Do your ears itch all the time, but you can't get anything out? These are the five possible problems. Check them out now.

In our daily lives, we sometimes encounter a subtle problem: itchy ears.

To many people, this may seem like just a minor problem. But itchy ears may be more than just an itch. It may also be a sign of something going on inside the body that we should pay attention to and deal with in a timely manner.

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Itchy ears,

These may be the reasons

I believe everyone has experienced the feeling of itching. It is a common symptom rather than a specific disease. It can be seen in many skin diseases. In addition, itching may also be a manifestation of non-skin diseases such as systemic diseases, neurological diseases and mental illnesses.

Most cases of ear itching are itching in the external auditory canal area (the red circle area in the picture). The following are some possible causes of ear itching.

The ear is divided into the outer ear, middle ear, and inner ear. Image source: UpToDate

1. Cerumen

Commonly known as earwax, more or less cerumen in the external auditory canal may cause ear itching. But this "shit" is not only "excrement", it also has the function of protecting our ear canal.

Earwax is a yellowish, sticky substance secreted by the cerumen glands and sebaceous glands in the outer 1/3 of the skin of the external auditory canal. Earwax plays an important role in the ear.

First, it can block the entry of some foreign objects, such as small flies. Secondly, earwax also helps to form an acidic ear canal environment to inhibit the growth of bacteria and fungi. Furthermore, earwax is hydrophobic and can repel moisture, thereby preventing the formation of an ideal growth environment for microorganisms; finally, the stickiness of earwax also helps to stick to small debris in the environment. These functions together constitute the "skin-earwax barrier" of our ears.

Treatment: Under normal circumstances, earwax will fall off by itself as we chew, exercise, etc. If the earwax seems to be blocking the ear canal, but it is only in the form of thin flakes or small pieces and does not cause discomfort, it does not need to be removed deliberately.

When too much earwax causes obvious ear itching or forms a blockage, we should go to the hospital to seek help from a professional otolaryngologist. At this time, it is not recommended to do it yourself at home. If we blindly pick our ears, if the operation is improper, it may damage the external auditory canal wall or even the eardrum, and in severe cases it may cause secondary infection.

2. Fungal otitis externa

Just as food can become moldy under certain conditions, with the surface covered with fuzzy mold, so too can our ear canals, which can also be moldy, i.e., fungal infections.

Fungal infection may occur when the barrier of the external auditory canal is damaged, such as when the ear canal is soaked in water, the ear is dug, or unclean ear-digging instruments are used. Fungi tend to grow in the dark, warm environment deep in the ear canal, and sometimes even grow on the surface of the eardrum. Aspergillus niger and Candida albicans are common pathogenic fungi.

A typical symptom of fungal infection is itching in the ear, which may also be located deep in the ear. This fungal otitis externa is prone to recurrence and may last for months or even years.

Image source: UpToDate

Treatment: When treating fungal ear infections, the first and most important step is to fully clean the ear canal. This is usually done under an otoscope and may require multiple trips to the hospital to completely clean the ear canal. After thorough cleaning, topical medications will follow, including the use of acidifying solutions and antifungal medications.

It should be noted that there is a lack of antifungal drugs specifically for the ear on the market, so some drugs may cause some discomfort during use. Some liquid preparations can be diluted before use, while some cream-type antifungal ointments can be injected or applied into the ear canal.

If you use medications without first cleaning the ear canal, the treatment may be less effective. Therefore, visiting an ENT specialist and cleaning the ear canal is an important part of treating fungal ear infections.

3. Bacterial infection

When the ear canal barrier is damaged, in addition to the possibility of fungal infection, bacterial infection is also a problem that needs to be vigilant. Exudate and purulent secretions in the ear canal may cause itching symptoms.

Image source: UpToDate

Treatment: Cleaning the secretions is the first step, and local treatment is the main treatment, such as antibiotics and glucocorticoid ear drops. If the symptoms are very severe, systemic antibiotic treatment is needed.

4. Eczema

Like other parts of the skin, the skin of the ear canal may also develop eczema, causing itching. This itch is usually different from the deep itch of fungal infection, and is more often manifested as itching of the skin at the opening of the external ear canal. When the eczema is small, it may be limited to the ear canal and difficult to observe from the outside, but when the eczema is large, obvious skin changes can be seen around the opening of the ear canal.

Source: Outpatient case provided by the author

Treatment: When treating external auditory canal eczema, the treatment principles are the same as those for eczema in other areas of the skin. The first priority is to keep the skin moisturized. When symptoms are obvious, hormone creams can be used for treatment. It should be noted that when applying moisturizing lotion or vaseline, you should avoid reaching deep into the ear canal and only operate within the visible range to ensure safety.

5. Drying

Dry skin can also cause itchy ears, which is especially common in older adults.

Treatment: To relieve the discomfort caused by dryness, you can moisturize the ear canal opening appropriately.

Avoid these bad ear habits

1. Frequent ear cleaning

When their ears itch, some people can't help but pick their ears, which is sometimes pleasant and refreshing. But little do they know that this "bad habit" can sometimes cause pain, bleeding, or even problems.

I believe many people have experienced the vicious cycle of more itching and more digging. Although frequent ear digging with tools such as ear picks can bring temporary comfort, it can easily damage the ear canal barrier and cause fungal and bacterial infections.

If you have transient ear itching, you can press and rub the tragus to make yourself feel a little more comfortable. If the itching is really unbearable, it is recommended to go to the hospital for treatment to check whether there are any of the above diseases. Even if it is to clean earwax, it is recommended to be done in a professional ENT institution.

2. Use cotton swab to clean your ears

Some people may think that using cotton swabs to clean ears is safer than using ear spoons, but this is not the case. Cotton swabs can easily push earwax deep into the ear canal, where it will accumulate over time and become more difficult to clean and remove.

If water accidentally gets into the ear canal, you can tilt your head and gently bounce it to let the water flow out, or use a hair dryer at a low temperature and low setting, and blow dry it from an arm's length away from the ear.

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3. Ear cleaning

In addition, you should be cautious when visiting an ear cleaning shop. In the outpatient clinic, we often encounter cases where people come to the clinic to find fungal infections after having their ears cleaned. Although ear cleaning can bring relaxation and comfort, if the ear cleaning shop's instruments are not disinfected to standard, the ear canal is over-cleaned, or the operation is improper, it may lead to ear canal infection.

4. Always wear earplugs

Long-term use of earplugs, in-ear headphones or hearing aids may also affect the normal discharge of earwax, thereby increasing the risk of ear canal blockage and secondary ear canal infection.

Unless necessary, we should try to reduce the use time of earplugs and in-ear headphones. For those who must wear earplugs or hearing aids, if any discomfort occurs, they should go to the ENT department in time and have the doctor clean the ear canal if necessary.

Author: Dr. Li Huimin, otolaryngologist

Review | Pan Chunchen, deputy chief physician of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China