Itchy Ears Wearing Hearing Aids | Sonant Hearing Clinic, Kent

Why are my hearing aids making my ears itch? 

If you are a new hearing aid user, having something foreign within your ear will take some getting used to. Prior to having hearing aids, nothing else really went and stayed in your ears for lengths of time.  According to a 1991 study, up to 39% of hearing aid users experience itching as a side effect of their hearing aids.

From the materials used in hearing aids and ear moulds to earwax buildup, several factors may contribute to that irritating itch. Whether you're a first-time user or an experienced user, understanding the causes of this common issue is essential. There are practical solutions and tips available to help alleviate discomfort, ensuring that your hearing aids work effectively without interfering with your listening and hearing pleasure.

Understanding the Causes of Itchy Ears

To effectively address itchy ears while using hearing aids, understanding the underlying cause is crucial. The skin within the ear canal is very sensitive. A stray hair or a stray granule of wax rolling around within the ear canal may cause itching. On the severe side, an ear infection or a build up of wax may cause itching and require removal. 

One common cause is an allergic reaction to the materials used in hearing aids or ear moulds. Some users may be sensitive to certain plastics, silicones, or metals, leading to an allergic reaction characterized by itching, redness, or swelling. If you suspect an allergy, your audiologist can help identify the specific material causing the reaction and recommend hypoallergenic alternatives. At Sonant Hearing, we only work with the leading hearing aid manufacturers. They use medical grade hypoallergenic silicone as a standard. So an allergic reaction is less likely to happen for this reason.

Another significant cause of itchy ears is earwax buildup. When you wear hearing aids, the devices can sometimes push earwax deeper into the ear canal, causing a blockage and leading to irritation. This can create a cyclical problem, as the more you scratch or touch your ears, the more likely you are to exacerbate the issue. In some cases, earwax can also become impacted, which may require professional removal by a healthcare provider.

Skin conditions such as eczema or psoriasis can also contribute to itchy ears. These conditions can cause the skin inside the ear canal to become dry, flaky, and irritated. Hearing aid users with these skin conditions may find that the constant presence of the device exacerbates their symptoms. If you have a known skin condition, it's important to manage it with appropriate treatments and to communicate with your audiologist about your situation, so they can help you find a comfortable solution.

How Hearing Aids Can Contribute to Itchy Ears

Hearing aids, though incredibly beneficial, can sometimes contribute to itchy ears due to their interaction with the ear environment. One way this happens is through the creation of a warm, moist environment within the ear canal. Hearing aids can trap moisture and heat inside the ear, which can promote the growth of bacteria and fungi, leading to infections that cause itching. Using a dehumidifier for your hearing aids and ensuring your ears are dry before inserting the devices can help mitigate this issue.

The physical presence of hearing aids can also lead to mechanical irritation. The constant rubbing of the device against the sensitive skin of the ear canal can cause microscopic abrasions that lead to itching. Over time, this irritation can become more pronounced, especially if the hearing aids do not fit properly. Regular consultations with your audiologist to ensure a proper fit and to make any necessary adjustments can help prevent this type of discomfort.

Additionally, the introduction of foreign objects into the ear canal, such as hearing aids, can alter the natural balance of the ear’s environment. The ear is a delicate ecosystem, and changes in airflow, temperature, and moisture levels can all contribute to sensations of itching. Some users may also experience a heightened sensitivity to the presence of the device, which can manifest as itching. Using hearing aids for shorter periods initially and gradually increasing wear time can help your ears acclimate to the new device.

Preventive Measures for Itchy Ears While Using Hearing Aids

Dealing with itchy ears due to hearing aids can be a persistent problem, but there are preventive measures that can help you maintain comfort.

1. One is to keep your hearing aids, domes and ear moulds clean. Regular cleaning can prevent the buildup of earwax and bacteria, which are common irritants that can cause itching. Using a soft, dry cloth to wipe down your hearing aids daily and using a specialized cleaning brush to reach small crevices can make a significant difference. Additionally, using a dehumidifier specifically designed for hearing aids can help keep them dry and free of moisture that can foster bacterial growth. If not ready to invest in a de-humdifier, dessicant sachets can be used as an alternative - these can be kept with the hearing aids inside the case. (Like the ones found in a new handbag to keep it dry).

2. Another important preventive measure is to ensure that your hearing aids fit properly. Poor-fitting hearing aids can cause friction and pressure points within the ear canal, leading to irritation and itching. If you suspect that your hearing aids are not fitting as they should, consult with your audiologist. They can make adjustments or recommend a different style or size that better suits the unique shape of your ear canal. Custom-fit ear moulds are often a good investment for those who experience frequent discomfort, as they are designed to match the contours of your ears precisely.

3. You can take short breaks from wearing your hearing aids when possible. Giving your ears time to breathe and recover can minimize irritation and allow your skin to recover from any minor chafing that may occur throughout the day. During these breaks, you can also use a moisturizing ear drop recommended by your audiologist to keep the skin inside your ear canal hydrated. However, it’s important to avoid overuse of such products as excessive moisture can also lead to itching and other complications.

