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Should Your Child See a Doctor?

Ear – Pulling at or Itchy

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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.

When to Call Your Doctor for Ear - Pulling At or Itchy

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.)
 

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

  • You think your child needs to be seen
  • 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
 

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 "When to Call Your Doctor" symptoms.


References

  1. Baker RB. Is ear pulling associated with ear infection? Pediatrics. 1992;90:1006-1007.
  2. Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Q J Med. 2004; 97:477-488.

Disclaimer

This information is not intended to 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.

Last Reviewed: 8/1/2010

Last Revised: 9/14/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

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