Is your ear also sore or red? It could be perichondritis!

Have you ever had your ears pierced? Especially the top of the ear, where the cartilage is? Or have you ever had a small injury to your ear, and then your ear became red, swollen, and painful to the touch? In that case, you may have developed a condition called perichondritis. Let's talk about this today, because it can be dangerous if left untreated.

What is Perichondritis?

Simply put, perichondritis is an infection that occurs when a germ enters the tissue around the cartilage on the outside of our ear. Take a look at the outside of our ear. What you can feel is a bit firm, but flexible. That's what cartilage is called. It's like the front of the nose. This cartilage is what gives the ear its shape. So, if something like bacteria enters the thin membrane around this cartilage (we call it the perichondrium, which is where the cartilage gets its nutrition), it gets infected and starts to swell, become red, and hurt. Sometimes this is also called auricular perichondritis.

This is often caused by an injury to the ear, a burn, or a piercing, especially a high ear piercing . Sometimes, pus can collect between the cartilage and tissue, forming an abscess .

The important thing is that if this is not recognized and treated quickly, the cartilage can become cut off from the blood supply and die (necrosis). If this happens, the ear can become permanently deformed. This is called 'cauliflower ear' .

What is the difference between Perichondritis and Cellulitis?

Now you might be thinking, "If it's a skin infection in the ear, it's cellulitis, right?" Yes, they're both skin infections, and both can cause inflammation. But there's a slight difference.

• Perichondritis: This usually only affects the cartilage on top of the earlobe. It does not affect the soft part under the ear (earlobe).
• Cellulitis: This can spread throughout the entire ear, both on the top of the earlobe and on the soft part underneath.

Therefore, it is easy for a doctor to recognize this difference.

How common is this condition?

Perichondritis is not a very common skin condition. However, researchers say that the incidence of this disease has increased since the popularity of high ear piercings, especially among young people. A study conducted in England showed that the number of these patients doubled from 1990 to 1998. They see this trend as the reason for this. Because the chance of infection is much higher when piercing the cartilage than when piercing the soft lobe of the ear. So, there is a higher chance of getting into trouble for something done to be beautiful, right?

What are the symptoms of Perichondritis?

The main and most common symptom is ear pain, redness, and swelling . It can feel like someone has hit you or something is stuck in your ear. This redness usually starts around a wound, cut, or scratch. Remember, this only affects the cartilage on top of the ear, not the soft part below the ear (earlobe).

There may be several other symptoms:

• You may get a fever .
• You may feel severe pain when you touch the ear (tenderness).
• You may feel warmth when you touch your ear.
• If an abscess has formed, a pus-like fluid may also drain from it.

If you have symptoms like these, you should definitely see a doctor.

Why does perichondritis occur? What are the causes?

This is actually a bacterial infection . The most common bacteria responsible for this is `Pseudomonas aeruginosa` . Apart from that, `Staphylococcus aureus` and `Escherichia coli` can also cause it.

Simply put, this happens when bacteria gets into the cartilage of the outer ear. There are several main reasons why this can happen:

Main cause - ear piercing (especially cartilage)

This is the main reason we see these days. When you pierce the cartilage above your ear, bacteria can easily enter through that wound. If you don't clean it properly, or if the piercing equipment is dirty, the risk is much higher.

Other reasons

• Injuries to the ear or side of the head: This can happen from an accident, a fall, or even a fight.
• Injuries during sports: Sports like boxing and rugby can cause blows to the ears.
• Burns: If something like hot water or oil gets into the ear.
• Insect bites: You may have been bitten by an animal like a mosquito or an ant.
• Acupuncture: Ear acupuncture can sometimes cause infections.

Less commonly seen reasons

• Ear surgery.
• If an infection inside the ear (like a middle ear infection) is not treated properly, it can spread to the cartilage.
• Minor injuries, such as frequent earwaxing.
• It can also be caused by a herpes zoster infection or shingles, which occurs after chickenpox.

Who is at higher risk?

Some people are more likely to develop this condition:

• People with inflammatory conditions in the body, for example, diseases like `granulomatosis with polyangiitis`.
• People with weak immune systems .
• People with diseases like diabetes .