Common Symptoms Associated with Itchy Ears

Persistent itch: If you have a persistent or recurrent itch that does not seem to subside despite efforts to clean or adjust the hearing aids. This can be a sign of an allergic reaction, earwax buildup, or an infection. Paying attention to the frequency and intensity of the itch can help you and your audiologist determine the cause and appropriate treatment.

Earache, Redness and swelling: These symptoms can indicate inflammation, which may be due to an allergic reaction, irritation from the hearing aids, or an infection. If you notice these symptoms, it’s important to seek medical advice and treatment from your doctor. In some cases, the skin inside the ear may also appear very dry, excessively flaky or peeling, which can be indicative of a skin condition such as eczema or otitis externa.

Discharge from the ear: This can range from clear fluid to pus and may be accompanied by an unpleasant odour. Discharge is often a sign of an infection and requires immediate medical attention. Persistent itching combined with discharge can indicate a serious condition that needs to be addressed immediately by by seeing one's doctor.

How to reduce itching with hearing aids in the ears. 

Use a moisturiser or gentle safe lubricant

Use a lubricant like olive oil ear drops to lubricate any loose dry skin or wax moving around. The oil is likely to "bind" the wax/stray hair in place and stop it moving around so freely whilst also allowing the ear canal itself to gradually push it outwards. (As long as we don't go back into our ears with a cotton bud!). If you are a hearing aid user, use the ear drops at night just before bed. As you will not be wearing your hearing aids then and less likely to get oil into your hearing aid!

Look out for irritants within your hearing aid cleaning tools

Check the ingredients within your cleaning wipes or hearing aid cleaning solution. Some cleaning solutions or wipes may have ingredients that are particularly irritating to your ears. 

Check the hearing aids

With open-fit hearing aids  too loose domes are more likely to cause itching than a well-fitting dome. As the loose dome would have space to move around in the ear canal therefore causing itching. At Sonant Hearing, we will see you over multiple appointments after you have had your hearing aids to make sure that they are comfortable. 

The length of the open tube or receiver length needs to be checked. As a too short tube could be pulling on the skin of the ear. A too long tube might be allowing the hearing aid to hang too loosely over the ear. Consider the dome shape as well. Would a closed dome cause less irritation than a vented dome? Sometimes the receiver sizes vary with power receivers having more bulk than medium receivers. As long as the receiver covers the audiogram range of loss, a medium receiver could sit differently within the canal and cause less irritation. If all these open fit measures fail to alleviate the itching, then a custom-made ear mould may need to be considered. More on hearing aids. 

With ear moulds, itching could occur due to an allergy of the earmould or a poor fit. There could be wax buildup within the ear canal or residual debris from a previous or current infection ( both awaiting clearance via micro-suction or irrigation).

If there is moisture within the canal, or tubing, the mould may need to have a larger ventilation hole (severity of audiogram loss permitting). Moisture within the ear mould and ear canal wall could lead to itching, especially due to extra moisture and body temperature warmth encouraging the growth of bacteria and fungus in the the ear. The latter serves as another reason to keep the ear dome or mould clean with a non-irritating cleaner and dry properly every night. 

If there is a bump or area on the ear mould causing irritation, it may need to be re-sent to the manufacturer for a re-make. The re-make could be bigger or smaller. If problems persist then the new impression may require a different technique to make the ear-mould. (closed jaw vs open jaw). 

Allergies

Allergies, Very rarely there might be dematitis or allergy on contact with an ear mould. With this case it maybe worthwhile having the audiologist speak to the manufacturer about considering a different type of material entirely to re-make the mould. Gold or titanium plated ear moulds could be a possibility.

Other skin related conditions

Dry skin as a result of pre-existing eczema, psoraisis or similar can cause itching and the skin is already easily irritated with or without hearing aids. Safe lubricants (vetted by your GP ) can be used with particular care taken not to block the sound outlet of the RIC aids or custom ear mould. It would also be advisable to seek medical advice from the GP, ENT or dermatologist if the skin irritation can't be alleviated despite all the best measures taken.

Conclusion: Managing Itchy Ears Effectively with Hearing Aids

Managing itchy ears effectively while using hearing aids involves a combination of preventive measures, understanding the causes, and seeking professional advice when necessary. Regular cleaning and maintenance of your hearing aids are crucial steps in preventing irritation and infections. Ensuring a proper fit and taking breaks to allow your ears to breathe can also help maintain comfort and reduce the risk of itching.

Understanding the various causes of itchy ears, from allergic reactions to earwax buildup and skin conditions, allows you to address the issue at its root. By being aware of the symptoms and monitoring any changes, you can take timely action to prevent complications. Consulting with your audiologist when necessary ensures that you receive professional guidance and treatment options tailored to your specific needs.

Ultimately, the goal is to ensure that your hearing aids enhance your quality of life without causing intrusive discomfort. With the right approach, you can manage itchy ears effectively and enjoy the full benefits of your hearing aids. Whether you are a new user or have been using hearing aids for years, staying informed and proactive in your ear care routine will help you achieve the best possible listening experience.

Reference

Itching in the external ear--a side effect of ear plugs. Madsen EF, Larsen J, Flink PO. Ugeskr Laeger, 1991 Jul 22, Vol. 153. 2125-8