Itchy Ears

What you’ll learn:

• Why your ears may be itching and how to tell
• How to treat itchy ears depending on what’s causing it
• When to see an ENT physician for help with itchy ears

Tune into the We Nose Noses podcast for more episodes on common ENT issues, from itchy ears to sinus issues, and learn more about how NJ ENT & Facial Plastic Surgery can help.

Whether it’s itchy ears or other ENT concerns, the experienced professionals at NJ ENT & Facial Plastic Surgery are here to help provide relief. Contact us today to learn more about our services. We look forward to serving you. Visit us online at njent.com for more information about itchy ears and ENT procedures to treat them, or call us today to schedule an appointment. We’re here to help!

Listen to the audio version below.

Audio Transcript:

Samir Undavia: The other thing that I was going to say when helping to identify whether this is bacterial or fungal, not a hard and fast rule, but sometimes a really, really painful ear typically is more bacterial. An ear that’s just itchy and clogged, more likely to be fungal.

Hey, guys. It’s Dr. Undavia. With me, I have Dr. Reddy and Dr. Smith. We’re from NJ ENT & Facial Plastic Surgery. And today, we wanted to add to our podcast series by talking about itchy ears. We have tons of patients that talk about itchy ears and complain about itchy ears, and they haven’t found any solution. So we wanted to talk to you about what could potentially cause itchy ears and what we do about them. So I’m going to lead by starting to ask Dr. Reddy about some of the things that he’s seen in the office that have caused itchy ears. Well, first, Dr. Smith, can you show us what patients do when they tell you that they have itchy ears?

Greg Smith: Yeah. Seriously? So most patients come in and they say, “My ears are really…”

Samir Undavia: Yeah, you have to.

Greg Smith: “My ears are really itching.”

Samir Undavia: Yeah. Have you guys ever had itchy ears?

Greg Smith: And they say they keep trying to stick their finger in their ear because it itches. And so often…

Samir Undavia: Yeah, I’ve had itchy ears that it’s very, very deep. You can’t get to it. You can never get to it. Okay, thank you for that demonstration. Now, Dr. Reddy?

Nishant Reddy: Yeah. People stick all sorts of things in their ears it’s so itchy. So multiple different causes of itchy ears. The first step is to do a proper physical examination of the ears where we put an otoscope into the ears and take a look around, but some common causes include first, various infections. So different infections like viral infections, bacterial infections, or fungal infections can all cause itchy ears. So those include things like swimmer’s ears, or otitis externa. Otomycosis is a medical term for a fungal infection of the ear. And a lot of those infections can cause itchy ears. And if you treat the infection, then you generally can make the itchiness get better. Another cause is earwax. So excessive earwax build up can for some people cause itchiness. And if you clean up the earwax, then that can help improve things. And then eczema, dryness, psoriasis in the ear canal can do it, allergies. Those are some of the main kinds of causes of itchy ears.

Samir Undavia: You were telling us last night about a patient that you found with a hair in there. Want to talk about that?

Nishant Reddy: Yeah. So yep. So foreign bodies including hair, if it’s in the right particular spot can cause itchiness, or other symptoms like coughing. And if you clean that all up, then generally speaking, your itchiness gets better.

Samir Undavia: Yep, yep, yep. All right. Dr. Smith, let’s go after the infectious stuff first as related to an itchy ear. Do you want to talk about what you would normally do for that?

Greg Smith: Sure. So the first thing is to try to figure out what the cause of agent is for the infection, whether it’s fungal or bacterial. Fungal infections and bacterial infections typically have different treatments. If they’re really resistant infections, sometimes we’ll even culture the ear to try to determine what the makeup of the bacterial or fungal infection is. Most commonly, the routine prescribed medications typically work for fungal infections and bacterial infections, but every once in a while, a special medication may need to be compounded based off of what a culture may show. So some things that can give us physicians some clues about whether it’s bacteria or fungal, sometimes we can even see little mold spores or fungal spores inside the ear canal. So if we see these little white furry or gray furry extensions coming out of the ear skin, or if there’s cheesy, fungal debris within the ear canal, sometimes we’ll get some ideas if it’s fungal versus bacterial.

