites of rashes.

Celiac disease (gluten intolerance) is a rare autoimmune disorder that has many symptoms sometimes manifesting as excruciating itchy, flaky ears.

If there are crusts and itching in the ears, the cause may be quite harmless, associated with hygiene, and, both with complete neglect of ear care, and with the biased performance of hygienic procedures.

Itchy and stuffy ears - these are the symptoms that can start otomycosis, but other symptoms will appear later. If there is a wax plug in the ear, these are the symptoms that are usually felt, and others usually do not appear. Itching in the ear canal and stuffiness may indicate the development of otitis externa. In addition, the ear becomes warm, later there is pain when chewing, hearing loss and fever.

Allergic reactions to the inhalation of irritating substances can manifest as itching in the nose and ears. This can be fumes and dust from laundry detergent, the smell of perfume or cologne, cosmetics, other volatile substances. The nose is usually blocked, there is abundant transparent discharge, red and watery eyes and throat itching. Itching in the ears and eyes is also the most likely manifestation of allergy to volatile substances. Such symptoms may accompany the development of a viral infection. They will be followed by coughing, runny nose, fever. Infection with fungus or bacterial infection cannot be excluded in such symptoms.

Itching and discharge in the ears can be signs of different pathologies. Turbid, grayish or yellow-green are most likely signs of fungal or bacterial infection. They can be of different consistency, sometimes, with a more acute and neglected process simply "flows" from the ear. It happens that the discharge is detected only when cleaning the ear with a cotton turunda or a stick. In addition, the patient usually begins to hear worse affected ear, there is noise in it, there may be soreness. With purulent otitis media - shooting pain, fever, swelling. Palpation at the location of the nearest lymph nodes usually causes pain.

Transparent discharge is observed with allergy of the external auditory canal or damage to the integrity of the tympanic membrane. The second case is characterized by complaints of fluid in the ears and itching. These symptoms indicate an accumulation of exudate in the middle ear cavity (middle exudative otitis media without signs of inflammation).

In a skull base fracture, cerebrospinal fluid may leak from the ear canal, but in such cases the symptomatology is very serious (itching and fluid in the ears are unlikely to be its main manifestations).

Bloody discharge from the ear usually indicates ear trauma or neoplasm.

Sometimes sulfur has a very liquid consistency, brownish copious discharge may be a sign of its hypersecretion.

Itching and tinnitus can be observed in almost all of the described cases. This is because the ear canal is clogged with wax or pus, a foreign body, or is severely narrowed by swelling. The noise may resemble the sound of a shell pressed against the ear, or it may be very strong and feel like wind whistling, ringing or roaring and be accompanied by the other symptoms already mentioned.

Itching in the head and ears - such clinical signs can give dry skin for various reasons: from frequent washing of the head with drying shampoos to systemic pathologies. In this case, there is dry flaking of the skin, on the head - dandruff. It can be dry: with insufficient moisturization, avitaminosis, psoriasis. In this case, the hair becomes dull, loses its healthy luster and becomes brittle, split at the ends. Rashes may appear on the skin.

Dandruff can be oily. Seborrheic dermatitis, caused by overproduction of sebum, is characterized by the formation of thick horny crusts and itching. It is most often localized on the scalp, affecting the external ear canal and the area behind the ears.

Itching in the head and ears may indicate allergic dermatitis. Any hair care product, perm, new cap, poorly rinsed pillowcase, exotic food, medication, and more can cause such a reaction.

Parasites: lice, mites (Demodex folliculorum), eczema bacterial, fungal, allergic, neglect of hygiene even in the absence of parasitic infestation leads to that itchy head and ears.

Itching in the ears is most pronounced at night, and in almost all cases, and especially allergic. Time of day is not a diagnostic marker and is not a characteristic symptom.

Pregnant women literally from the first days of pregnancy begins to undergo a powerful restructuring of the body. First of all, the immune system weakens, and against this background it is possible to "catch" a fungal or bacterial infection.

The expectant mother becomes more sensitive to many irritants, and itchy ears in pregnancy can be a manifestation of an allergic reaction.

In the last trimester of pregnancy, bile stasis can be the cause of skin itching.

The reasons may be different - the same wax plug or vitamin deficiency. But self-medication for a pregnant woman is at least shortsighted. It is necessary to discuss your problem with a doctor, possibly undergo an examination and be treated under his supervision.

Itching in a child's ears is most often caused by a lump of wax, which should be removed at the edge of the ear canal, but only where it can be seen with the eyes. Cleaning the ears of a child with cotton swabs is not allowed in any case, even with so-called children's cotton swabs.

The ears are a self-cleaning system, even water that gets into healthy baby ears when bathing will drain out on its own. The most you can do after bathing is to blot the outside of the ear with a towel.

