Hearing aids do not inherently cause ear infections, but their presence in or behind the ear can create conditions that make infection more likely. The physical placement of the device can interfere with the ear’s natural environment. The infections most commonly associated with hearing aid use are external ear infections, known as otitis externa, which affect the ear canal.
How Hearing Aids Create a Susceptible Environment
Hearing aids, especially those worn inside the ear canal, can block the natural flow of air and earwax, a process called occlusion. This blockage traps moisture and heat, creating a warm, humid microclimate favorable for the growth of bacteria and fungi. This sealed environment compromises the ear canal’s natural defense mechanisms, including its slightly acidic cerumen.
The device also contributes to moisture buildup from sweat, particularly in humid conditions or during physical activity. This excess moisture softens and breaks down the skin lining the ear canal (maceration), allowing pathogens to penetrate the skin barrier more easily. While modern hearing aids often include small vents for air circulation, clogging with earwax or debris substantially increases the risk of moisture trapping.
Physical irritation is another mechanism that increases infection risk. A poorly fitted hearing aid or repeated insertion/removal can rub against the skin, causing micro-abrasions or scratches. These serve as entry points for bacteria or fungi residing on the device or skin surface. Constant pressure from an ill-fitting device can also lead to irritation or pressure sores, further compromising the ear canal skin.
Recognizing the Signs of an Infection
Otitis externa, the most common hearing aid-related infection, presents with distinct symptoms. Pain is a primary indicator, often worsening when the outer ear is touched or the jaw is moved. This discomfort arises from swelling and inflammation within the ear canal.
Persistent itching or irritation inside the ear canal can signal the beginning of an infection, sometimes caused by fungal growth. As the infection progresses, the ear may produce discharge that is clear, yellow, or foul-smelling, indicating a bacterial presence. The ear canal opening may appear red and swollen, and surrounding lymph nodes might become tender.
Temporary muffled hearing is another common symptom, occurring because swelling and discharge physically block sound transmission to the eardrum. If symptoms appear, stop wearing the hearing aid immediately to allow the canal to breathe and dry out. Consulting a healthcare provider is necessary for proper diagnosis and treatment.
Reducing Risk Through Proper Care and Fit
Daily Hygiene
Daily hygiene is highly effective in mitigating infection risk. The device should be wiped down every evening to remove accumulated earwax, oil, and moisture. Use a specialized cleaning tool, such as a wax pick or soft-bristle brush, to clear debris from ports and openings, including the microphone and receiver. Avoid using harsh chemicals or liquid cleaners unless manufacturer-approved, as they can damage the device or leave irritating residue.
Moisture Management
Managing moisture is important, especially for those in humid climates or who sweat frequently. After removal, hearing aids should be stored overnight in a drying kit or electronic dehumidifier. These devices use desiccants or controlled heat and airflow to remove excess moisture from the internal components and the shell. The ear must also be completely dry before reinserting the hearing aid, particularly after showering or swimming.
Physical Fit
The physical fit of the hearing aid is a fundamental component of infection prevention. A device that is too tight causes constant friction, leading to micro-abrasions that allow pathogens to enter the skin. Conversely, a loose device may shift, allowing more debris and moisture into the ear canal. Regular appointments with an audiologist ensure the mold or shell remains comfortable and correctly seated, as the ear canal shape can change over time.
Allowing the Ear to Breathe
Allowing the ear canal to “breathe” is a powerful preventive measure. Wearing hearing aids for prolonged, uninterrupted periods increases heat and moisture retention. Removing the devices for a few hours each day, such as when sleeping or during quiet periods, provides necessary air exposure. This short rest period helps restore the natural balance of the ear environment and reduces the constant presence of the occluding device.