Swimmers ear infection – otitis externa
- Otitis externa is a common condition that affects the outer ear – causing pain resulting from inflammation, irritation, or infection
- These symptoms are experienced when water gets trapped in the ear allowing bacteria to spread
- Because this condition commonly affects swimmers it is known as swimmer’s ear
- Swimmer’s ear affects mostly children and teenagers, but can also affect those with eczema (a condition that causes the skin to itch), or excess earwax
- Swimmers ear remedy includes early treatment with ear drops and vigilant ear care
What causes swimmer’s ear?
- Swimmers ears – a common source of the infection is increased moisture trapped in the ear canal, bathing, or showering, increased humidity or living in warm moist climates
- When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection and irritation of the ear canal
- If the infection gets worse it may affect other areas of the ear
- Swimmer’s ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing
Other factors that may contribute to swimmer’s ear include:
- Contact with excessive bacteria that may be present in hot tubs or polluted water
- Excessive cleaning of the ear canal with cotton buds – cotton bud use can cause microlacerations in the ear canal skin promoting infection
- Contact with certain chemicals such as hair spray or hair dye which can cause irritation or contact dermatitis
- Damage to the skin of the ear canal following syringing to remove wax
- A cut in the skin of the ear canal
- Other skin conditions affecting the ear canal such as eczema or seborrhea
Swimmers ear symptoms
- The most common symptoms of swimmer’s ear are an itchy ear and mild to moderate pain that gets worse when you tug on the auricle (outer ear)
- Other signs and symptoms may include any of the following:
- The sensation that the ear is blocked or full
- Drainage from the ear
- Fever
- Decreased hearing
- Ear pain – intense pain that may radiate to the neck, face, or side of the head
- The ear may appear to be swollen and pushed forward or away from the skull
- The neck lymph nodes may become swollen
- Redness and swelling of the skin around the ear
Swimmers ear infection
If left untreated, complications resulting from swimmer’s ear may include:
Hearing loss
- When the infection clears up, hearing usually returns to its normal state
Recurring ear infections (chronic otitis externa)
- Without treatment, infection can persist
Bone and cartilage damage (malignant otitis externa)
- When ear infections spread to the base of your skull, brain, or cranial nerves they become painful and dangerous
- Diabetics and older adults are more at risk
Swimmers ear management issues
- To evaluate you for swimmer’s ear, your doctor will look for redness and swelling in your ear
- Your doctor also may take a sample of any abnormal fluid or discharge in your ear to test for the presence of bacteria or fungus (ear culture) if you have recurrent infections
Swimmers ear treatment
- Treatment for swimmers ear in the early stages of includes careful cleaning of the ear canal and eardrops that inhibit bacterial growth
- Mild acid solutions such as boric or acetic acid are an effective remedy for early infections
Ear drops – How should ear drops be applied?
- Ear drops for the treatment of swimmers ear are more easily administered if done by someone other than the patient
- The patient should lie down with the affected ear facing upwards
- Ear drops should be placed in the ear until the ear is full
- After drops are administered, the patient should remain lying down for a few minutes so that the drops can be absorbed
- Cotton balls should not be placed in the ear – the ear needs to absorb the drops and dry naturally.
Other measures as part of the swimmers ear remedy
- If the ear canal is swollen shut, a sponge or wick may be placed in the ear canal so that the antibiotic drops will be effective
- Pain medication may also be prescribed
- If you have tubes in your eardrum, a non oto-toxic (will not affect your hearing) topical treatment should be used
- Topical antibiotics are effective for infection limited to the ear canal
- Oral antibiotics may also be prescribed if the infection goes beyond the skin of the ear canal
Follow up
- Follow-up appointments are very important to monitor progress of the infection, to repeat ear cleaning, and to replace the ear wick as needed – you need to contact your doctor for follow up appointments as needed
Why do ears itch?
- An itchy ear can be an irritating symptom
- Sometimes it is caused by a fungus or allergy, but more often it is from chronic dermatitis (skin inflammation) of the ear canal
- One type is seborrheic dermatitis, a condition similar to dandruff in the scalp; the skin is dry, flaky, thickened, and inflammed (irritated)
- This may be aggravated by certain food groups
- Some patients with this problem will do well to decrease their intake of foods that aggravate it, such as greasy foods, carbohydrates (sugar and starches), and chocolate
An ENT Specialist is a doctor who specializes in the structures of the head and neck, also treats allergies. They often prescribe a steroid-containing eardrops, creams or ointments to treat the problem and to be used as needed when the ears itch. There is no long-term cure, but it can be controlled.
Tips for prevention
- A dry ear is unlikely to become infected, so it is important to keep the ears free of moisture during swimming or bathing
- Use ear plugs when swimming
- Use a dry towel or hair dryer to dry your ears
- Have your ears cleaned periodically by an ENT specialist if you have itchy, flaky or scaly ears, or extensive earwax
- Don’t use cotton buds which may pack ear wax and dirt deeper into the ear canal, remove the layer of earwax that protects your ear, and irritate the thin skin of the ear canal creating the perfect environment for infection
