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What Causes Foul Smell From Nose And Ear Lobes?
Question: Some foul smell is coming from the side of my nose (nose crease) and ear lobes / ear. It becomes prominent when my face is oily. Even if I didn't eat any oily food this smell is always there. Also when I eat some sugar content food (ice cream, chocolate) this smell become very severe. I tried some anti fungal creams but no use. when I apply clotrimazole antifungal powder this smell become little bit reduced for 1 hr and again become severe. I changed my diet to sugar free diet but not much change. I consulted doctor and treated for dandruff. Now I dont have dandruff but this smell is still there.Is it some fungal infection or diet related thing?
Brief Answer:
Parosmia due to nasal disease
Detailed Answer:
Hi. Since your complaints are only related to foul smell it is suggestive of nasal disease such as allergy, allergic fungal rhinosinusitis (AFRS), ethmoidal polyps, chronic sinusitis or parosmia (perception of abnormal smell due to neurological causes).
If it were a fungal skin infection of the nasal crease or earlobe then it is more likely that there is an associated visible lesion and itching. If such a lesion exists then it will useful if an image of the same can be shared as well.
It is also important to note if other family members also perceive the same smell as you do. If they do then it points towards AFRS and other nasal conditions and if they don't it is advised that you seek a neurological consultation for evaluation of a parosmia. An MRI of the brain will be indicated in such a case.
It is recommended that you get an ENT consultation for evaluation of your nasal cavity. A nasal endoscopy and a CT scan of your Paranasal sinuses will rule out all possible differentials for nasal diseases. Management in the form of nasal sprays, antibiotics or antifungal agents or in some cases endoscopic surgery may be indicated.
Since the smell worsens with diet rich in sugars, there may be a relation to an underlying diabetes or prediabetic condition. Blood sugar test is indicated to rule this out ( random, fasting and post prandial blood sugars).
Oily skin may or may not be contributory. If there are visible skin lesions and itching then it may just be a fungal skin infection for which antifungal powder may not be enough. In such a situation oral antifungal medications may be indicated and can be prescribed after a dermatology consult.
Hope this information helps. Do share more information of possible such as a photograph of a skin lesion, blood sugar results, ENT inferences from endoscooy or CT reports. It will me advise you further. Hoping for a speedy recovery.
Parosmia due to nasal disease
Detailed Answer:
Hi. Since your complaints are only related to foul smell it is suggestive of nasal disease such as allergy, allergic fungal rhinosinusitis (AFRS), ethmoidal polyps, chronic sinusitis or parosmia (perception of abnormal smell due to neurological causes).
If it were a fungal skin infection of the nasal crease or earlobe then it is more likely that there is an associated visible lesion and itching. If such a lesion exists then it will useful if an image of the same can be shared as well.
It is also important to note if other family members also perceive the same smell as you do. If they do then it points towards AFRS and other nasal conditions and if they don't it is advised that you seek a neurological consultation for evaluation of a parosmia. An MRI of the brain will be indicated in such a case.
It is recommended that you get an ENT consultation for evaluation of your nasal cavity. A nasal endoscopy and a CT scan of your Paranasal sinuses will rule out all possible differentials for nasal diseases. Management in the form of nasal sprays, antibiotics or antifungal agents or in some cases endoscopic surgery may be indicated.
Since the smell worsens with diet rich in sugars, there may be a relation to an underlying diabetes or prediabetic condition. Blood sugar test is indicated to rule this out ( random, fasting and post prandial blood sugars).
Oily skin may or may not be contributory. If there are visible skin lesions and itching then it may just be a fungal skin infection for which antifungal powder may not be enough. In such a situation oral antifungal medications may be indicated and can be prescribed after a dermatology consult.
Hope this information helps. Do share more information of possible such as a photograph of a skin lesion, blood sugar results, ENT inferences from endoscooy or CT reports. It will me advise you further. Hoping for a speedy recovery.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor,
Thanks for your reply. I would like to add some more information.
1. Earlier I used to have acne and small bump behind ear.After taking some medicines from past 6 months it is ok. Currently I don't have visible lesions. Also no itching.
2. I have tested blood sugar-- Result-->Normal
3. Based on a skin specialist's prescription I have done anti allergy test- Result-->Detected allergy
I don't have dust allergy. He told it may due to sea food/ non veg.
4. My one nose is always half closed. ENT diagnosed it as a bend in nasal cavity.He suggested an operation some years before. (Not done yet)
5. All who are closer to my ear is able to detect this foul smell.
I have one query. If i have AFRS smell come from ear?
In my day to day life I am struggling a lot because of this smell. I am unable to sit with my ear closer to people.
Hope you can help me.
Thank you.
Thanks for your reply. I would like to add some more information.
1. Earlier I used to have acne and small bump behind ear.After taking some medicines from past 6 months it is ok. Currently I don't have visible lesions. Also no itching.
2. I have tested blood sugar-- Result-->Normal
3. Based on a skin specialist's prescription I have done anti allergy test- Result-->Detected allergy
I don't have dust allergy. He told it may due to sea food/ non veg.
4. My one nose is always half closed. ENT diagnosed it as a bend in nasal cavity.He suggested an operation some years before. (Not done yet)
5. All who are closer to my ear is able to detect this foul smell.
I have one query. If i have AFRS smell come from ear?
In my day to day life I am struggling a lot because of this smell. I am unable to sit with my ear closer to people.
Hope you can help me.
Thank you.
Brief Answer:
Parosmia and diabetes ruled out
Detailed Answer:
Hi. Thank you for writing back and providing this information.
Based on this information we can rule out the possibility of a parosmia or an underlying diabetes mellitus.
