Dr Scurr: Stop Cotton Buds and Use Steroid Drops for Ear Itch

Dr Martin Scurr addresses a reader from Dorset suffering from chronic itching in both ears. Sandra Cooke reported that the sensation has recently become maddening despite trying Vaseline online. Dr Scurr identifies the primary cause as eczematous otitis externa, a form of dermatitis specifically affecting the ear canal skin. This inflammation results from skin damage often triggered by over-cleaning or the regular use of cotton buds. Allergic reactions to shampoo residues represent another potential trigger for bilateral symptoms. The most effective medical treatment involves prescription corticosteroid drops to suppress the underlying inflammation. Patients must stop using cotton buds immediately because ear canals are naturally self-cleaning. Ear wax traps dust and dirt, then falls out to remove debris without intervention. Scratching the canals causes further trauma and carries a serious risk of perforating the eardrum. A simple test for shampoo allergies involves switching to mild baby shampoo for one month. Applying a small amount of Vaseline or olive oil to the outer ear canal can help if excessive dryness exists.

Dr Scurr responds to another reader who suffered severe thrush during a difficult pregnancy thirty-five years ago. The reader's daughter tragically died, and the mother has endured recurrent outbreaks that recently returned without relief. Although initial tests failed to identify the exact cause, the reader found temporary relief with amitriptyline. Dr Scurr notes this is puzzling because amitriptyline is an antidepressant, not a standard antifungal drug for thrush infections. He suggests the reader initially had Candida albicans thrush but later developed neuropathic pain in the vaginal and vulva area. This nerve pain can mimic thrush symptoms such as soreness, rawness, and pain during intercourse. The traumatic pregnancy and subsequent bereavement likely triggered this specific nerve pain condition. Amitriptyline helps nerve pain alongside its antidepressant effects, though the brain may eventually develop a tolerance to the drug. When higher doses stop working, other medications like gabapentin offer alternative treatment options. Referral to a vulva clinic provides access to specialists managing complex long-term conditions. There is real hope for improvement because the reader has not exhausted all available medical options.

The recent death of eminent surgeon Professor Harold Ellis serves as a stark reminder that modern medicine has lost ground despite its technological advances.

Dr. Scurr, who trained under Ellis as the most junior member of his team, describes today's training as a disaster compared to the past.

The legendary 'firm' structure included a senior registrar, registrar, junior registrar, and houseman who worked under Ellis's direct supervision.

Ellis was an inspirational yet uncompromising mentor who remained available seven days a week, forcing his team to match his relentless dedication.

This intense environment provided an exhilarating learning experience that cannot be outclassed by current methods.

Dr. Scurr recalls Ellis's favorite catchphrase, "I'm glad you asked me that question," which always opened a chance for instruction and shared memorable anecdotes.

The collapse of the traditional 'firm' model has been nothing short of a disaster for medical education.

Furthermore, this shift has moved patient care away from the control of doctors and nurses to the hands of management.

Dr. Scurr writes these words to honor a great man of medicine while lamenting the loss of a superior approach to treating patients.