What causes persistent itching, yellow discharge, and recurring scabs inside the ear, and what should be done about it?

Generally, recurrent itching inside the ear, yellow discharge, and crusting may be caused by factors such as water entering the ear canal, frequent ear picking, external auditory canal eczema, otitis externa, or suppurative otitis media. Depending on the specific situation, patients can improve symptoms through general management, medication, or surgical treatment. Detailed analysis is as follows:

1. Water in the ear canal: After bathing or swimming, residual moisture in the ear canal can promote bacterial growth and irritate the skin, leading to itching and fluid leakage. Promptly wipe the outer ear canal with a dry cotton swab and tilt the head to help drain trapped water, avoiding prolonged dampness in the ear canal.

2. Frequent ear picking: Scratching with fingernails or tools can damage the delicate skin of the ear canal, compromising its protective barrier and causing infection, resulting in oozing and crusting. Stop self-ear cleaning to allow natural healing of the ear canal skin. Outer ear debris can be gently removed using a cotton swab.

3. External auditory canal eczema: Allergies or irritants can trigger inflammatory reactions in the ear canal skin, causing papules and exudation that form crusts when dried. Under medical guidance, treatments such as hydrocortisone cream, loratadine tablets, or calamine lotion may be used. Avoid allergens like pollen and dust mites.

4. Otitis externa: Bacterial infection causes inflammation of the ear canal, with mucosal congestion and exudation, accompanied by pain and itching. Under medical supervision, medications such as cefradine capsules, ofloxacin ear drops, or amoxicillin-clavulanate potassium tablets may be prescribed. Keep the ear canal dry and clean.

5. Suppurative otitis media: Pus-forming infection of the middle ear mucosa leads to accumulation of pus, which may rupture through the eardrum and drain into the ear canal, causing crusting. Treatment under medical guidance may include sustained-release cefaclor tablets, tobramycin ear drops, or azithromycin dispersible tablets. In severe cases, tympanoplasty (eardrum repair surgery) may be required.

Maintaining ear health starts with small daily habits: wear earplugs during showers to prevent water entry, and seek professional services for ear cleaning. Maintain a light diet and avoid spicy or irritating foods to strengthen immunity and reduce infection risks. If symptoms recur, do not delay—seek timely medical evaluation for accurate diagnosis and treatment.