Ear - Pulling At or Itchy

Symptoms

DEFINITION

  • A child repeatedly pulls, tugs, pokes or itches the outer ear or ear canal
  • No crying or report of earache

Causes

  • Main cause (infants): normal touching and pulling with discovery of ears. This behavior is usually not seen before 4 months of age
  • Main cause (older children): mild swimmer's ear from: (1) water accumulation during swimming or showers, (2) soap or shampoo retention, or (3) canal irritation from cotton-tipped swabs. Some children are reacting to a piece of earwax in the ear canal.
  • Not an ear infection: Most younger children (under age 2 or 3) who pull or poke at the ear are unable to confirm or deny the presence of an earache. Dr. Ray Baker examined 100 children with ear-pulling as the chief complaint. The main conclusion was that simple ear-pulling without other symptoms of an illness or infection was never associated with ear infections.

See More Appropriate Topic (instead of this one) If

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine
  • Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen.)
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently
  • Seems to be in pain or crying without an obvious reason
  • Starts awakening from sleep
  • Fever or symptoms of a cold are present
  • Drainage from the ear canal
  • Constant digging inside 1 ear canal

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Pulling at the ear continues over 3 days
  • Itching continues over 1 week

Parent Care at Home If

  • Normal ear touching or pulling
  • Itchy ear canal

Care at Home

HOME CARE ADVICE FOR EAR PULLING HABIT OR ITCHY EAR CANAL

  1. Reassurance:
    • Most of these children have discovered their ears and are playing with them.
    • Some have an itchy ear canal.
    • Ear pulling that is a new symptom and begins when a child has a cold usually is caused by fluid in the middle ear. Less often it's caused by an ear infection.
    • Ear pulling without other symptoms is not a sign of an ear infection.
  2. Habit: If touching the ear is a new habit, ignore it (prevent doing it for attention).
  3. White Vinegar Eardrops: For itchy ear canal, use ½ strength white vinegar by diluting it with equal parts water. Place 2 drops in each ear canal daily for three days (Reason: restore the normal acid pH). (EXCEPTION: ear drainage, ear tubes or hole in eardrum)
  4. Avoid Soap: Keep soap and shampoo out of the ear canal.
  5. Avoid Cotton Swabs: Cotton swabs remove the earwax that normally protects the lining of the ear canal, and this leads to itching and irritation.
  6. Expected Course: With this treatment, most itching is gone in 2 or 3 days.
  7. Call Your Doctor If:
    • Pulling at the ear continues for over 3 days
    • Itching of ear continues for over 1 week
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Version Year: 2012

Copyright 1994-2012 Barton D. Schmitt, M.D.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

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