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Itching in the ears: causes, diagnosis

 
, medical expert
Last reviewed: 20.07.2022
 
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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. It is quite acceptable to remove it with your fingertip, after which the discomfort immediately passes. But sometimes itching in the ears becomes intrusive, felt deep inside, accompanied by ear congestion and causes constant discomfort. These are already pathological signs. Do not try to eliminate them using cotton swabs or other devices, rinse your ear with a jet of water from a large syringe. In such ways, you can only aggravate the situation and even lose your hearing. 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 complete hearing loss for reasons, the vast majority of which could be prevented. More than a third of all cases of ear disease are otitis - external and middle ear, a quarter - fungal infections. Approximately 5% of the population of different ages visit medical institutions periodically for the removal of sulfuric plugs in the world. In addition, the ear can itch for other reasons. So the problem is quite common.

Causes of the itching in the ears

We have special glands (ceruminous) in our ears that secrete sulfur, a light brown substance that is a natural lubricant that performs protective functions. Sulfur protects the auditory canal from drying out, dust, dirt, water drops, various microorganisms and even small insects that enter from the outside are eliminated with it. 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 lingering 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-purification usually does not annoy us. But the annoying itching deep in the auditory canal, from which it 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 lubrication. The fact that sulfur intensively accumulates in the ears, clogging the ear passages, forming sulfur plugs and causing itching, is caused by its excessive secretion and / or insufficient self-cleaning, which are at risk for people who use hearing aids, do not remove headphones from their ears, elderly people, as well as those who regularly clean their ears with cotton swabs. In addition, such an anatomical feature as a narrowed or curved auditory canal also contributes to the formation of sulfur accumulation even with its normal secretion.

Low sulfur production leads to overdrying 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 external part of the ear canal is affected. In humans, otomycosis, in most cases, is caused by fungi of the genus Aspergillus (ear aspergillosis)  [1] and  Candida  (ear candidiasis). Other pathogens are found much less frequently. You can become infected when contaminated water enters the ear, scratching it with dirty hands or a hard object (match, hairpin). The causative agents of the fungus 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 the destruction of beneficial bacterial microflora. [2]

Infectious agents are not only fungal in origin, but also bacterial, viral. Often there is itching in the ear after otitis media, which arose as a complication of influenza, SARS, 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]

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

Itching in the ear canal may manifest allergy or  contact dermatitis , it can occur in patients with non-infectious dermatoses (psoriasis, eczema).

Chronic systemic diseases can be manifested by such a symptom as itching in the ears. Dryness of the skin surface in the ear canal occurs in people with reduced thyroid function. Disorder of the hormonal balance entails disruption of 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 disposal of toxins, and the skin is connected to this process.

With itching in the ears, the body can signal a deficiency of vitamins and mineral substances, which happens after prolonged adherence to dietary restrictions in the diet.

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

Parasitic invasions, for example, giardiasis complicated by dyskinesia or inflammation of the bile ducts, can also manifest as such a symptom.

Otokariasis - infection with an ear mite in our climatic zone occurs infrequently. A person cannot get infected from those ticks that parasitize in the ears of cats and dogs. An ear mite in humans is an insect most often brought from a trip to Asian countries (India, Thailand and others), where small parasites are waiting for their victims, hiding on vegetables and fruits, tree leaves. Larger ticks 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 doesn't happen very often.

Demodex  , a mite that parasitizes the sebaceous glands (Demodex brevis) and hair follicles (Demodex folliculorum) of the skin of the face, 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 skin richly supplied with sebaceous glands. Ears are not, so the desire to scratch them is unlikely to be the first symptom of demodicosis.

Often there is an itch in the ear from the bite of a mosquito or other bloodsucker. It is doubtful that the insect will fly deep into the ear, but its bite can cause allergies, and it will itch not only at the bite site from the outside, but deep in the ear canal.

There may be itching in the ears with neurological diseases. Its psychogenic nature is assumed if the examination does not indicate pathological changes associated with infection, inflammatory processes, injuries, peeling or sulfuric plugs are not found in the ears.

Acute respiratory viral infections are accompanied by cough and runny nose. However, itching in the ears with a cold (as we often call SARS) is also possible. The ear, throat and nose are closely related, and 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 cough reflex trigger there, it is they who begin to cough when they try to "dig" deep in the ear. Feedback can be traced with a cold: coughed - and itched in the ear.

A runny nose also leads to 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, leading to discomfort. In addition, with a cold in the ear, the production of a protective secret increases, the immune system reacts with an increase in 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 ear shell can be varied, as well as the pathogenesis of the appearance of this symptom, therefore, understanding the nature of its occurrence will help get rid of excruciating discomfort, for which you need to contact specialists. After all, without qualified diagnosis and treatment, many diseases can lead to hearing impairment up to its complete loss.

