Itching in the ears: causes, diagnosis

The desire to scratch your ear is not so rare. We almost immediately involuntarily realize it, sometimes without even attaching importance to this action. Most often, such a reaction is caused by a piece of sulfur that has come to the very edge of the ear canal. Removing it with a fingertip is quite acceptable, after which the discomfort immediately passes. But sometimes the itching in the ears becomes obsessive, is felt deep inside, is accompanied by ear congestion and causes constant discomfort. These are already pathological signs. You should not try to eliminate them using cotton swabs or other devices, or wash your ear yourself with a stream of water from a large syringe. Such methods can only aggravate the situation and even lead to hearing loss. You need to see 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 for reasons, the vast majority of which could have been prevented. More than a third of all ear diseases are otitis - external and middle ear, a quarter - fungal infections. Periodically, about 5% of the world's population of different ages seeks medical attention for the removal of earwax. In addition, the ear can itch for other reasons. So the problem is quite common.

Causes itchy ears

We have special glands in our ears (ceruminous glands) that secrete sulfur, a light-brown substance, a natural lubricant that performs protective functions. Sulfur protects the ear canal from drying out, and it eliminates dust, dirt, water droplets, various microorganisms, and even small insects that enter from the outside. Settling on the lubricant, they do not penetrate further, but gradually move towards the exit, which is facilitated by chewing, swallowing, and talking. It is this lump of sulfur that lingers at the edge that can periodically be felt as an itch at the entrance to the ear canal. But everything that happens within the framework of natural self-cleaning usually does not irritate us. But the annoying itch deep in the ear canal, which is impossible to get rid of and abstract, brings significant inconvenience.

The reasons for this can be very different. For example, a violation of the production of ear lubricant. The fact that sulfur intensively accumulates in the ears, clogging the ear canals, forming sulfur plugs and causing itching, leads to its excessive secretion and / or insufficiently effective self-cleaning, at risk of developing which are people using hearing aids, who do not remove headphones from their ears, elderly people, as well as - lovers of regularly cleaning their ears with cotton swabs. In addition, such an anatomical feature as a narrowed or curved ear canal also contributes to the formation of sulfur accumulation even with normal secretion.

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

The most common infection that causes itching in the ear is a fungus. Most often, the outer part of the ear canal is affected. In humans, otomycosis is most often caused by fungi of the genus Aspergillus (ear aspergillosis) [ 1 ] and Candida (ear candidiasis). Other pathogens are found much less often. You can become infected by getting contaminated water into your ear, scratching it with dirty hands or a hard object (match, hairpin). Fungal pathogens live with us everywhere, so injuries 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. Mycosis often occurs after long-term treatment with antibacterial ear drops against the background of the destruction of beneficial bacterial microflora. [ 2 ]

Infectious agents are not only of fungal origin, but also bacterial and viral. Often, itching in the ear appears after otitis, which arose as a complication of influenza, acute respiratory viral infections, tonsillitis, sinusitis. It can be a symptom of erysipelas - infection of the skin of the face in the ear area with β-hemolytic streptococcus-A. [ 3 ]

People with weakened immunity are most susceptible to contracting various infections.

Itching in the ear canal may be a manifestation of an allergy or contact dermatitis; it may occur in patients with non-infectious dermatoses (psoriasis, eczema).

Chronic systemic diseases can manifest themselves with such a symptom as itching in the ears. Dryness of the skin surface in the ear canal occurs in people with reduced thyroid function. Hormonal imbalance entails disruptions in the functioning 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 disposal of toxins, and the skin joins this process.

Itching in the ears can be a sign that the body is experiencing a deficiency of vitamins and minerals, which can occur after a long period of dietary restrictions.

Often, it is the itching in the ears that becomes the most noticeable and painful manifestation of the early growth of intoxication. Moreover, the accumulation of toxins in the skin and the desire to scratch the ear can be provoked by chronic renal and/or hepatic insufficiency.

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

Otocariasis - infection with ear mites in our climate zone does not happen often. A person cannot become infected from those mites that parasitize in the ears of cats and dogs. The ear mite in humans is an insect most often brought from a trip to Asian countries (India, Thailand, etc.), where small parasites lie in wait for their victims, hiding on vegetables and fruits, tree leaves. Larger mites live in our latitudes, but it is impossible to completely exclude their penetration into the ear, like any other insect, for example, an ant. Although this does not happen very often.

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

Often, itching in the ear appears from a mosquito bite or other bloodsucker. 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 at the site of the bite on the outside, but deep in the ear canal.

