Swimmer’s Ear (Otitis externa)

Swimmer’s Ear (Otitis externa)

What do we know?

Swimmer’s ear is an infection of the ear canal.  It occurs outside of the eardrum and is called otitis externa.  Most ear infections are behind the eardrum, called otitis media.

It occurs when water stays in the ear canal after swimming.  This allows bacteria which are naturally in the ear canal, or bacteria from the water, to grow and multiply in the wet ear canal.

Swimmer’s ear can also occur when the ear canal is scratched. This can occur from fingers in the ear, cotton-tip swabs, or ear buds.

What are the symptoms of swimmer’s ear?

The strongest symptom is pain when the ear lobe is tugged, or when you push on the tragus, which is the small portion of skin in front of the ear canal.

Other common symptoms include:

  • itchiness in the ear
  • discharge from the ear canal – usually clear at first, but can become thick
  • redness or swelling of the ear

If untreated, symptoms can progress to:

  • redness around the ear
  • decreased hearing
  • a feeling of fullness or something being in the ear (usually pus and swelling in the ear canal)

Who can get swimmer’s ear?

Swimmer’s ear is most common in children, however people of all ages can get it.

It is important to remember that this infection is not spread from person-to-person.

Very rarely, people with diabetes and immune weaknesses can get a more severe complication of swimmer’s ear, called malignant otitis externa.

How does the body prevent swimmer’s ear?

The body has two defences against infection of the ear canal:

  1. Cerumen, or ear wax.  This substance coats the wall of the ear canal to reduce bacterial growth.  It also collects dirt and debris and moves these substances out of the ear canal.  You should never try to remove wax from an ear canal unless you can see it directly at the opening to the ear canal.  Trying to remove wax often pushes it back into the canal, which works against the protective activity of the wax.
  2. The positioning of the ear canal.  The ear canal points downwards from the eardrum, helping water and debris drain out of the ear.  Younger children have narrower and flatter ear canals, increasing their risk of swimmer’s ear.

How can I help prevent swimmer’s ear?

Dry your ears after swimming, bathing and showering.  Use a towel, and avoid putting cotton-tip swabs or other small objects in the ear.

You can also use a hairdryer on a warm (not hot) setting to blow into the ear to help it dry.

Don’t try to clean out ear wax that you cannot see.

Be sure to keep your pool or hot tub properly treated with disinfectant, and monitor the pH level of the water.

When should my child or teen see a doctor or nurse practitioner?

When the ear becomes painful, as described above, or the drainage is no longer clear, treatment with antibiotics is usually needed.

Sometimes this can be done with antibiotic ear drops.  However, if your child has tubes, or ruptured or perforated ear drums, drops cannot be used.

Other treatments that are sometimes needed include oral antibiotics, steroids to reduce inflammation, and anti-fungal medications.

During treatment, avoid swimming, keep water out of the ears during bathing, and don’t use ear buds.

– Dr G Paul Dempsey

Feature Image:  HealthTap


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