Itchy Ears – A Universal Condition

JUST about everybody at one point or another has experienced itchy ears. One of the most common questions I am asked in my practice is: “what makes my ears itch?”

There are a variety of causes of itchy ears ranging from temporary and easily treatable to chronic and difficult to treat. Itchy ears can be grouped into two broad categories: non-pathological and pathological.

Non-pathological itching does not require treatment and results from normal bodily processes. It is  generally mild and short-lived.

Skin migration is the most common reason normal healthy ears  become itchy. The eardrum and the skin lining the ear canal are unique in that they are programmed to migrate laterally toward the ear canal opening. If you were to put a stain on the centre of the eardrum, you would observe it gradually move to the perimeter of the eardrum and then travel laterally along the ear canal wall. This progression of skin cells occurs at about the rate at which finger nails grow. By the time the migrating skin reaches the outer third of the ear canal, it begins to shed and mix with oils and perspiration to form ear wax.

As the ear canal contains a multitude of tiny nerve endings, it is highly sensitive to the movements of skin and ear wax. As the skin sheds into flakes (desquamates) it can produce a sensation of itchiness. Similarly moist ear wax can also irritate the skin.

The amount of ear wax you produce is partly determined by your genes and partly by environmental changes. Heat combined with humidity, strenuous physical activity, fever and stress are correlated with higher rates of ear wax production.

The best way to relieve the itching caused by non-pathological processes, is to gently massage the outside of the ear. You should avoid inserting any kind of implement into the ear canal, as it is likely to compress the ear wax back down towards the eardrum.

Dry ears may benefit from occasionally instilling a few drops of baby oil into the ear or application of glycerol based ear lotions.

Pathological causes of itchy ears stem from conditions which are not considered normal or healthy and may require medical treatment.

Infections of the outer ear (otitis externa) can produce itching which is often accompanied by inflammation, pain and discharge. Otitis externa is most commonly caused by bacterial or fungal infection. Bacteria can penetrate the skin after swimming, particularly in fresh water, or through scratches caused by manual probing.

Fungus is an opportunistic invader and may flourish during periods of steamy weather or in ears which are frequently blocked with ear wax, earplugs or hearing aids.

Depending on the severity of the condition, it may require treatment with topical antibiotics, anti-fungal  agents or corticosteroids. If excess debris is present, the ear may need to be debrided first to improve treatment efficacy.

Mild cases of otitis externa may benefit from instilling a solution of one part rubbing alcohol and one part white vinegar. An eyedropper can be used to instil a few drops of the solution with the head tilted over. The solution should be allowed to drain after a few minutes. Stinging may occur if the infection is anything but mild.

Dermatitis can also cause itchy ears. It may result from an auto-immune response such as in the case of psoriasis, or from an allergic reaction to certain metals, chemicals and soaps. It is advisable to prevent shampoo or soap from entering the ear while showering.

If you experience severe or chronic itching in the ears, or if the itching is accompanied by pain or discharge, ask your doctor or audiologist to examine your ear canals for signs of pathology.