How do doctors diagnose this?

When you go to a doctor, the first thing they do is examine your ear carefully . They look at it, feel it, and check for swelling, redness, and pain. Then they ask you about your symptoms.

Your medical history will also be asked. This means whether you have recently had an ear injury, ear surgery, burns, or acupuncture. This information will help the doctor determine if it is perichondritis. Usually, no specific tests are needed for this.

What are the treatments for perichondritis?

Antibiotics are the main treatment for this. The type of antibiotic you are given will depend on the severity of your condition and the type of bacteria causing the infection.

Treatment with medication

• Most often, a fluoroquinolone antibiotic is prescribed. This can be a pill that you take or a cream that you apply directly to the infected ear.
• There are mixed opinions about giving fluoroquinolones to children . Some studies have shown that this drug can cause side effects such as joint stiffness and tendon rupture in children. However, the American Academy of Pediatrics says that this drug is safe for children. However, it is the doctor who decides what is best.
• The doctor will remove any foreign objects from your ear, such as earrings or dust.
• You may be given an oral corticosteroid (this helps reduce swelling).
• They say to apply warm compresses .
• They say to take over-the-counter pain relievers to reduce the pain.

What if an abscess develops?

Sometimes an abscess can form in the ear, blocking the blood supply to the cartilage. In this case, a small operation is required. The doctor makes a small incision in the abscess, removes all the pus inside, and removes any dead cartilage or skin. This incision allows the cartilage to start bleeding again.

The doctor may leave a small tube (drain) in there for one to three days, until the pus has completely drained. To maintain the blood supply to the cartilage, the doctor may also stitch your tissue back into place.

How to protect yourself from this? (Prevention)

The best way to avoid this is to avoid piercing the cartilage above the ear as much as possible . In fact, it's a very risky procedure. If you must pierce your ear, get the soft part under the ear (earlobe) pierced. The risk of infection is much lower there.

There are a few more things you can do:

• Avoid acupuncture on the ear (if you do, only have it done by a very clean, qualified person).
• If you develop an ear infection, get it treated quickly . Don't delay.
• Be careful not to injure your ears when playing certain contact sports (e.g., using headgear).
• Avoid frequent ear picking and putting things in your ears as much as possible.

What happens if you get perichondritis? How long does it take to heal?

Imagine you have this. Don't panic! If you see a doctor quickly and take the right antibiotics, your symptoms will start to subside in two or three days . You may feel a little uncomfortable for a month or so. But, you can make a full recovery.

However, if you have an abscess and need surgery, the drain that the doctor placed will need to be removed in a few days. After surgery, the wound will need to be kept clean, dressed, and dressed until it heals properly.

Complications that may occur if left untreated

This is the most dangerous thing. If you don't treat it, as I said before, an abscess can cut off the blood supply to the cartilage and cause the cartilage to die (necrosis). If that happens, the ear can become permanently deformed, leading to a condition called 'cauliflower ear' . The ear looks like a cauliflower.

Not only that, perichondritis can also cause an infection (chondritis) of the cartilage of the ear. This can severely damage the shape of the ear. Some of the tissue in the ear dies and may need to be surgically removed. Then, ear reshaping surgery may be performed to restore the ear to its normal shape.

So, if you have pain, redness, or swelling at the top of your ear, don't just ignore it. See a doctor right away and get treatment.

Finally, things to remember (Take-Home Message)

Okay, so I hope you can remember some of the most important points from what we've talked about.

• Perichondritis is a bacterial infection of the tissue surrounding the cartilage of the outer ear.
• The main reason for this is the piercing of the cartilage above the ear .
• Ear pain, redness, and swelling are the main symptoms.
• If treated quickly, it can be completely cured.
• If left untreated, permanent deformities such as 'cauliflower ear' can occur.
• The best way to protect yourself from this is to avoid piercing the cartilage above the ear .

So, take care of your ears. Don't get into trouble, especially when it comes to fashion. A pair of nice earrings in the soft part under the ear is enough, right? Because, health is the most valuable thing!

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