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Dermatitis of the Ear Canal

(Chronic Otitis Externa)

By Bradley W. Kesser, MD, Professor, Department of Otolaryngology - Head and Neck Surgery, University of Virginia School of Medicine

Dermatitis of the ear canal is itching, scaling, flaking, and swelling of the skin of the ear canal and skin at the entrance of the ear canal.

There are two types of dermatitis of the ear canal:

  • Contact dermatitis

  • Aural eczematoid dermatitis

Contact dermatitis of the ear canal is an allergic reaction to triggers such as nickel-containing earrings and numerous beauty products (for example, hairsprays, lotions, and hair dye).

Aural eczematoid dermatitis of the ear canal can occur spontaneously in some people who have certain kinds of dermatitis-like conditions such as seborrhea and psoriasis.


Both types of dermatitis cause itching, redness, a clear discharge or moisture, and peeling, darkening, and painful cracking of the skin. The skin irritation and cracking may allow an infection caused by bacteria (acute external otitis) to develop. The first symptom of a bacterial infection is typically severe ear pain.


  • Corticosteroids

  • For contact dermatitis, elimination of allergic triggers

  • For aural eczematoid dermatitis, aluminum acetate solution

To treat contact dermatitis, people should eliminate allergic triggers, especially earrings and possibly even hearing aid molds. Trial and error may be needed to identify the allergic trigger. Doctors give people a cream containing a corticosteroid such as betamethasone to decrease swelling and itching. People should avoid putting cotton swabs, water, and other possibly irritating substances in the ear.

To treat aural eczematoid dermatitis, doctors give people drops of a diluted aluminum acetate solution (Burow solution) to put in the ear as often as is required for comfort. Itching and swelling can be reduced with a cream containing a corticosteroid (such as betamethasone). For more severely inflamed ears, corticosteroids taken by mouth (such as prednisone) may be prescribed. Again, avoidance of all irritants to the ear canal, such as cotton swabs and water, is an important part of the treatment of this condition.

External otitis is treated in standard fashion if it occurs.