Food allergy red and swollen ears

Ear redness and swelling caused by food allergy is essentially a local manifestation of IgE-mediated type I hypersensitivity reaction involving the mucosa of the auricle or external auditory canal. In most cases, after the allergen is removed and second-generation antihistamines are taken regularly, it will completely subside within 3 days without leaving permanent damage. However, if it is accompanied by symptoms such as tight throat, difficulty breathing, confusion, etc., you need to go to the emergency department as soon as possible to be alert to the risk of severe allergic reactions.

Last week I met a little boy in the second year of high school at the clinic. When his mother dragged him in, his ears were bright red, like shrimp crackers just fished out of boiling water. He also scratched several light red marks behind his ears. His mother said that she bought a mango pancake on the way home from school. After eating only half a piece, her ears were itchy. When she got home, she looked in the mirror and it was so swollen that she couldn't even put on her headphones. She thought it was frostbite due to the freezing weather, so she rushed here in a hurry.

Many people think that allergies only cause rashes and diarrhea. How can they also cause swollen ears? In fact, the skin of our auricles and external auditory canals is very thin, with almost no dense fat layer under the skin, and the soft tissue is as loose as a sponge filled with water. Once food triggers an allergic reaction, inflammatory factors such as histamine and leukotrienes released in the body travel throughout the body with blood circulation. When the blood vessels in the ears expand, tissue fluid leaks out, and the ears immediately become swollen. This is earlier than the appearance of swollen eyelids and cheeks. The first warning sign of food allergies for many people is red and hot ears.

Nowadays, there are actually two different approaches to clinical treatment of this kind of food allergy that only manifests as red and swollen ears. One group of people believes that as long as it is clearly related to eating, even if there is only redness and swelling of the ears, it is a local manifestation of systemic allergic reaction. It is recommended to take antihistamine drugs as soon as possible to prevent further spread of inflammation and induce more serious reactions. ； The other group believes that if there is only simple redness and swelling, no obvious itching or other discomfort, you can observe it for 1-2 hours first. After all, it may be a contact allergy caused by food residue on your hands and rubbing it into your ears, or even just in time for the dilation of blood vessels caused by hot and cold stimulation, which is not necessarily directly linked to food allergies. I met a girl before. After eating crayfish, half of her ears were swollen. I thought she was allergic to shrimp. In the end, I checked and found out that her hand rubbed a new earring while peeling the shrimp. The foreign protein in the shrimp roe came into contact with the wound and caused a local allergy. It was not a problem of eating it.

To be honest, I have been an allergist for so many years. When I encounter this kind of situation, I usually don’t prescribe a bunch of medicines. I first ask about the cause and effect. As long as there is no other discomfort, I will first teach you a little emergency method: don’t use a hot towel to apply it, the more you apply it, the more blood vessels will expand and swell faster, and don’t scratch it desperately. Scratching the mucosa of the external auditory canal can easily lead to infection. If it is really itchy and uncomfortable, wrap an iced mineral water bottle with a clean towel and apply it on the ear for three to five minutes, which will relieve most of the pain. If it doesn't go away after half an hour of observation, or even becomes more and more itchy, and wheals begin to form on the body, it's still time to take second-generation antihistamines. These drugs have very few side effects and will hardly cause drowsiness. They can be taken without delaying work and school.

But don’t think that swollen ears are a trivial matter. If after swelling, you still feel stuffy in your ears, blurry hearing, or even gradually feel that your throat becomes tight, it is difficult to breathe, and your chest feels tight, don’t hesitate to call 120 and go to the emergency department. This is a sign that the allergic reaction is developing seriously. If it really induces laryngeal edema or anaphylactic shock, it can be fatal. In this case, even if you have just taken antihistamines, you must go to the hospital for observation. Don’t bear it on your own.

The little boy who was allergic to mangoes mentioned at the beginning was tested positive for mango IgE. He took loratadine for two days. When he came for a follow-up visit on the third day, his ears were completely gone. He still had half a bag of unopened dried mangoes in his pocket. He shook his head and asked me if he would never be able to eat mangoes again. I told him to wait until the allergy has completely subsided in another month and do a food challenge test. If it is an acute allergy caused by low immunity during this period, it will be no problem to eat a small amount in the future. If it is really a serious allergy, just avoid it. There are so many delicious foods, and this one is not bad, right?