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

Acute respiratory viral infections are accompanied by cough and runny nose. However, itching in the ears during a cold (as we often call ARVI) is also possible. The ear, throat and nose are closely connected, it is not for nothing that they are treated by the same specialist. The ear canal is rich in reflexogenic receptors. Many people have a trigger for the cough reflex there, they are the ones who start coughing when they try to "dig" deep into the ear. The feedback is observed during a cold: you cough - and your ear itches.

A runny nose also causes congestion and itching in the ear canal. Swelling and accumulation of mucus in the nasal passages and sinuses compresses the Eustachian tube, which connects the nasopharynx and middle ear, causing discomfort. In addition, when a cold occurs, the production of protective secretions in the ear increases, the immune system responds by increasing the nasopharyngeal lymph nodes, which also contributes to congestion and itching in the ears.

It is already clear that the risk factors for itching in the auricle can be varied, as well as the pathogenesis of this symptom, so understanding the nature of its occurrence will help get rid of the painful discomfort, for which it is necessary to contact specialists. After all, without qualified diagnostics and treatment, many diseases can lead to hearing deterioration up to its complete loss.

Symptoms itchy ears

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

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

Constant severe itching of the ears from the outside probably indicates an allergic reaction to contact with a new shampoo, a hat made of unsuitable material, a new hair dye, poorly rinsed bed linen, or a bite of a blood-sucking insect. Such symptoms at the end of a sunny day spent outdoors may indicate that the skin on your ears is sunburned, and if the day was windy, it is also chapped. Ears can also be frostbitten, and they will start to itch in a warm room. In addition to itching, other symptoms will appear, in particular, hyperemia of the skin and swelling. Allergies may not only be contact-related. Skin itching in any place can appear from unfamiliar food or a medicine.

If you are constantly in a room with increased dryness of air and at the same time drink little water, your skin will begin to dry out. Your ears may itch more because they are usually not protected by anything and, in addition to dryness in the room, are exposed to adverse environmental influences. In this case, the skin on your ears is unlikely to "burn", unless you scratch them. Rather, there will be peeling, the skin will become thin and "parchment-like". In addition, with dehydration, you will often be tormented by thirst.

Itching outside the ear canal, combined with a feeling of fullness and some local hyperthermia, may be the first sign of otitis externa ("swimmer's ear"). Usually, when dirty, bacteria-infected water gets in, one ear is affected, where the epithelium was damaged, but bilateral inflammation of the external auditory canal is also possible. External otitis is not always of infectious origin. Inflammation may develop after chlorinated water in a swimming pool gets into the ear (as a reaction to the presence of chlorine). Long swimming, cold air on land can cause general hypothermia, which will ultimately end in otitis externa. As the disease progresses, some hearing loss, hyperthermia and soreness are possible.

Xerosis (dry skin) of any etiology, arising from chronic metabolic disorders, can manifest itself as a constant severe itching of the outer surface of the ears, capturing the auditory canal. The accompanying symptoms suggest in which organ the pathological process is maturing. Renal itching is accompanied by a dull pain in the lower back or slightly lower, dysuric disorders; liver - a bitter taste in the mouth, nausea, belching with the smell of rotten eggs, a yellowish tint of the skin and 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 eating, thirst, weight change and deterioration of vision. Frequent colds and other infections simply cling to diabetics. With hypothyroidism, 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, gastrointestinal motility, hypothermia, hypotension, anemia are observed. It is worth noting that with systemic pathologies, itching in the ears can be and will "get" more noticeable 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, brittle. Constant weakness will remind you of the deterioration of your general health.

Psychogenic itching may be in one place or may be observed in several places. The patient may complain of various clinical symptoms, but physical and instrumental examinations and analyses usually do not confirm the presence of a pathological process corresponding to the complaints.

Itching in the throat and ears can be a symptom of nasopharyngeal mycosis. In this case, a whitish coating is noticeable in the throat, a sour smell is felt from the mouth, and liquid discharge from the ears may appear. Fungal infection of the throat is also called fungal tonsillitis - in this case, the throat is sore, the temperature may rise and the patient's health may significantly worsen.

The oral cavity, throat and ear can be infected with different pathogens. Most often, infection occurs in water, especially stagnant water. In this case, itching of the palate and ears is often felt. The palate becomes edematous, hyperemic or with a whitish coating, depending on the pathogen. To identify it, it is necessary to take a smear for analysis.

An allergic reaction from the respiratory organs is usually not limited to one particular one; all of them suffer to one degree or another: itching, swelling of the mucous membranes, clear discharge, and even an increase in body temperature can be part of a complex of manifestations of a hypersensitivity reaction.