AFRS is a nasal condition and it will not generally lead to foul smell from within the ear. It can explain the foul smell from the nose crease. The nose is connected to the ear via the Eustachian tube so if smell was to come through this connection then the foul smell would have emitted from both ears. (The eardrum should have a perforation for this to occur and you do not have any hearing complaints).
In my opinion your nasal symptoms are not directly related to your foul smell near the ear.
I would recommend an ENT evaluation for examination of your eardrum and to rule out subclinical attic cholesteatoma which can lead to foul smell from the ear without significant hearing loss or for any canal wall disease. Also for examination of the ear canal and mastoid region to rule out any sinus, fistula or signs of fungal infection.
I would also recommend a nasal endoscopy and a CT scan of the paranasal sinuses to evaluate for the septal deviation, possible AFRS and one sided nasal blockage.
I am sure that with this evaluation, we will have a clear idea on your illness and how we can proceed to manage this effectively. Please keep me posted on your progress and do let me know if you have any further queries.
Parosmia and diabetes ruled out
Detailed Answer:
Hi. Thank you for writing back and providing this information.
Based on this information we can rule out the possibility of a parosmia or an underlying diabetes mellitus.
AFRS is a nasal condition and it will not generally lead to foul smell from within the ear. It can explain the foul smell from the nose crease. The nose is connected to the ear via the Eustachian tube so if smell was to come through this connection then the foul smell would have emitted from both ears. (The eardrum should have a perforation for this to occur and you do not have any hearing complaints).
In my opinion your nasal symptoms are not directly related to your foul smell near the ear.
I would recommend an ENT evaluation for examination of your eardrum and to rule out subclinical attic cholesteatoma which can lead to foul smell from the ear without significant hearing loss or for any canal wall disease. Also for examination of the ear canal and mastoid region to rule out any sinus, fistula or signs of fungal infection.
I would also recommend a nasal endoscopy and a CT scan of the paranasal sinuses to evaluate for the septal deviation, possible AFRS and one sided nasal blockage.
I am sure that with this evaluation, we will have a clear idea on your illness and how we can proceed to manage this effectively. Please keep me posted on your progress and do let me know if you have any further queries.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi,
1. I have uploaded an image of the side of my nose where I have some visible redness and dandruff like particles which stick to the skin. From the same region I have this smell especially when that portion becomes oily. Similarly I have smell from both ears too (more than 2 yrs). Earlier I consulted a skin doctor for this. He has given some anti fungal creams and medical shampoo and soap. I have taken oral medicines also. But I didn't get any cure. whether dandruff in the ear canal /nose cause smell with oil?
2. I don't have any pain on sinus area that generally comes while sinusitis.
1. I have uploaded an image of the side of my nose where I have some visible redness and dandruff like particles which stick to the skin. From the same region I have this smell especially when that portion becomes oily. Similarly I have smell from both ears too (more than 2 yrs). Earlier I consulted a skin doctor for this. He has given some anti fungal creams and medical shampoo and soap. I have taken oral medicines also. But I didn't get any cure. whether dandruff in the ear canal /nose cause smell with oil?
2. I don't have any pain on sinus area that generally comes while sinusitis.
Brief Answer:
Appears like Seborrheic dermatitis
Detailed Answer:
Hi. Thanks for sending the pictures. It speaks more than a thousand words.
It makes it clearer now that what you have appears to be Seborrheic dermatitis or intertrigo of the nasal and post auricular crease due to yeast or bacterial infection.
This happens due to the collection of moist/oily secretions within the creases for long periods of time.
Unfortunately these do not go away easily and will probably only do as the skin starts to become dry. This may happen with age, maybe as you near the thirties.
Since you have a predominantly oily skin, this may recur multiple times especially during the summers when the skin is extra oily. It may improve during the winters.
In my opinion you must continue with the antifungal creams, ketoconazole shampoos and powders for a much longer duration of time till your skin starts to dry with progressive age. It is very common in these conditions for it to worsen after stopping treatment. Eating food with high sugars raises the body's metabolism and increases body secretions hence worsening the condition.
You may also benefit sooner by moving to places with drier and cooler climates or remain in air conditioned surroundings.
It doesn't seem that you have AFRS or middle ear disease. You may review with an ENT to rule out any spread of yeast infection into the ear canals.
This is not something too serious but I can understand that foul smell is a difficult problem to deal with. You may just have to apply these topical medications for longer than what you may have anticipated and they will help in the recovery considerably.
Let me know if you have any other questions.
Appears like Seborrheic dermatitis
Detailed Answer:
Hi. Thanks for sending the pictures. It speaks more than a thousand words.
It makes it clearer now that what you have appears to be Seborrheic dermatitis or intertrigo of the nasal and post auricular crease due to yeast or bacterial infection.
This happens due to the collection of moist/oily secretions within the creases for long periods of time.
Unfortunately these do not go away easily and will probably only do as the skin starts to become dry. This may happen with age, maybe as you near the thirties.
Since you have a predominantly oily skin, this may recur multiple times especially during the summers when the skin is extra oily. It may improve during the winters.
In my opinion you must continue with the antifungal creams, ketoconazole shampoos and powders for a much longer duration of time till your skin starts to dry with progressive age. It is very common in these conditions for it to worsen after stopping treatment. Eating food with high sugars raises the body's metabolism and increases body secretions hence worsening the condition.
You may also benefit sooner by moving to places with drier and cooler climates or remain in air conditioned surroundings.
It doesn't seem that you have AFRS or middle ear disease. You may review with an ENT to rule out any spread of yeast infection into the ear canals.
This is not something too serious but I can understand that foul smell is a difficult problem to deal with. You may just have to apply these topical medications for longer than what you may have anticipated and they will help in the recovery considerably.
Let me know if you have any other questions.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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