Symptoms of the itching in the ears

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

Nevertheless, the first signs of trouble may suggest in which direction it is advisable to look for the cause of discomfort.

Constant severe itching of the ears on the outside, perhaps, indicates an allergic reaction to contact with a new shampoo, a hat made of inappropriate material, a new hair dye, poorly rinsed bedding, a bite of a blood-sucking insect. Such symptoms at the end of a sunny day spent outdoors may indicate that you have burned skin on your ears, and if the day was windy, then it was windy. Ears can also get frostbite, in a warm room they will begin to itch. In addition to itching, other symptoms will appear, in particular, skin flushing and swelling. Allergy can be not only contact. Itchy skin anywhere can come from an unfamiliar food or drug.

If you are constantly in a room with increased dryness of the air and at the same time drink little water, your skin will begin to dry out. The ears, on the other hand, can 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, it is unlikely that the skin on the ears will “burn”, unless you comb 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 fullness and some local hyperthermia, may be the first sign of otitis externa ("swimmer's ear"). Usually, when dirty water infected with bacteria gets in, one ear is affected, in which the epithelium was damaged, however, bilateral inflammation of the external auditory canal is also possible. External otitis is not always of infectious origin. Inflammation may develop after chlorinated pool water enters the ear (as a reaction to the presence of chlorine). Long bathing, cold air on land can cause general hypothermia, which in total will end in external otitis media. With the development of the disease, some hearing impairment, hyperthermia and soreness are possible.

Xerosis (dry skin) of any etiology that occurs with chronic metabolic disorders can manifest itself as constant severe itching of the outer surface of the ears, exciting and auditory canal. At the same time, the accompanying symptoms suggest in which organ the pathological process is maturing. Renal itching is accompanied by dull pain in the lower back or slightly lower, dysuric disorders; hepatic - a taste of bitterness in the mouth, nausea, belching with the smell of rotten eggs, a yellowish tinge 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 changes, and blurred vision. Frequent colds and other infections simply 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 be 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. The ever-present weakness will remind of the deterioration of the general state of health.

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

Itching in the throat and ears can be a symptom of mycosis of the nasopharynx. At the same time, a whitish coating is noticeable in the throat, a sour smell is felt from the mouth, liquid discharge from the ears may appear. A fungal infection of the throat is also called fungal tonsillitis - while the throat is sore, the temperature may rise and the patient's well-being may worsen significantly.

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

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

Sometimes itching in the throat and ears accompanies the onset of ARVI, 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 also associated with damage to the ENT organs.

Pain and itching in the left, right ear, that is, any one, at least excludes systemic diseases. Most likely it may be acute otitis media, which is often complicated by a previous infectious disease. Intense shooting pain, congestion, hearing loss is usually felt on one side. Edema 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 occurs in the initial stage of the disease. The inflammatory process leads to swelling of the auditory canal, degreasing of its surface epithelium, hearing loss. In the acute stage, pain and discharge from the ear with a specific odor, containing desquamated crusts of the epidermis and fragments of fungal mycelium, join. Lymph nodes under the jaw, collarbones and back of the neck may increase. Common symptoms join - weakness, sleep disturbances, hyperthermia.

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

Itching and dryness in the ears, in addition to the xerosis described above, associated with 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, secretions will appear, through which the body will eliminate dead skin particles and fragments of fungal mycelium from the ear canal.

Itching in the ears and peeling 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 media. The disease is characterized by a long relapsing course. In the warm season, patients usually go into remission, and with the first autumn cold, an exacerbation occurs. Mild forms are characterized by flaking, 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, on which fatty thick crusts form. In places of rashes, the skin itches.

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

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

Itching in the ears and congestion - otomycosis may begin with such symptoms, other signs will appear a little later. In the presence of a sulfur plug in the ear, just such symptoms are usually felt, and others usually do not appear. Itching in the ear canal and congestion may indicate the development of otitis externa. In addition, it becomes warm in the ear, later there is pain when chewing, hearing loss, fever.

Allergic reactions to the 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. At the same time, the nose usually lays, abundant transparent discharge appears, the eyes turn red and watery and itchy in the throat. Itching in the ears and eyes is also most likely as a manifestation of an allergy to volatile substances. Similar symptoms may accompany the development of a viral infection. They will be followed by cough, runny nose, fever. Infection with a fungus 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 spots are most likely signs of a fungal or bacterial infection. They can be of different consistency, sometimes, with a more acute and advanced process, they simply “flow” from the ear. It happens that the discharge is detected only when cleaning the ear with a cotton swab or turunda. In addition, the patient usually begins to hear worse in the affected ear, there is noise in it, and there may be pain. With purulent otitis - shooting pain, high fever, swelling. Palpation at the locations of the nearest lymph nodes usually causes pain.

