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Dermatitis of the Ear Canal

by Bradley W. Kesser, MD

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

Dermatitis of the ear canal can be an allergic reaction to triggers such as nickel-containing earrings and numerous beauty products (for example, hairsprays, lotions, and hair dye). This type is called contact dermatitis. Dermatitis of the ear canal can also occur spontaneously in some people who have certain kinds of dermatitis-like conditions such as seborrhea and psoriasis. This type is called aural eczematoid dermatitis.

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

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 corticosteroid creams. For more severely inflamed ears, corticosteroids taken by mouth (such as prednisone) may be prescribed.

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