And often, it’s a problem with lack of improper acidification within the ear. The ears themselves make cerumen or wax, and that cerumen helps keep the ear canal healthy. The cerumen is oily and also acidic. And so it helps keep that warm, dark ear canal, which is a setup for fungal and bacterial infections, healthy so that we don’t end up with these infections. Some people often use Q-tips or other things to itch their ears, and that makes them more likely and more prone to get infections. Water exposure being trapped behind wax can make somebody more prone to get infections. So trying to figure out one, what the cause of it may have been. Whether it was just a dry itchy ear that someone kept using Q-tips and caused a break in the skin, allowing an infection to get through, or whether it’s chronic water exposure trapped behind wax from swimming, or someone who does water aerobics, and some daily water exposure can get these infections.

So always, we take a thorough history just to see if there’s a causative, something that we can do to prohibit these from recurring. And then treatment, usually it’s a topical treatment for the outer ear canal, whether it’s an ointment or a drop or a cream, depends on what the causative agent is, fungal infections, sometimes just re-acidifying the ear can help. So over-the-counter homeopathic treatments like alcohol-vinegar type solutions. And those are what the swimmer’s ear-over-the-counter type treatments are. They’re usually an acidifying agent and a drying agent to try to help dry the ear out. But often, those may not be enough. And so we can use antibiotic drops that we have prescribing abilities for, as well as antifungal drops and medications that we can prescribe. And some are over the counter, but most of these are prescription based.

Samir Undavia: The other thing that I was going to say when helping to identify whether this is bacterial or fungal, not a hard and fast rule, but sometimes a really, really painful ear typically is more bacterial. An ear that’s just itchy and clogged, more likely to be fungal. The other things are if the patient took an antibiotic for a foot infection or pneumonia or something, they’re more likely to have a fungal infection afterwards because you killed off all the good bacteria. The ear canal is actually a very sensitive balance of viruses, bacteria, and fungus. And when you kill off one, you raise the possibility of the others taking over and overflowing. I’ll talk a little bit about the allergy component of itchy ears. So if the patient really does have only itchy ears and doesn’t have itchy eyes or sneezing or coughing, we want to rehydrate the ear.

So we can use oils, just baby oil or mineral oil. Using a thicker oil can sometimes be helpful, but also can be a little bit clogging. So baby oils, mineral oils. If that’s not enough, we can use a prescription called DermOtic. And that is an oil that has a steroid inside of it. And you do five drops twice a day of that. It can be very, very helpful. This is not going to cure the problem. This is going to treat the symptoms. So if you stop using the drop and you still have whatever the allergy is that’s inciting this around you, you’re going to have the itchiness. So you’ll just need to use the drop when you have the allergies around it. If you have other symptoms like cough or runny nose or itchy eyes, sometimes using a systemic like Zyrtec or Claritin or Xyzal or Allegra, those can all be very helpful. Sometimes we need to put patients on nasal sprays too, just to get it into the station tubes so that the ear stops itching as well.

Greg Smith: Along the lines of the eczema and skin conditions that are related to allergy, sometimes the biggest enemy of the patient is them themselves with the chronic itching. So if they have dry ears and they don’t have a lot of wax and they continue to use Q-tips or pen caps or bobby pins or something to scratch the inside of the ear, that itself, that chronic inflammation from scratching will make the eczema worse, which then makes the itching worse. So it’s a cyclical thing that needs to get broken. And often, just instructing a patient to avoid any instruments and keeping the ears dry can sometimes be enough just to stop the ear itching.

Samir Undavia: I think we covered most of the topics pretty well. The visit is usually an easy visit for patients. So it’s often, you just come in, we take a look in the ear and we have a quick simple fix for you. Do you guys have anything else to add to that?

Nishant Reddy: Nope.

Greg Smith: No, I think that was great.

Nishant Reddy: I think we covered everything.

Samir Undavia: Cool. So once again, we’re NJ ENT & Facial Plastic Surgery. If you guys have any questions or comments, you can always email us at info@njent, or call or text us at 609-710-6673. Stay tuned and follow up for more podcasts coming soon. Take care.