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

Pain and itching in the left, right ear, that is, one of them, at least excludes systemic diseases. Most likely, it may be acute otitis media, which often complicates a previous infectious disease. Intense shooting pain, congestion, hearing loss are usually felt on one side. Swelling of the ear canal contributes to the accumulation of sulfur, 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 rise in temperature to 39℃ and above.

Pain and itching in one ear can be symptoms of otomycosis. Itching and congestion occur at the initial stage of the disease. The inflammatory process leads to swelling of the ear canal, degreasing of its surface epithelium, and hearing loss. In the acute stage, pain and discharge from the ear with a specific odor, containing exfoliated crusts of the epidermis and fragments of fungal mycelium, join in. The lymph nodes under the jaw, collarbones, and on the back of the neck can enlarge. General symptoms join in - weakness, sleep disorders, hyperthermia.

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

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

Itching and flaking in the ears can be a symptom of dermatosis - psoriasis, eczema. Seborrheic dermatitis is often localized in the external auditory canal and behind-the-ear folds. The scalp is also more often affected, but sometimes the only manifestation of this disease is external otitis. The disease is characterized by a long relapsing course. In the warm season, patients usually experience remission, and with the first autumn cold weather, an exacerbation occurs. Mild forms are characterized by flaking, moderate redness and itching. In more severe cases, a relapse begins with a rash of small follicles merging into larger erythemas with clear boundaries, round or oval in shape, on which greasy thick crusts are formed. The skin itches in places of rashes.

Celiac disease (gluten intolerance) is a rare autoimmune disease that has many symptoms, sometimes manifesting as excruciating itching and flaking of the ears.

If crusts and itching appear in the ears, the reason may be completely harmless, related to hygiene, both with complete neglect of ear care and with the passionate performance of hygiene procedures.

Itching in the ears and congestion - these are the symptoms that may begin otomycosis, other signs will appear a little later. With a sulfur plug in the ear, these are the symptoms that are usually felt, and usually no others appear. Itching in the ear canal and congestion 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 inhalation of irritating substances can manifest as itching in the nose and ears. These can be fumes and dust from washing powder, the smell of perfume or cologne, cosmetics, and other volatile substances. The nose usually gets stuffy, there is abundant clear discharge, the eyes become red and watery, and the throat is sore. Itching in the ears and eyes is also most likely as a manifestation of an allergy to volatile substances. Similar symptoms can accompany the development of a viral infection. They will be followed by a cough, runny nose, and fever. Fungal or bacterial infection with such symptoms also cannot be ruled out.

Itching and discharge in the ears can be signs of various pathologies. Cloudy, grayish or yellow-green are most likely signs of a fungal or bacterial infection. They can be of different consistencies, sometimes, with a more acute and advanced process, they simply “flow” from the ear. It happens that discharge is detected only when cleaning the ear with a cotton swab or stick. In addition, the patient usually begins to hear worse with the affected ear, there is noise in it, there may be pain. With purulent otitis - shooting pain, high temperature, swelling. Palpation in the places where the nearest lymph nodes are located usually causes pain.

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

When the base of the skull is fractured, cerebrospinal fluid may leak from the ear canal, although in such cases the symptoms are very serious (itching and fluid in the ears are unlikely to be its main manifestations).

Bloody discharge from the ear usually indicates injury or neoplasms.

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

Itching and noise in the ears can be observed in almost all of the described cases. This is explained by the fact that the ear canal is clogged with wax or pus, a foreign body, or has become very narrow due to swelling. The noise can resemble the sound of a shell pressed to the ear, or it can be very loud and felt like a whistle of wind, ringing, or roaring, and accompanied by other symptoms already mentioned.

Itching in the head and ears - such clinical signs can be caused by skin that is overdried for various reasons: from frequent washing of the head with drying shampoos to systemic pathologies. In this case, dry peeling of the skin is observed, on the head - dandruff. It can be dry: with insufficient moisture, vitamin deficiency, psoriasis. In this case, the hair becomes dull, loses its healthy shine and becomes brittle, split at the ends. Rashes may appear on the skin.

Dandruff can be greasy. Seborrheic dermatitis, caused by overproduction of sebum, is characterized by the formation of thick horny crusts and itching. Most often, it is localized on the scalp, capturing the external auditory canal and the area behind the ears.

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

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

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

Pregnant women literally from the first days begin to experience a powerful restructuring of the body. First of all, the immune system weakens, and against this background, you can "catch" a fungal or bacterial infection.

The expectant mother becomes more sensitive to many irritants, and itching in the ears during pregnancy may be a manifestation of an allergic reaction.

