Itchy Ears: Causes, Itching Deep Inside and What Helps

01Why

Why ears itch

The outer ear canal is lined with skin that makes wax and constantly renews itself. Wax keeps the canal moisturised and protected. When the skin becomes dry, inflamed or irritated, or when the natural wax layer is removed, nerve endings in the skin send itch signals. Scratching damages the skin further, removes more wax and creates small breaks where bacteria and fungi can enter, starting an itch–scratch cycle.

02Causes

Common causes of itchy ears

• Dry skin: often from over-cleaning, frequent swimming or showers, or cold weather.
• Eczema and dermatitis: red, flaky, itchy skin in and around the ear.
• Seborrhoeic dermatitis: greasy, yellowish flakes, often also on the scalp and eyebrows.
• Psoriasis: thick, silvery scaling that may extend into the canal.
• Allergic contact dermatitis: reactions to shampoo, hair dye, earrings, earbuds or hearing aid moulds.
• Earwax build-up: a blocked, itchy feeling; see earwax removal at home.
• Otitis externa: itching that progresses to pain, discharge and swelling.
• Fungal infection (otomycosis): intense itching, fullness and sometimes visible white, grey or black debris.
• Hay fever and food allergies: itching felt deep in the ear or throat.

03Night

Itching deep inside the ear at night

Itching deep in the ear is often noticed more at night when there are fewer distractions, and heat from pillows can increase it. It is usually due to dry or inflamed skin in the inner part of the canal, an early infection, or allergies, which can cause itching felt deep in the ear because the throat and ear share nerve supply. Occasionally hair growth or a foreign body is responsible. Avoid putting anything into the ear to reach the itch; a warm, not hot, compress on the outside of the ear and treatment of allergies may help while you wait to be seen.

04Dry

Dry, flaky skin in the ear canal

Dry, flaky skin in the ear canal is common in people with eczema, seborrhoeic dermatitis or psoriasis, and in those who clean their ears frequently. A couple of drops of olive oil or almond oil once or twice a week can soothe dryness, provided the eardrum is intact. If flakes are thick, red or keep returning, a doctor may prescribe a mild steroid drop or ointment for short periods, and an antifungal treatment if fungi are involved. Treating scalp dermatitis with suitable shampoos often helps the ears as well.

05Relief

Safe ways to relieve itchy ears

• Stop using cotton buds, fingers, hairpins or other objects in the ear canal.
• Keep ears dry: tilt your head after swimming or showering and dry the outer ear gently with a towel; use earplugs or a swimming cap if you swim often.
• Use a hairdryer on a low, cool setting held away from the ear to dry it.
• Apply one or two drops of olive oil occasionally for dryness, if the eardrum is not perforated.
• Switch to fragrance-free hair products and keep hairspray away from the ears.
• Clean earbuds and hearing aids regularly and give your ears breaks from them.
• Treat hay fever with antihistamines if allergies are a trigger.

06Drops

Ear drops for itching

Over-the-counter acidifying drops (often containing acetic acid) can help prevent infection in people who swim frequently. Prescription drops include mild steroids for eczema and dermatitis, antibiotic and steroid combinations for otitis externa, and antifungal drops for otomycosis. Using steroid or antibiotic drops for long periods without review can cause problems, including fungal infections, so they should be used as directed. Drops should not be used if the eardrum may be perforated unless a doctor confirms they are safe.

07Infection

When itching is an infection

Otitis externa often begins with itching, then the ear becomes painful, especially when the outer ear is pulled or pressed, with swelling, discharge and muffled hearing. It is common after swimming and is described in our guide to swimmer’s ear. A doctor can clean the canal and prescribe drops. Fungal infections tend to itch more and hurt less, and are more likely after long courses of antibiotic drops or in humid climates. Middle ear infections behind the eardrum usually cause pain and hearing loss rather than itching.

08Cases

Three common situations

• Daily cotton bud user with itchy, dry ears: stopping cotton buds for a few weeks and using occasional oil drops usually breaks the itch–scratch cycle.
• Hearing aid user with itchy, red ear canals: the mould material, poor fit or trapped moisture may be responsible; ask the audiologist to check the fit and materials.
• Swimmer with an itchy ear that is now painful: this suggests otitis externa; see a doctor or pharmacist for drops and keep the ear dry until it heals.

09Summary

Key points to remember

• Itchy ears usually come from dry or irritated skin, skin conditions, allergies or over-cleaning.
• Avoid cotton buds and scratching inside the ear.
• Keep ears dry and use gentle oil drops for dryness.
• Pain, discharge, swelling or hearing loss need medical review.