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Red Ear Syndrome (RES) Revisited and Updated

March 11, 2012
red ear syndrome picture 2

Dear Tucson Audiologists’ Friends and Colleagues,

We wrote a post on RES 8 months ago.  RES was a new syndrome to us and therefore–we thought–a rare one.  But the comments make us wonder.  A number of people reported that they or a family member have RES.  It may be more common than we thought but it seems to be diagnosed only rarely.  For some, RED is extremely irritating and debilitating.   Here are the comments, gathered together to further the discussion of this interesting and little-understood syndrome.  We’ve underlined parts of the comments for emphasis.

Sam commented:  It is incredibly annoying, I can’t wear hats, earmuffs, hoods or headphones. I have to sleep on a rock hard pillow and cannot lie on my side. I have no family history of the disorder and it occurs whenever my ears are touched or during a rapid temp change. I had to quit football because it felt like my ears would burn through my head. Another thing was when a doctor used a ear-thermometer, it picked up a near 120 degree reading, after explanation the doctor was unfamiliar with the syndrome. I haven’t ever met anyone else who has it though, glad to see it is recognized because it has really shaped my life far more significantly then anyone could imagine.

Jennifer said:  I have a 7 year old son who has classic autism. He is nonverbal and was recently diagnosed with Chiari Malformation. They found 2 blockages and performed decompression surgery. I recently have been observing him having the same symptoms as described for Red Ear Syndrome. I would like to know more and if there are specific doctors who do treat this disorder.

Joolz saw a bright (red) side: I experience res on a regular basis and have done for the last 18 months, I am 42 years of age and have no other health issues, i was so relieved to find that there is actually a name for this and other sufferers. I have no triggers that I know of and have no other symptons and its usually unilateral and very rarely bilateral. it really is just a very very hot feeling of my outer ear associated with extreme redness! crazy!! i am actually quite proud of it and alot of my friends think its funny and weird, doesn’t cause me any problems apart from being a little uncomfortable when its occasionally extreme.

Nicole used ice:  My son Isaiah is 4 and was recently diagnosed with RES he has been months of doctor after doctor not able to tell us what is wrong with him he has burning red ears all the time he complains of ear pain and they turn bright red the only thing we can do to relieve it is put ice packs on it. We don’t know much about RES so any info is appreciated. Thank you.

Matt wondered if RES was related to his migraine symptoms.  I’m 28 and have had red ear syndrome for about a year and a half. In addition to red ear syndrome I also got palinopsia, visual snow, tinnitus, and halos around lights at this same time. These symptoms have not gone away and are quite bothersome. One theory is that I have “persistent migraine aura without infarction”.  I note some people above saying they don’t get migraines, but migraines can occur without pain, they’re called acephalgic or silent migraines. These may occur at any age, and unlike normal migraines, are more common in men.

Kevin linked his to stress and wondered if his toddler had it too: I can remember having occasional red ears since I have been in my early 20s. Some of it, I believe, has correlated with anxiety or stress. I have never had a problem with migraines so there is no correlation there. I just noticed tonight at the dinner table that my 3-year-old son’s left ear is red. He was watching one of his favorite shows, Max and Ruby. I asked him and he said that he is not hurting anywhere. My wife informed me that if he had migraines, he would definitely be complaining about them because she suffered with them when she was younger.

Breanna was just curious:  I’m so glad to hear I’m not the only one who has this problem. I am about to be 25 in a couple of weeks and I’ve had the red ear syndrome since I can remember, I’ll just be sitting watching tv or something and boom my ear gets wicked hot and beet red sometimes my whole face gets red and hot as well but I never really thought anything about it and never mentioned it to my doctor just got curious one day and decided to look it up to see if there was anything posted about it.Thanks for the info!

Dr. Marc observed his clinically:  Very interesting. I have had this phenomenon for years (I’m currently 45 years old). Many times it’s unilateral, at other times bilateral. I’ve never had a headache associated with it and have never found a real pattern in terms of triggers. I think I could count the number of true migraine headaches I’ve had in my life on a single hand. But I never had a name for this and find the autonomic connection interesting. Thanks for posting the information!

So there you have it.  Since these comments, another blog site has picked up on RES and extended the discussion (click on Red is More than a Color).  We’ll keep you posted on this interesting syndrome and invite those who know about it to contribute to the discussion.

Submitted for your reading pleasure by

Your Tucson Audiologists,

Holly Hosford-Dunn PhD


Sharon K Hopkins MA

photo courtesy of mulicia

4 Comments leave one →
  1. Phyllis Lewis permalink
    March 21, 2014 9:43 AM

    This seems to happen to me most often in winter when I’m indoors, especially if I’m in an overwarm house, but it varies. I’m in my seventies, but this has happened for years. It’s embarrassing since I have short hair and thus can’t cover my ears. I can’t name a specific trigger and no pain is associated with it. It’s usually my right ear only, but VERY hot and red. It’s instant, and takes about 45 mins. to go away. Cold air helps. I’m happy to be able to put a name to it…RES…and to know that I’m not alone. Are there any solutions?
    Thanks, Phyllis

  2. Mary Coleman permalink
    November 22, 2012 7:16 AM

    I suspect Red Ear Syndrome is the same thing as Erythromelalgia (EM), but possibly Secondary Erythromelalgia rather than Inherited Erythromelalgia which would more often affect the hands or feet. EM (all types) most often affects the feet, hands, ears and/or face. I’ve had EM for 19 years, and my audiologist thinks it’s likely the cause of my mild hearing loss and tinnitus. It’s neurovascular and most people with EM also have migraines. My EM seems to be related to my Mast Cell Activation Syndrome and Heritable Disorder of Connective Tissue, but there are many disorders than can cause EM. There are EM groups on Yahoo Groups, facebook and Ben’s Friends, for more discussion. The Erythromelalgia Association is also a great resource.

    • Mary Coleman permalink
      November 22, 2012 7:32 AM

      I should add that it’s especially those with bilateral red, hot burning ears who should consider the possibility that they have Erythromelalgia and that EM does indeed involve dysautonomia. Those who also have TMJ or Chiari Malformation may want to consider the possibility that they have a Heritable Disorder of Connective Tissue (eg, Ehlers-Danlos Syndrome) or hypermobility which can affect the blood vessels and sometimes involves dysautonomia &/or mast cell activation. These disorders are hard to diagnose, so it may require travel to see an expert in the specific disorder that’s suspected. The most common EM triggers are heat, humidity, alcohol, and some foods. Food reactions may be immediate or several hours later and it isn’t just spicy foods that can trigger it, despite what you may read. Cold also triggers some with EM and some with EM develop Raynaud’s Phenomenon. EM is a miserably painful condition. It’s not subtle or mild.


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