Otis externa is also known as “Swimmer’s Ear” and is a common ear problem that we see in the medical clinic. This is a condition that occurs when the skin in the ear canal becomes irritated. This can be caused directly from a bacterial or fungal infection but also can start as the result of an allergy or skin disorder such as eczema or psoriasis. We call it “swimmer’s ear” because it is more common in individuals who swim frequently.
External ear infections are different from the typical ear infection (otitis media). When a patient says the have an ear infection, we usually think of otitis media, and that is an inner ear infection.
Risk factors: Cleaning the ear canal removes wax that actually protects the ear canal from water and bacteria. If the wax is hard, crusty or sharp, it can actually tear the fragile skin within the ear canal and cause bleeding and lead to infection. Swimming on a regular basis can increase the risk of water remaining in the ear canal, and that can lead to infection. Wearing a hearing aid, headphones or ear plugs may increase the chances of external ear infections as well.
Symptoms: Pain, especially if the outer ear is pulled or moved, itchiness in the ear canal, fluid or pus leaking from the ear, difficulty hearing – the ear canal can actually swell shut.
Diagnosis: Your healthcare provider can examine the ear canal with a special instrument called an otoscope and make the diagnosis.
Treatment: The goal is to treat the infection, and also help with the pain/discomfort. In some cases, we irrigate the ear with water and hydrogen peroxide to remove dead skin cells and/or bacteria and that can speed recovery. Ear drops that contain antibiotics and sometimes a steroid are usually prescribed. It is important to apply the drops correctly.
1) Lie on your side or tilt your head towards the opposite shoulder
2) Fill the ear canal with the medication as prescribed by your medical provider
3) Lie on your side for 20 minutes or place a cotton ball in the ear canal to keep the medicine from draining out right away
4) Finish the entire course of treatment even if you feel better within a couple days
5) If your pain is not improving within 36-48 hours, call your healthcare provider
Pain medication can be prescribed, but most of the time over the counter anti-inflammatory medications such as ibuprofen or Aleve can be helpful.
Avoid getting your ears wet during treatment. When you’re in the shower, you can put a small piece of cotton over the ear canal to prevent water from getting in. You should not swim for 7-10 days after starting the treatment. Avoid wearing hearing aids or in-ear headphones until the treatment is completely finished.
Prevention: Avoid putting fingers, towels, Q-tips, or other devices within the ear. If you need to clean ear wax, talk to your healthcare provider.
For swimmers, some possible hints are:
1) Shake your ears dry after swimming, brow dry your ears on a low setting with the dryer at least 12 inches away from the ear (be careful),
2) Use ear drops after swimming to prevent infections
3) Consider wearing ear plugs that are made for swimming to prevent water from getting into the ear canals.
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO