Cat Scratching Ears: Could It Be Mites or Allergies?

Introduction

If your cat is scratching their ears, shaking their head, or rubbing against furniture, you’re right to take notice; it’s a common sign that something’s irritating those sensitive ears. Ear scratching can be caused by mites, infections, allergies, or debris (wax) buildup. It is important to determine the cause as each requires a different solution. Read on to learn about the most likely causes of itchy cat ears, how to tell them apart, and how to help your cat find relief.

Cat Scratching Ears: Fast Facts

• Occasional ear grooming can be considered a normal part of cat behavior, however, constant scratching is not.
• Common causes of cat ear scratching include ear mites, infections, and allergies.
• Other signs that cats might show are head shaking, odor, discharge, or redness affecting the ears.
• Never insert cotton buds into your cat’s ear, visit your veterinarian for a diagnosis and to learn how you can safely clean their ears.

How a Healthy Cat Ear Should Look

Picture a healthy cat ear. The inside skin should be pale pink, smooth, and clean. Their ear canal should be free from discharge and odor. A minimal amount of brown wax in the ear is absolutely normal. Your cat should allow you to gently touch or clean their ears without pain or resistance.

Common Reasons Cats Scratch Their Ears

1. Ear Mites (Otodectes cynotis)

Cat ear mites are tiny parasites that live inside the ear canal and feed on skin debris, including wax. These pesky mites are the most common cause of ear scratching in kittens and outdoor cats, with typically both ears affected. They are highly contagious to other cats and even dogs.

Signs:

• Intense ear scratching and head shaking.
• Dark, coffee-ground-like debris inside the ears.
• Restlessness or crying when their ears are touched.
• Crusty scabs or hair loss around their ears and head.

Treatment:

• Prescription ear drops, or topical medications from your veterinarian, are essential to treat the infestation. Typically, these are applied for around 14 days, but follow your veterinarian’s guidance on duration.
• Bedding must be washed at a high temperature and disinfected. All pets in the household should be treated to ensure all ear mites are thoroughly gone.
• Avoid over-the-counter “mite drops” unless directed by a veterinarian; they can cause irritation and are generally ineffective.

2. Ear Infections (Bacterial or Yeast)

Cat ear infections can be caused by bacteria or yeast overgrowth. Typically, they develop secondary to a trigger, such as an allergy (to fleas, food, or the environment), moisture buildup, or a foreign body. You may notice your cat scratching their ears, with one or both sides affected. This can cause pain and odor, so cats may resist you touching their sore ears.

Signs:

• Red, inflamed, or thickened ear canal.
• Thick brown, yellow, or black discharge, which can be dry or sticky.
• Foul odor.
• Head tilting or frequent shaking.

Treatment:

• Ear cleaning and medicated ear drops, prescribed by your veterinarian
• Sometimes oral antibiotics or antifungals are needed if the infection is severe.
• Loss of balance in severe cases, for example, if the infection progresses into the middle ear
• Never use hydrogen peroxide or alcohol, as these worsen irritation and are dangerous - ouch!
• Management of any underlying triggers, removal of any foreign body (if present), and, in severe cases, flushing of the ear canal under sedation or general anesthetic.

3. Allergies

Allergies can trigger ear irritation, even without a visible infection. This can stem from flea bite hypersensitivity (allergy to flea saliva), food hypersensitivity (allergy to certain proteins - chicken is a common culprit), or environmental allergens (such as pollen and dust). Other signs of allergies in cats include licking their belly or paws and dandruff.

Signs:

• Mild ear redness or inflammation without dark debris or discharge
• Chronic cat ear scratching or head shaking, which is often seasonal.
• Secondary ear infections due to ongoing inflammation.

Treatment:

• Treatment is focused on identifying and eliminating the trigger. 
• Keep up-to-date with year-round veterinary-prescribed flea treatment (yes, even indoor cats can get fleas!)
• Consider a diet trial with a prescription diet, following your vet’s guidance.
• Consider allergy medications, such as prescribed cat antihistamines or corticosteroids. Be sure to ask your vet to formulate a plan for the next steps.
• Regular ear cleaning to reduce topical allergens and rebalance the ear canal's healthy flora, with vet-approved ear solutions.

