Advice after your nerve block for surgery
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Introduction
You have been given Betamethasone scalp application to use as eardrops. This medicine is a type of steroid that was originally licensed for the treatment of eczema on the scalp; however, we are prescribing it to be used in an unlicensed way as eardrops.
This is to help manage the excessive amount of skin and wax that is building up in your ear canals as a result of eczema type condition of the ear canal skin. Although this is a scalp application, it is safe to use as ear drops.
These drops are a steroid based medication and must only be used as directed. Steroids are a group of drugs which are potent anti-inflammatories. Used in your ears, they can reduce the overproduction of skin and wax which is contributing to your problems. By using the drops, you will reduce itching and the risk of infection that comes from scratching your ear.
There is a risk that use of the medication may thin your ear canal skin, so it should not be overused.
How to use the ear drops?
First two weeks of treatment:
- Warm the drops to body temperature before use. You can do this easily by placing the bottle in your pocket for half an hour before use; this will warm the drops enough, so they are not too cold when they go into your ear.
- You may find on using the drops that you experience a slight hot burning type sensation–this is normal and should wear off after 15 minutes.
- Put two drops in your affected ear/ears every night for 2 weeks.
After the first 2 weeks of treatment, use the drops as follows:
- Two drops of solution only in whichever ear itches, whenever it itches, but no more than twice in 1 day.
Using the drops in the long term:
Most chemist can supply you with a small “dropper” style bottle. This will make putting the diluted eardrops in much easier.
If you are having worsening ear symptoms, such as increased itching, please use the drops daily for two weeks as directed above.
How to put in your eardrops?
- Check the instructions on label on the bottle, including the number of drops, how many times a day (up to twice a day) and which ear/s to put it into.
- If possible, ask someone else to put the drops in for you. Lie on a bed with the ear to be treated facing the ceiling. Warm the drops further by holding the bottle in your hand for a few minutes.
- Take a firm hold of your ear pulling gently backwards, then up and away from your head. This will make your ear canal straighter, so that the drops go in more easily. Put the prescribed number of eardrops into your ear canal.
- To make sure that your ear canal is coated with drops, gently pull your ear backwards and upwards and then let go. You cannot also press rapidly on the small piece of cartilage towards the front of your ear (the tragus) (as if you were trying to block your ears).
- Stay lying on the same side for at least 5 minutes. This gives the drops time to soak in.
- Place a piece of cotton wool in the outer part of your ear canal, just to prevent any of the drops running out. Make sure you use enough cotton wool so that you can easily remove it. Remove the cotton wool after 10 minutes.
- Sit up slowly.
- If both ears need drops, wait for 10 minutes before treating the second ear, so that you do not lose drops from the first ear when you lie on the other side.
What are the benefits?
We have found this treatment to be helpful in preventing frequent bouts of otitis externa (outer ear infections) caused by eczema, with associated itching. The treatment should reduce the amount of skin building up and reduce the itchiness.
Risks and side-effects
You may find that you experience a hot or burning sensation when you use the drops–this is entirely normal and should be expected. You need to be aware of the following:
- This treatment should not be used if a perforation of the tympanic membrane is present.
- You may need additional treatment if infection is suspected.
- In some this treatment may lead to local skin reactions and dilated blood vessels in the skin.
- Occasionally, colour changes to the skin near to where the drops have been applied.
- It is rare of very rare to see adrenal suppression due to the systemic absorption of the steroid.
- Note the liquid is flammable. Keep your body away from fire or flames after you have put on the medicine.
If you experience tinnitus (ringing or whistling in your ears), hearing loss, intense pain, or other symptoms not mentioned in this leaflet please stop using this medication and contact our team on the numbers mentioned at the end of this leaflet.
Please note that this medication is a licensed medication, however this way of using it is unlicensed. It is still safe and a well-recognised way of using this medication and should not cause any other problems than those detailed previously. If you have concerns about using it, please speak to the team looking after you.
Contact us
If you have any queries relating to this information, please contact the Ear or nose and throat (ENT) service.
About this information
Service:
Ear, nose and throat (ENT)
Reference:
G/045
Approval date:
23 February 2026
Review date:
1 February 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.