In the last trimester of pregnancy, itchy skin may be caused by bile stasis.

The reasons may be different – the same sulfur plug or vitamin deficiency. But self-medication for a pregnant woman is, at the very least, short-sighted. You need to discuss your problem with a doctor, perhaps undergo an examination and be treated under his supervision.

Itching in the ears of a child is most often caused by a lump of sulfur, which must be removed from the edge of the ear canal, but only where it can be seen by the eyes. In no case should you clean your child's ears with cotton swabs, even so-called children's ones.

Ears are a self-cleaning system, even water that gets into healthy children's ears during bathing, flows out by itself. The most you can do after taking a bath is to dry the auricle from the outside with a towel.

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

Parasites such as lice may well appear in a child, especially one attending a kindergarten. There is no need to be too complex about this. In the civilized world, a special term has already been invented: "successful lice infestation". Modern lice have adapted to sanitation and hygiene. They say that 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 and quite adult diseases. So, if you do not find a lump of sulfur, lice or a mosquito bite, then you should consult a doctor.

Complications and consequences

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

Removing earwax with improvised means is especially dangerous - hairpins, toothpicks, cotton swabs, which are often called ear swabs. Unprofessional actions often lead to various complications. A cotton swab can often push the earwax accumulation deeper into the ear canal or make it even denser, rupture the eardrum and damage the ligaments of the auditory ossicle chain.

Itching in the ears caused by dry air, hypersecretion of sulfur, psychogenic causes, does not directly pose a threat to 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 microtrauma and infection. So even innocent, at first glance, causes of itching require serious attention.

Untimely or incorrect treatment of otitis, fungal infections 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 cured completely. However, if measures are not taken in time, the inflammatory process spreads to the internal structures of the ear - "swimmer's ear" is transformed into otitis media. Favorable conditions for the reproduction of fungal flora are created in the ear canal. It is warm, dark and humid there. The infection can spread to other ENT organs, skull bones (acute mastoiditis), brain structures.

If a systemic pathology, which manifests itself as itching in the ear canal, is not detected in time, it can become a serious chronic disease, a cause of loss of ability to work and even premature death.

Diagnostics itchy ears

To determine the cause of the above 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 smear of discharge from the ear canal is taken to exclude/confirm the presence of fungal or bacterial flora. A clinical blood test may indicate the presence of an inflammatory process (increased ESR), an allergic reaction or parasitic invasion (eosinophils), changes in the immune status (lymphocytes, leukocytosis). Changes in other indicators may indicate the presence of trouble in the body. If chronic diseases are suspected, a blood test for sugar, thyroid hormones, liver function tests, creatinine and urea levels may be prescribed. General and specific urine tests are prescribed if renal dysfunction is suspected.

An ear examination (otoscopy) is performed using ear funnels, which allow visualization of the external auditory canal (optical), the eardrum, and checking its integrity and mobility (Ziegle pneumatic funnel). A frontal reflector and ear probe are also used for examination. If hearing impairment is suspected, audiometry is performed.

A modern method for examining the internal structures of the ear and the nasopharyngeal opening of the Eustachian tube is optical endoscopy.

A consultation with doctors of other specialties and any instrumental diagnostics may be prescribed to identify systemic diseases that manifest themselves with such a symptom as itching in the ears.

Based on the examination results, differential diagnostics are carried out to identify the cause of the pathology and prescribe effective treatment tactics.

Treatment itchy ears

For more information on treatment, read the publication Treatment for itching in the ears.

Prevention

The main method of preventing the formation of sulfur plugs is proper ear hygiene. This is a self-cleaning organ. You do not need to climb into the ear canal with cotton swabs and other devices. It is enough to wash the outer part of the ear with water and soap (shampoo) and dry it with a towel.

To avoid barotrauma, it is necessary to blow your nose correctly, alternately pinching one of the nasal passages and clearing the other of mucus.

Treat ENT diseases promptly, avoid ear injuries, prevent irritants from getting into the ear - protect them with an individual rubber cap from chlorinated water in the pool, wear a hat when working in a dusty room, test it when buying a new brand of hair dye, etc.

Protect the skin of the ears from the sun, frost and other external influences. Do not use headphones constantly, keep them clean, periodically wiping the parts that come into contact with the skin of the ear canal with an antiseptic.

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

If you experience any discomfort, consult a doctor and find out the cause.

Forecast

The causes of itching in the ears are, in the vast majority of cases, not life-threatening. If you contact a doctor in a timely manner, it is quite possible to get rid of the unpleasant sensations.

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