Transparent discharge is observed with allergies to the external auditory canal or damage to the integrity of the tympanic membrane. In the second case, complaints are characteristic that there is liquid in the ears and itching. These symptoms indicate the accumulation of exudate in the middle ear cavity (otitis media without signs of inflammation).

If the base of the skull is fractured, cerebrospinal fluid may leak from the ear canal, however, 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 an injury 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 cases described. This is due to the fact that the ear canal is clogged with sulfur or pus, a foreign body, or is greatly narrowed from edema. The noise may resemble the sound of a shell pressed against the ear, or it may be very loud and feel like a whistle of the wind, a ringing or a roar, and be accompanied by other symptoms already mentioned.

Itching in the head and ears - such clinical signs can be given by overdried skin for various reasons: from frequent shampooing with drying shampoos to systemic pathologies. In this case, dry peeling of the skin is observed, dandruff on the head. It can be dry: with insufficient moisture, beriberi, psoriasis. At the same time, the hair fades, loses its healthy shine and becomes brittle, cut at the ends. Rashes may appear on the skin.

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

Itching in the head and ears may indicate allergic dermatitis. Any hair care product, a perm, a new hat, a poorly rinsed pillowcase, exotic food, a drug, 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 the fact that the head and ears itch.

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

In pregnant women, literally from the first days, a powerful restructuring of the body begins to occur. First of all, immunity weakens, and against this background, you can “pick up” 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 can be caused by bile stasis.

The reasons may be different - the same sulfur plug or beriberi. But to self-medicate a pregnant woman is at 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 with the eyes. In no case should a child clean his ears with cotton swabs, even the so-called children's ones.

Ears are a self-cleaning system, even the water that enters healthy children's ears when bathing pours out on its own. The maximum that can be done after taking a bath is to blot the outside of the ear with a towel.

A child can be bitten by an insect in the ear. In this case, you can find the bite site and treat it with bepanthen or a rescuer.

Parasites such as lice may well appear in a child, especially one attending a kindergarten. Don't get too complex about this. In the civilized world, they have already come up with a special term "prosperous lice." Modern lice have adapted to sanitation and hygiene. They say they even prefer clean and not too thick hair. After all, it is not in vain 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 completely 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 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, both directly to the ears and other vital organs.

It is especially dangerous to remove the sulfur plug with improvised means - hairpins, toothpicks, cotton buds, which are often called ear buds. Unprofessional actions often lead to various complications. With a cotton swab, you can often push the sulfur accumulation deep into the ear canal or make it even more dense, break the eardrum and damage the ligaments of the ossicular chain.

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

Untimely or incorrect treatment of otitis media, fungal infections of the ear can lead to perforation of the eardrum and partial or complete hearing loss. Infections of external structures look more harmless at first and can be cured completely. However, if measures are not taken on time, then the inflammatory process spreads to the internal structures of the ear - the "swimmer's ear" transforms into otitis media. In the ear canal, favorable conditions are created for the reproduction of fungal flora. It's warm, dark and humid. The infection can spread to other ENT organs, skull bones (acute mastoiditis), brain structures.

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

Diagnostics of the itching in the ears

To determine the cause of the appearance of this discomfort, it is necessary to comprehensively examine, first of all, the hearing organs. The doctor listens to the patient's complaints, prescribes the necessary tests - a smear of discharge from the ear canal is necessarily 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). A change in other indicators may indicate the presence of trouble in the body. If chronic diseases are suspected, blood tests for sugar, thyroid hormones, liver tests, creatinine and urea levels may be ordered. General and specific urine tests are prescribed for suspected impaired renal function.

An ear examination (otoscopy) is performed using ear funnels that allow visualization of the external auditory canal (optical), tympanic membrane, check its integrity and mobility (pneumatic Sigle funnel). For inspection, a forehead reflector and an ear probe are also used. If hearing loss is suspected, audiometry is performed.

Optical endoscopy is a modern method for studying the internal structures of the ear and the nasopharyngeal orifice of the Eustachian tube.

A consultation of doctors of other specialties and any instrumental diagnostics can be prescribed to identify systemic diseases, manifested by such a symptom as itching in the ears.

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

Who to contact?

Treatment of the itching in the ears

Read more about the treatment in the publication Treatment of itchy ears .

Prevention

The main method of preventing the formation of wax plugs is proper ear hygiene. It is a self-cleansing 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 soap and water (shampoo) and dry with a towel.

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

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

Protect the skin of the ears from the sun, frost and other external influences. Do not constantly use the headphones, 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 discomfort, consult a doctor and find out their cause.

Forecast

The causes that cause itching in the ears are overwhelmingly not deadly. With a timely visit to the doctor, it is quite possible to get rid of unpleasant sensations.

In advanced and complicated cases, hearing may deteriorate up to its complete loss.

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