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Dermatitis of the Ear Canal

(Chronic External Otitis)

By

Bradley W. Kesser

, MD, University of Virginia School of Medicine

Last full review/revision Oct 2019| Content last modified Oct 2019
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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

Causes

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 seborrheic dermatitis and psoriasis.

The skin irritation and cracking caused by dermatitis may allow a bacterial or fungal ear canal infection (acute external otitis) to develop.

Symptoms

Both types of dermatitis cause itching, redness, a clear discharge or moisture, and peeling, darkening, and painful cracking of the skin. In contrast, the first symptom of a bacterial infection is typically severe ear pain. Fungal ear canal infection causes more intense itching than pain.

Treatment

  • Topical (and for severe cases, oral) 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 containing nickel, hairsprays, 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. For more severely inflamed ears, corticosteroids taken by mouth (such as prednisone) may be prescribed.

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). 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.

Drugs Mentioned In This Article

Generic Name Select Brand Names
CELESTONE SOLUSPAN, DIPROLENE, LUXIQ
RAYOS
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