Itchy ears: causes, treatment and what to avoid

The right treatment depends on what is behind the itch, so the first step is working out whether it is skin, wax or an infection. The NHS and NHS inform give consistent advice for the common causes.

For an outer ear infection (otitis externa), the NHS says a pharmacist or GP may give antibiotic tablets or eardrops, antifungal or steroid eardrops, or painkilling eardrops. NHS inform says ear drops usually improve symptoms within a few days and are used several times a day for about a week. NICE CKS lists self-care measures: avoiding ear trauma, keeping the ear clean and dry, and considering over-the-counter acetic acid 2% ear drops or spray, with topical antibiotic or antifungal preparations considered depending on clinical judgement.

For earwax, the NHS suggests lying on your side and putting 2 to 3 drops of olive or almond oil in the ear (not almond oil if you are allergic to almonds), staying there for 5 to 10 minutes and repeating 3 to 4 times a day for 3 to 5 days. A pharmacist can suggest medicines to dissolve the wax.

For eczema or dermatitis in and around the ear, the NHS lists treating conditions that affect your ears, such as eczema or an allergy to hearing aids, as a way to help prevent ear infections. A pharmacist or GP can advise on the right preparation for your skin.

• Do remove any discharge by wiping the outer ear with cotton wool (NHS).

• Do use paracetamol or ibuprofen for pain if suitable (NHS).

• Do keep the affected ear dry, for example with a shower cap when bathing if you are not washing your hair (NHS inform).

• Do remove anything that may cause an allergic reaction, such as hearing aids, ear plugs and earrings (NHS inform).

• Do not put cotton buds, cotton wool or your fingers inside the ear (NHS, NHS inform).

• Do not go swimming while you have an ear infection, or until the condition has fully cleared (NHS, NHS inform).

There is rarely a single cause. The sources reviewed point to the following.

Itching on its own is common and often mild. NHS inform lists the symptoms of otitis externa as ear pain, itching and irritation in and around the ear canal, redness and swelling, a feeling of pressure and fullness, scaly skin that may peel off, discharge that can be thin and watery or thick and pus-like, tenderness when you move your ear or jaw, swollen and sore glands in the throat and some hearing loss. It says usually only one ear is affected.

The NHS lists symptoms of earwax build-up as hearing loss, earache or a feeling that your ears are blocked, ringing or buzzing (tinnitus) and vertigo.

No. The NHS says not to use your fingers or objects like cotton buds to remove earwax because this will push it in and make it worse, and NHS inform says putting cotton wool buds or other things into your ears, including your fingers, can damage the sensitive skin in your ear canal. Clean only the outer ear, gently, with cotton wool.

The NHS adds that there is no evidence that ear candles or ear vacuums get rid of earwax.

It depends on the cause. The NHS says most ear infections clear up within 3 days, although sometimes symptoms can last up to a week. NHS inform says otitis externa symptoms should clear up within a few days with treatment, that it sometimes gets better without treatment but can take several weeks, and that some cases persist for several months or longer.

For earwax treated with oil drops, the NHS says that over about 2 weeks lumps of earwax should fall out and symptoms should improve. See a nurse at your GP surgery if symptoms have not cleared after 5 days.

The NHS says to see a pharmacist if your child is aged 1 to 17 years and you think they have an ear infection. See a GP if you have earache that does not get better after 3 days, if you or your child keep getting ear infections, or if a child under 12 months old may have an ear infection.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 now if you have symptoms of an ear infection and you feel generally unwell, have a very high temperature or feel hot, cold or shivery, have swelling around the ear, have fluid coming out of the ear, have a change in hearing or new hearing loss, feel sick or dizzy or have a severe sore throat, or have diabetes, a heart, lung, kidney or neurological condition or a weakened immune system.

NICE CKS describes a more serious form, necrotizing (previously called malignant) otitis externa, as a potentially life-threatening infection that can be associated with diabetes, immunocompromise and older age, with unremitting pain and ear discharge. This is why persistent pain or discharge should not be left.

NHS inform lists the following ways to reduce the chance of otitis externa. The NHS also advises treating conditions that affect your ears, such as eczema or an allergy to hearing aids.

• Wear a swimming cap or ear plugs if you swim regularly, but insert ear plugs carefully and do not use them if they irritate (NHS inform).

• Have earwax removed by a healthcare professional if build-up is a problem (NHS inform).

• Keep your ears dry and clean, and turn your head from side to side after getting out of water (NHS inform).

• Avoid getting water, soap or shampoo into your ears when you shower or bathe (NHS inform).

• Do not swim in polluted water (NHS inform).

The NHS says a pharmacist can help with earwax build-up and with ear infections in children aged 1 to 17. Not all GP surgeries remove earwax; some flush the wax out with water, use microsuction or scrape it out with a small device, and a doctor may refer you elsewhere, or you may have to pay to have it done privately. Private ear care and audiology services also exist, and they use the same approaches described above.