From the Guidelines
Ear itching is most commonly caused by dermatoses of the ear canal, such as eczema, seborrheic dermatitis, and contact dermatitis, as well as earwax buildup and allergies, and the best approach to address it is to identify and treat the underlying cause. To address ear itching, several factors should be considered, including:
- Dry skin: apply a few drops of mineral oil or baby oil around the ear canal entrance
- Earwax buildup: use over-the-counter earwax removal drops like Debrox or Murine (containing carbamide peroxide) following package instructions, typically 5-10 drops twice daily for 3-4 days 1
- Allergic reactions: try an oral antihistamine like cetirizine (10mg daily) or diphenhydramine (25mg every 6 hours)
- Fungal or bacterial infections: may require prescription medications from a healthcare provider
- Eczema or seborrheic dermatitis: management includes gentle skin care, application of emollients, prevention of secondary skin infection, and the use of topical corticosteroids and other antipruritics 1
- Contact dermatitis: avoidance of the metals that trigger a reaction and the application of topical corticosteroids hasten the resolution of allergic dermatitis 1 It is essential to avoid inserting objects into the ear canal as this can worsen irritation and potentially damage the ear. The ear canal has sensitive skin with minimal protective oils, making it prone to dryness and irritation. Additionally, the ear's warm, dark environment can foster microbial growth when moisture is present. If itching persists beyond a week, is accompanied by pain, discharge, hearing changes, or dizziness, consult a healthcare professional promptly. Some key points to consider when evaluating ear itching include:
- The ear canal's anatomy and physiology, which make it prone to dryness and irritation
- The potential for microbial growth in the ear canal, particularly in the presence of moisture
- The importance of avoiding inserting objects into the ear canal to prevent further irritation and potential damage
- The need to identify and treat the underlying cause of ear itching, whether it be dry skin, earwax buildup, allergies, or another factor.
From the Research
Causes of Ear Itching
- Eczema is a common skin condition that can cause ear itching, and topical corticosteroids are a first-line treatment for eczema 2
- Atopic dermatitis (AD) is a chronic inflammatory skin condition that can cause ear itching, and treatment options include skin moisturization, topical anti-inflammatory agents, and proactive therapy with twice weekly use of topical corticosteroids and calcineurin inhibitors 3
- Contact hypersensitivity to hydrocortisone can cause allergic skin reactions, including ear itching, in presensitized subjects 4
- Cumulative effects of corticosteroid exposure in patients with eczema can lead to worsening symptoms, development of new symptoms and conditions, and symptoms consistent with topical steroid withdrawal syndrome, which can include ear itching 5
- Topical corticosteroids can be applied to the ear to treat eczema and other inflammatory skin conditions, but prolonged use can increase the risk of adverse effects such as atrophy, striae, and rosacea 6
Risk Factors for Ear Itching
- Prolonged use of topical corticosteroids
- High-potency topical corticosteroids
- Occlusion
- Application to areas of thinner skin such as the face and genitals
- Contact hypersensitivity to hydrocortisone
- Cumulative effects of corticosteroid exposure