Food allergy, red, swollen, hot and itchy ears

Food allergy causes red, swollen, hot and itchy ears. This is essentially a manifestation of an immediate (type I) allergic reaction involving the skin and mucous membranes of the ears. As an emergency response, stop eating suspected allergenic foods as soon as possible and take second-generation antihistamines such as loratadine and cetirizine for rapid relief. If the medication does not improve after 3 days, or is accompanied by tight throat, poor breathing, or large rashes all over the body, you must seek medical attention immediately to avoid severe allergic reactions.

To be honest, many people are confused when encountering this situation for the first time: I either have diarrhea or a rash on my mouth after eating the wrong thing, but why do my ears suffer first? Last week, I received a 19-year-old art student. Half an hour after eating half a plate of mango sashimi, his ears were itchy and red, and there was even a small swelling behind the ears. He thought it was chilblains caused by the cold when he went out in the winter. When he came to the clinic, he lifted up his mask and saw a light red rash on the corners of his mouth. When he asked about it, he found out that his mouth was numb after eating mangoes before. He didn't take it seriously. This time, he drank iced drinks with the cold drinks, and the allergic reaction went directly to his ears.

In fact, it’s not surprising. The skin on the ears is inherently thin and the dermal layer has dense blood vessels. The number of mast cells responsible for releasing inflammatory mediators is no less than that of the skin around the mouth and nose. During an allergy attack, substances such as histamine travel along the blood vessels. When the blood vessels in the ear expand, they become red and hot. When the nerve endings are stimulated, they become itchy. When tissue fluid leaks out, the entire auricle may become swollen twice as thick as usual. An old man was so itchy that he couldn't sleep when he had an allergy attack. He used a hot towel to apply it for ten minutes. Originally, it was just a swollen ear. After applying the application, the ear canal became swollen and stuffy, and the sound sounded like it was separated by a layer of cotton. The heat stimulation would only make the blood vessels expand even more, which completely added fuel to the fire.

As for the specific treatment methods, in fact, there is no absolutely unified clinical standard, and the habits of different doctors vary greatly. Conservative doctors recommend treatment without additional irritation: as long as there is no ulceration or pus, just take oral antihistamines. If the itching is severe, use gauze moistened with normal saline for 10 minutes, two or three times a day. There is no need to worry about hormone side effects. I usually recommend this method to patients with mild symptoms. Many people apply it twice and most of the itching disappears. Many dermatology colleagues also believe that if the ear is so swollen that the outline of the ear cannot be seen clearly, and it is so itchy that you cannot work or sleep normally, it is better to use a weak hormone ointment for less than 3 days, such as desonide cream, to get better faster. As long as it is not applied to the thin skin of the ear for a long time, there will be basically no problems with pigmentation and skin atrophy. Both options are supported by a large number of clinical cases, and you can choose according to the severity of your symptoms.

But no matter which treatment method you choose, there are a few minefields that you must not step on. Don't scratch it with your nails. The skin on your ears is thin and can break if you scratch it. Secondary bacterial infection is easy to occur. Allergy and inflammation will then cause the recovery to be slower. ； Don’t put anti-inflammatory ear drops into your ears casually. This is not a bacterial infection. Putting it in may irritate the ear canal mucosa and aggravate allergies. ； Don’t just think that “it’s just itchy ears and it’s not a big deal.” I have seen patients who were allergic to cashew nuts only have swollen ears at first, but they continued to eat them without taking it seriously. Two hours later, they showed signs of laryngeal edema, and they were out of breath and were brought to the emergency room by their family members.

When this allergy goes away, should I check for allergens? There are also different opinions in the industry. Some people think that the accuracy of food-specific IgE testing is not high. Many delayed allergies cannot be detected. It is more reliable to keep a food diary. If you have a reaction after eating something on a certain day, write it down and avoid it next time. ； Some people think that one test can screen out most common allergens, saving them the trouble of trying blindly. How you choose depends entirely on you. Anyway, there are only a few common allergens: mango, pineapple, nuts, seafood, milk, and some people are even allergic to wheat protein. I have encountered swollen ears after eating vegetable buns before. It really can be anything.

I usually tell patients who come back for follow-up consultations not to take minor allergies seriously. This time I just suffered from swollen ears. Next time, the reaction may be severe. Don’t be greedy for the foods you should avoid. If you really can’t help but want to eat some "dangerous foods", put anti-allergy medicine in your pocket in advance. It is better than going to work or school with your ears red and being asked if you secretly cried, right?