Swimmer's Ear

Affecting the outer ear canal (not the inner or middle ear), swimmer’s ear (also called acute otitis externa or AOE) is a painful condition resulting from inflammation, irritation, or infection of the skin in the ear canal.

WHAT CAUSES SWIMMER’S EAR?

Increased moisture trapped in the ear canal, from baths, showers, swimming, or moist environments is the most common culprit. When moisture is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection of the ear canal. Swimmer’s ear often affects children and teenagers, but can also affect those with eczema (a condition that causes the skin to itch), or those with excessive earwax (trapping moisture beneath). Swimmer’s ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing, as well as to prevent the spread of infection.

Other factors that may contribute to swimmer’s ear include:

•Contact with excessive bacteria that may be present in hot tubs or polluted water (like lakes and oceans)

•Excessive cleaning of the ear canal with cotton swabs or anything else (removing the protective natural barriers)

•Contact with certain chemicals such as hair spray or hair dye (Avoid this by placing cotton balls in your ears when using these products.)

•Damage to the skin of the ear canal following  irrigation to remove wax

•A cut in the skin of the ear canal

•Other skin conditions affecting the ear canal, such as eczema or seborrhea

WHAT ARE THE SIGNS AND SYMPTOMS?

The most common symptoms of swimmer’s ear are itching inside the ear and  pain (often very severe) that gets worse when you tug on the auricle (outer ear). Other signs and symptoms may include any of the following:

•Sensation that the ear is blocked or full

•Drainage

•Fever

•Decreased hearing

•Intense pain that may spread to the neck, face, or side of the head

•Swollen glands around the ear or in the  upper neck or redness and swelling of the skin around the ear

WHAT CAN HAPPEN WITH SWIMMER’S EAR?

Hearing loss. When the infection clears up, hearing usually returns to normal. Left untreated, temporary hearing loss can occur.

Recurring ear infections (chronic otitis externa). Without treatment, infection can continue and lead to chronic pain, drainage, and discomfort.

Bone and cartilage damage (malignant otitis externa). External ear infections, when not treated, can spread to the base of your skull, brain, or cranial nerves. Diabetics and older adults are at higher risk for such dangerous complications.

HOW IS IT DIAGNOSED?

To evaluate you for swimmer’s ear, your doctor will look for redness and swelling in your ear canal. 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 or severe infections.  

HOW IS SWIMMER’S EAR TREATED?

Treatment includes careful cleaning of the ear canal and use of eardrops that inhibit bacterial or fungal growth and reduce inflammation. Mildly acidic solutions containing boric or acetic acid are effective for early infections. Antibiotic and anti-inflammatory drops may be prescribed for more severe infections. With proper treatment, most infections should clear up in 7-10 days.


HOW SHOULD PRESCRIPTION EAR DROPS BE APPLIED?

•Drops are more easily administered if done by someone other than the patient.

•The patient should lie down with the affected ear facing upwards.

•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 the drops can be absorbed.

*If the ear canal is swollen shut, a sponge or wick may be placed in the canal so the antibiotic drops will enter the swollen canal more effectively.  Pain medication may also be prescribed.

HOW CAN YOU PREVENT SWIMMER’S EAR?

You can make your own eardrops using rubbing alcohol or a mixture of half alcohol and half vinegar. These eardrops will evaporate excess water and keep your ears dry. After swimming, shake out any moisture in your ear canal, instill 4-5 drops of vinegar or alcohol solution, and leave in for a minute or two.   You can also blow dry your ear canals with cool air, on a low speed, to dry out wet ear canals.

ARE THERE ANY MORE TIPS FOR PREVENTION?

•Use ear plugs when swimming   - a dry ear is at less risk •Have your ears cleaned periodically by an otolaryngologist if you have itchy, flaky or scaly ears, or extensive earwax

•Don’t use cotton swabs to remove earwax. They may pack earwax 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. This creates an ideal environment for infection.

When to Call the Doctor

Call your doctor immediately if your child has any of the following: pain in the ear with or without fever, decreased hearing in one or both ears, or abnormal discharge from the ear.

For a link to the segment on this subject go to: http://youtu.be/GmeTHVCsptg