| Physical trauma(e.g., cotton swabs, earphones) | Mechanical damage to the ear canal skin, causing injury to the epidermis and potential infection risk. | Avoidance of physical trauma |
| Environmental factors(e.g., water exposure) | Persistent moisture exposure from swimming or frequent bathing weakens the ear canal’s natural barrier function, promoting infection and inflammation. | Drying the ear canal after exposureCessation of swimming |
| Bacterial infection | Pathogen-induced growth and spread of pathogenic microorganisms, causing infection and inflammation. | Topical or systemic antibiotics (e.g., ciprofloxacin, ofloxacin) |
| Fungal infections | Fungal infections, especially from Aspergillus and Candida, thrive in moist environments, leading to chronic inflammation. | Topical antifungals (e.g., clotrimazole 1%) |
| Allergic contact dermatitis | Skin irritation and inflammation caused by external allergens like neomycin, shampoos, and hair sprays. | Discontinuation of allergens (e.g., neomycin)Topical steroids |
| Chronic skin diseases(e.g., psoriasis, atopic dermatitis) | Skin inflammation caused by diseases weakens skin barrier function, leading to chronic irritation. | Topical corticosteroidsCoordination with dermatologyManagement of the underlying skin disease |
| Systemic diseases(e.g., amyloidosis, sarcoidosis, Sjögren’s syndrome) | Dysregulation of immune function, contributing to systemic inflammation that affects the ear canal. | Topical corticosteroidsCoordination with dermatology or rheumatology specialistsTreatment of the underlying systemic disease |
| Dermatophytid reaction(due to foot or nail fungal infections) | A hypersensitive immune reaction (ID reaction) to fungal infections elsewhere in the body (e.g., tinea pedis, onychomycosis). | Treating the primary fungal infectionAvoiding further fungal exposure |