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Q: I would like to have some information regarding the practice of ear candling. What is the difference between ear candling and having the ears irrigated? Are there side effects to this practice? -- Name withheld, Redfield, S.D.

A: I couldn't find anyone who was sure what ear candling was. One person thought that it might be an ancient practice of filling up the ear canal with melted wax. When it hardens, a foreign object would be caught in the wax and the whole wax plug could be pulled out, removing the object from the ear. I strongly recommend against this practice.

Irrigation is one method recommended for clearing an accumulation of earwax, called cerumen, and foreign objects from the ear. It is done using a small water hose to force water into the ear. This loosens and floats cerumen and other objects out. The irrigation is performed with water at body temperature, followed by complete drying of the ear canal to prevent infection.

Some people claim they use the hose of a Water Pic normally used for dental cleaning. However, I've never seen studies on home use of this device for cleaning ears. The pressure from hoses, especially if not turned to the lowest setting, can be quite strong and may damage the ear and even rupture the eardrum.

Other methods include detergent eardrops, mechanical removal and suction, all of which, including irrigation, are best done by a health-care professional using the right light and magnifier to avoid damage to the ear.

Water should never be placed in the outer ear if there is a possibility of an open eardrum. Also, in the case of outer ear infection, called external otitis, protection of the ear from moisture is fundamental to treatment.

Ear drops containing a mixture of antibiotics and anti-inflammatory steroids are usually effective for treating outer ear infections.

Occasionally, it is difficult to get the eardrops far enough into the external ear canal to get to the infected area. When the ear canal is blocked because of swelling of the canal wall, a cotton wick can be made, saturated with eardrops and inserted in the canal at least overnight to promote entry of the medication.

Is the use of this wick what you mean by candling? If so, remember that the wick is used for infections, and irrigation is used for clearing earwax and, sometimes, for removing a foreign body.

I'm sure you have known someone that cleans his ears with a bobby pin, safety pin or other similar objects. Not only does this increase the risk of puncturing the eardrum, it can irritate and damage the lining of the ear canal. The irritation can cause even more earwax to be made and the damage may lead to an infection.

If earwax is a problem for you or someone you know, please be careful. Talk with a health professional to get sound advice about how to manage it.

Q: I would appreciate it if you could give me some information on Mucha's/Habermann's disease. My dermatologist says he knows almost nothing about it.

I have just recently had a biopsy of one of these lesions and the result was "perivascular inflammatory infiltrate consistent with this disease." He prescribed an ointment that cleared the lesions, but two weeks later they came back, mostly on my legs. They are not itchy, but are ugly. -- I.B., Massilon, Ohio

A: I can well understand why your dermatologist said he knew almost nothing about this disease -- not very much is known. I can also understand your frustration. Let me share with you what I know about this disorder.

The technical term for Mucha's/Habermann's disease is pityriasis lichenoides et varioliformis acuta. It's also known as parapsoriasis varioliformis. Whew!

All those big words mean is that your disorder is a skin disease similar in some respects to psoriasis and its close cousin, pityriasis rosea. It is characterized by the sudden appearance of various forms of skin eruptions, including reddened or other discolored spots, bumps and blisters. Mealy scales may also be present.

It can be a short- or long-term disorder, and can affect different people differently. The cause of the disorder is unknown; it is suspected to be a virus.

Like its more common cousin, pityriasis rosea, no specific treatment in terms of a cure is known. The ointment your dermatologist recommended was for treating your skin changes, rather than the cause itself. Unlike pityriasis rosea, this form of pityriasis often lasts for more than a year.

When you next talk with your dermatologist, I suggest you discuss the expected course of your skin condition, the purpose of ointment and what do if the disorder recurs in the future.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Avenue, Suite 1400, Chicago, IL 60611.

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health care provider.

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