Does my son have an ear infection?

Dear Doctor,

My three-year-old son keeps scratching his ear and I’m beginning to think it might be some sort of infection. How can I know for sure, and can an ear infection lead to hearing loss?
Dear  Beth,

How long has your son been scratching his ears? Is it externally or within the ears? Is there any other problems like pain, redness, swelling,  discharge from ears, e.t.c.

Build up of ear wax is the most common cause  of itching in the ears. The function of wax inside the ears is commonly to clean up the dead skin cells.  But if it becomes  excess in quantity, it tends to cause irritation and subsequent itching. The ear wax can be dissolved and cleaned by wax  solvent ear drops available in the market.  A trained technician can clean it in the hospital. But a cotton swab  or needle should never be used for this purpose.  A cotton swab can push it further inside, whereas a needle can injure the ear internally. However wax should not be removed totally.  Lack of it, would increase susceptibility of ears to acquire infection.

Acute or chronic infections of the ear can cause itching within the ears or around it.  Viral infections cause acute cold and or cough and this is associated with ear itching. Bacterial infections cause ear itching and also ear pain, ear discharge,  redness with or without swelling Fever may also occur with bacterial infections.  Fungal; infections of the  ears cause scaliness and itching inside or around the ears. It  grows insidiously.  Swimming is an activity that increases risk of infections within the ear due to increasing dampness within the ears.   People with reduced immunity like diabetic individuals, those suffering  from diabetes or chronic kidney failure are more prone to develop ear infections.

Itching within the ears can be due to irritation caused by some hair care product like  drops of shampoo entering the ear during hair wash.  It can be due to allergy  to some food substance or some body care product.

Skin disorders like eczema, psoriasis, can occur over the ears externally or internally within the ears, as elsewhere in the body. They can cause eruptions or rashes along with itching. Some old injury, even minor will cause itching during healing.

The cause for itching can be known by simple physical examination and relevant tests. Treatment depends on treatment of underlying cause. A word of caution here.  When ears become itchy, putting in a needle, pin, e.t.c. sharp object for scratching should be totally avoided. Sharp objects like this can induce infection, cause injury and  even  permanent ear damage resulting in  hearing loss.  The skin of children is soft, making them more susceptible to damages within ear.

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