4. Foreign Material or Wax Buildup

Grass seeds or dirt can find their way into a cat’s ear canal, more often than you’d think! The most frequently affected cats are the outdoor explorers. Hardened wax (ceruminoliths) can also form over time if the ear does not naturally remove the wax; this can irritate the ear canal and eardrum.

Signs:

• Sudden onset of head or ear scratching, or developing a head tilt after roaming outdoors
• Sometimes visible debris or a wax plug might be seen, but often by the time signs are noticed, the contents are much further down the ear canal. 
• Sensitivity when the affected ear is touched

Treatment:

• Gentle vet cleaning and removal using saline or ear flush, occasionally under sedation (depending on how anxious your cat becomes at the clinic), forceps may be needed to grasp the foreign body within the ear to remove it.
• Never insert cotton swabs into the ear as this can push debris deeper, making it more difficult to extract.

5. Ear Polyps or Growths (Less Common)

Ear polyps are non-cancerous growths that can develop in the ear canal or Eustachian tube, which can cause chronic ear irritation. They are often mistaken for an infection as symptoms can overlap.

Signs:

• Chronic ear irritation, occasionally with blood present in the ear.
• Recurrent cat ear infections.
• Pain and discomfort around the ear, head tilting, or frequent shaking.
• Loss of balance.

Treatment:

• Veterinary examination, with possible need for advanced imaging and surgical removal.

How Veterinarians Diagnose the Cause

If you notice your cat ear scratching, book a veterinarian appointment for further investigation and treatment. This typically starts with an otoscopic exam, which allows your veterinarian to look inside your cat’s small ear canals for assessment of the walls and eardrum (called the tympanic membrane). This is important as certain medications cannot be given if the eardrum is ruptured. Your veterinarian will likely take a swab for analysis under the microscope, checking for ear mites, yeast, and bacteria. For cats who do not respond to treatment, or who have severe ear disease, a swab may be taken to send to the laboratory, which will culture (grow) the type of bacteria present and test how well different antibiotics work to kill this specific bacteria (sensitivity testing). Bacterial strains can be resistant to certain antibiotics, and this test ensures that the appropriate medication is being used. Your veterinarian may recommend allergy testing or a diet trial to rule out underlying allergic causes if the infections are recurring. Imaging using equipment such as video otoscopy, X-rays, or a CT scan may be advised if polyps or tumors are suspected in the vicinity.

Home Care and Prevention Tips

Cat ear scratching can be difficult to manage. To prevent ear issues, be sure you stick to veterinarian-approved ear cleaners and always use positive reinforcement during or after cleaning, such as a tasty treat. This will help your cat become more accustomed to ear handling rather than making a dash for it when you approach them with the bottle. Keep up-to-date with veterinary-prescribed year-round flea prevention (remember fleas and flea allergy can trigger cat ear itching too)! Groom your cat regularly to reduce environmental allergens that can latch onto their coat. Wipe and dry their ears gently following any baths or rainy weather; this will prevent the damp, humid environment in which bacteria thrive. Cat ears are sensitive, so avoid home remedies, including vinegar, hydrogen peroxide, or oils, as these can cause more harm than good, worsening their ear irritation.

When to Call the Vet

Call your veterinarian if your cat is showing any of the following:

• Constant ear scratching, head shaking, or a head tilt.
• Redness, swelling, or black/brown debris inside their ears.
• Foul odor or discharge from their ears.
• Hair loss or scabbing around their ears.
• Crying, pawing at their face, or balance changes.
• If you see no improvement within 1–2 days of ear cleaning after mild signs start.

FAQs

Conclusion

Rest assured, ear problems are common in cats, they can be frustrating to treat, but when caught early, they tend to respond very well to management. Remember that a diagnosis is essential when formulating a treatment plan, whether they have mites, infection, allergies, or a structural disease, and that can only be confirmed by a veterinarian’s examination.

Bio

Dr Grace Mee BVSc MRCVS

Grace graduated from the University of Liverpool in 2022. She works as a small animal vet in London and has published research in the Veterinary Record. She enjoys consulting and operating on dogs, cats, and exotic pets. Beyond clinical practice, she applies her expertise as a veterinary writer and mentors aspiring veterinary students.

Photo in feature: istockphoto