I have a 6-year-old son in good health who has an interesting problem.
For the last year or so, one of his outer ears sometimes becomes very hot to the touch and bright red. This can happen when he is resting, bouncing around or even eating. It doesn't seem to have any pattern, except that it is only one ear at a time. He doesn't have a cold or an ear infection when this happens.
Someone said it is blood pressure, so I am concerned. I have asked doctors in the past who brush it off. Please let me know what you think.
Like the other doctors you have spoken with, we find it difficult to give you a satisfactory explanation for your son's red ear "problem." We believe we can reassure you, however, that it is highly unlikely that you have anything to worry about.
We say this, because we have observed a number of other normal, healthy children whose ears, even one at a time, occasionally get warm and red. And since your letter came we have asked other doctors about it, we have reread all our "symptom" books, and we have come up with absolutely no clues suggesting this is anything serious at all.
Although we can't tell you exactly why the red ears are happening, we think we can tell you what is happening. Your son's ear gets warm and red because it is getting a temporary chemical signal from the body telling the ear capillaries to dilate, that is, to get larger.
Capillaries are small blood vessels, and the skin of the outer ear has a particularly healthy crop of them! When capillaries dilate, more blood flows through them, adding both warmth and color to the skin. It's really a "blush" affecting just one part of the body.
Can anything other than a blush cause a red ear? Certainly. Other processes that can make on ear hot and red include rashes, burns and infections. None of these come and go quickly, and they have other features that rule them out in this case.
Most rashes appear on the surface of the skin. Many rashes itch. Burns don't crop up without an obvious cause. And both burns and infections usually hurt like the blazes.
Though sending more blood through dilated capillaries in the skin is one way the body cools off, we doubt that either heat or embarrassment is the explanation for all of your son's "one ear blushes." The red ear may be a response to a variety of different triggers. Your son may eventually figure out what some of them are. We do not think high blood pressure is one of the triggers, although it is a good idea for all children your son's age to have regular checkups that include blood pressure measurement.
Without wanting to seem to brush you off, we believe you should regard your son's ears as especially attentive to his body's chemical signals and cross red ears that come and go off the worry list.
Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.
Pub Date: 6/25/96