Your baby may be bitten on the ear by an insect. In this case, you can find the bite site and treat it with Bepanthen or Rescue.

Parasites such as lice may well appear in a child, especially a child attending kindergarten. Do not be too complex about it. In the civilized world, a special term has already been coined, "safe lice". Modern lice have adapted to sanitation and hygiene. They say they even prefer clean and not too thick hair. It is not for nothing that pharmacies offer a number of remedies for pediculosis, including imported ones.

Constant itching in the ears of a child can be a symptom of infection, nutritional errors, injuries, otitis media and quite adult diseases. So, if you do not find a lump of wax, lice or a mosquito bite, it is worth consulting a doctor.

Complications and consequences

It is impossible to ignore the constant itching in the ears. Such discomfort brings too much inconvenience to our lives. In addition, it can be a symptom of serious diseases of the ears and other vital organs.

Especially dangerous is the removal of wax plugs by improvised means - pins, toothpicks, cotton swabs, which are often so called - ear plugs. Unprofessional actions often lead to various complications. A cotton swab can often push the wax accumulation deep into the ear canal or make it even more dense, rupture the eardrum and damage the ligaments of the ear ossicle chain.

Itching in the ears, caused by dry air, wax hypersecretion, psychogenic causes, does not directly threaten the hearing organs, but creates discomfort and causes a constant desire to scratch the ear. And it is this action that increases the likelihood of microtraumas and infection. So even innocent, at first glance, the causes of itching require a serious attitude.

Untimely or improper treatment of otitis media, fungal lesions of the ear can lead to perforation of the eardrum and partial or complete hearing loss. Infections of external structures initially look more harmless and can be treated completely. However, if measures are not taken in time, the inflammatory process spreads to the inner structures of the ear - "swimmer's ear" is transformed into otitis media of the middle ear. In the ear canal, favorable conditions are created for the reproduction of fungal flora. It is warm, dark and humid. The infection can spread to other ENT organs, skull bones (acute mastoiditis), brain structures.

Not detected in time, systemic pathology, the manifestation of which was itching in the ear canal, can become a serious chronic disease, the cause of disability and even premature death.

Diagnostics of the itchy ears

To determine the cause of this discomfort, it is necessary to conduct a comprehensive examination, first of all, of the hearing organs. The doctor listens to the patient's complaints, prescribes the necessary tests - a swab of discharge from the ear canal is necessarily taken to exclude/confirm the presence of fungal or bacterial flora. Clinical blood tests may indicate the presence of inflammation (increased COE), allergic reaction or parasitic invasion (eosinophils), changes in immune status (lymphocytes, leukocytosis). Changes in other indicators may indicate the presence of unfavorable conditions in the body. If chronic diseases are suspected, blood tests for sugar, thyroid hormones, liver tests, creatinine and urea levels may be prescribed. General and specific urine tests are prescribed if kidney dysfunction is suspected.

Ear examination (otoscopy) is performed with the help of ear funnels that allow visualizing the external auditory canal (optical), tympanic membrane, check its integrity and mobility (pneumatic funnel Ziegle). A frontal reflector and an ear probe are also used for examination. If hearing loss is suspected, audiometry is performed.

Optical endoscopy is a modern method of examining the internal structures of the ear and the nasopharyngeal orifice of the eustachian tube.

Consultation with physicians of other specialties and any instrumental diagnostics may be prescribed to detect systemic diseases manifested by such a symptom as itching in the ears.

According to the results of the examination, differential diagnosis is carried out to identify the cause of the pathology and the appointment of effective treatment tactics.

Treatment of the itchy ears

For details on treatment, see Treating itchy ears.

Prevention

The main method of preventing wax plugs is proper ear hygiene. It is a self-cleaning organ. There is no need to use cotton swabs and other devices in the ear canal. It is enough to wash the outer part of the ear with soap and water (shampoo) and dry it with a towel.

To avoid barotrauma, it is necessary to blow your nose correctly by alternately clamping one of the nasal passages and releasing mucus from the other.

Treat diseases of the ENT organs in a timely manner, avoid ear injuries, prevent irritants from entering the ear - protect them with an individual rubber cap from chlorinated water in the swimming pool, wear a headgear while working in a dusty room, do a test when buying a new brand of hair dye, etc.

Protect the skin of the ears from sun, frost and other external influences. Do not use headphones all the time, keep them clean by periodically wiping the parts in contact with the skin of the ear canal with antiseptic.

Strengthen your immune system by living a healthy lifestyle and eating right.

In case of discomfort, consult a doctor and find out the cause.

Forecast

The causes of itching in the ears, in the vast majority of cases are not deadly. It is quite possible to get rid of unpleasant sensations if you contact a doctor in time.

In advanced and complicated cases, hearing may deteriorate to the point of complete hearing loss.