Prevent Swimmer’s Ear this Summer

Otitis externa – more commonly known as ‘swimmer’s ear’ – is an inflammation or infection of the outer ear and ear canal. This should not be confused with otitis media – an infection of the middle ear that most commonly affects young children and may be associated with upper respiratory infections such as colds. Otitis externa is found in all age groups, most commonly in teens and young adults. It typically occurs when the protective skin barrier which lines the ear canal and outer ear is disrupted. When this lining is damaged, bacteria can penetrate the skin and lead to otitis externa.

The most common symptom of otitis externa is pain beginning over a day or two and usually only involving one ear. The pain may intensify when the outer ear is touched or pulled. The ear or ear canal may itch and the ear canal may feel full and swell, sometimes so much that hearing is affected. Occasionally, the ear may drain a yellow or yellow-green liquid which may be foul-smelling. Fever is unusual.

Swimmer’s ear is more likely if you wear headphones inserted into the ear or if you scratch the ear canal with a cotton swab, bobby pin, fingernail, or other sharp object. People with a narrow or hairy ear canal or with impacted ear wax may trap excess water in the ear canal and are also at greater risk. Some skin conditions such as eczema or psoriasis may lead to excess scratching of the ear and skin breakage, thus increasing your chances of developing otitis externa. Of course, persistent moisture in your ear from swimming (especially in polluted water), living in a humid climate, or taking long showers can also lead to otitis externa. Finally, irritating the ear canal with chemicals such as hair dyes, bleaches or shampoos can put you at risk of swimmer’s ear.

If you suspect that you have swimmer’s ear, home care may control pain temporarily, but over-the-counter eardrops do not contain antibiotics, which can only be obtained after a doctor’s evaluation. People with diabetes or immune system problems definitely need to be seen by their physician if they think they have otitis externa because they are more likely to develop complications which may require oral or intravenous antibiotics and perhaps even hospitalization.

If your doctor diagnoses otitis externa, he or she is likely to prescribe ear drops containing antibiotics and perhaps steroids to reduce swelling, itching and inflammation. If the ear is very swollen, it may be difficult for ear drops to penetrate the canal. In this case, your doctor may insert a wick into the canal or may refer you to an otolaryngologist (ear, nose and throat specialist). If you develop persistent fever or if new symptoms develop, including pain and redness behind the ear, call your doctor right away. Otitis externa usually clears up within a week and pain generally resolves within 24 hours of starting the prescribed ear drops.

Otitis externa can be prevented. Avoid scratching your ears and definitely do not put cotton swabs or other objects into your ear canal. Keep your ears clean and dry and do not let water enter your ears while shampooing or bathing. Avoid swimming in polluted water. Use earplugs when swimming or a shower cap when bathing. If your ears do get wet, you can put a few drops of a 50:50 solution of rubbing alcohol and white vinegar into your ear canals to help them dry and to prevent bacterial growth. However, if you have a hole in your eardrum or if you have had ear surgery or ear tubes, consult your doctor before you use any type of ear drop.

Dr. McMahon, a graduate of Yale University and the University of Pittsburgh School of Medicine, is board certified in Internal Medicine. She is a member of the American College of Physicians and the Allegheny and Pennsylvania Medical Societies. She is in solo practice in the North Hills.