Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry that you have been waiting for a response, but your requested expert isn't online which delayed your question coming up on the list for all to answer. I would like to help if you are still interested in an opinion.Facial and ear
itchiness and secondary sores and scabs can be for several reasons.The most common reason tends to be secondary to fleas or other insect or spider bites, inhaled or food
allergies. Cats with these allergies get a type of lesion in response to allergic stimulation called miliary dermatitis. We usually see crusts, scabs and hair loss along the back, and on the face, especially in the thinly haired area between the ears and eyes.Other possible reasons for facial scabs include a mite called Demodex gatoi, sarcoptic mites, mosquito bite hypersensitivity (usually affects the bridge of the nose and ears but can cause itchiness all over the face), ringworm
, solar dermatitis which is an extreme form of sunburn (usually very light skinned cats with pink skin are affected) and rarely autoimmune condition conditions such as pemphigus.If he has a dark haircoat then solar dermatitis is unlikely. But if he goes outdoors ringworm, flea bite and mosquito bite hypersensitivity and demodex or sarcoptic mites are possible.Indoor only kitties are more likely to have inhaled or food allergies, but flea or other insect or spider bite allergy is possible too, and so are autoimmune diseases. If he isn't improving with the suggestions I give you I would recommend having your veterinarian examine him to look at a skin swab to look for Demodex Gatoi mites, a skin scraping for signs of sarcoptic mites, or evidence of fleas. A fungal culture should be checked for completeness. In the meantime you may wish to consider a true hypoallergenic diet such as Royal Canin Duck & Green Pea or Hills z/d to test him for food allergies. This must be the only things he eats for at least 8 to 12 weeks, no treats or flavored medication. You may have tried diet changes but unless it was a prescription food it may not have been restrictive enough. The trouble with "limited ingredient" or "low allergy" pet store brands is that the same machinery is used on multiple lots of food without sterilization cleaning in between. So for example even if a food says it has salmon and rice if the previous batch had beef and corn then you will get traces of those ingredients in your bag of food. Not a big deal if your cat isn't allergic but a waste of money thinking that the food was hypoallergenic and not good for your cat if those happen to be allergens for your cat. The veterinary brand true hypoallergenic foods are more expensive because it isn't cheap to thoroughly remove all traces of a previous food mixture from the machines used to process food. Generally what I recommend is trying to clear the skin and ears and then adding one food item (chicken, beef, corn wheat etc) every month to see what they react to. Then we can find a regular food to try. I do tend to stick with Purina Pro Plan brands or Nature's Recipe as I find those rarely if ever have cross contamination. You might also wish to try a combination of antihistamines and omega 3 fatty acids to help with inhaled, flea, or other insect including mosquito bite allergies. You can use either:1) chlorpheniramine 4mg at half to one full tablet orally every 12 to 24 hoursOR2) Benadryl (diphenhydramine) at half of a 25mg tablet per 8 to 15 pound cat every 8 to 12 hours (1mg to 2mg per pound of body weight every 8 to 12 hours). Make sure it is NOT the formulation with a decongestant or acetaminophen because cats cannot tolerate decongestants or acetaminophen.OR3) Zyrtec (Cetirizine hydrochloride) at a dose of 5 mg per cat given orally every 24 hours. (Make sure it is NOT the formulation with a decongestant (such as Zyrtec-D) because cats cannot tolerate decongestants.)Antihistamines can cause sleepiness or hyperactivity in some cats but those effects usually wane with repeated use.Good brand name omega 3's to try are 3V Caps or Derm Caps. I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 20mg of EPA per pound of body weight per day. For example an 8 pound cat could take 160mg of EPA per day. Together antihistamines and omega-3 fatty acids work synergistically. These should help reduce the itch.The way to avoid mosquito bites is by keeping him in at dawn and dusk when these insects are most likely out.If he is not improving with these measures then then the diagnostics I mentioned above and possibly a skin biopsy would be the best way to get a definitive diagnosis and direct treatment.Please let me know if you have any further questions.