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Otitis Externa
(Swimmer’s Ear)

Definition:
Otitis externa is an infection, inflammation, or irritation of the ear canal, the tube leading from the outer ear to the eardrum. Because it is often found in swimmers, particularly in warm, humid climates, it is often referred to as swimmer’s ear. This condition can easily be treated but can become serious, even life-threatening in some people, if left untreated. This can be very serious particularly in diabetics, where the infection can spread to the middle and inner ears, and cause an infection in the bone (osteomyelitis).Contact your doctor if you think you may have otitis externa.

Causes:
Otitis externa can develop under the following circumstances:
  • Following frequent swimming or bathing when the ears are repeatedly filled with water and not drained completely afterward
  • After removal of protective ear wax, especially if the cleaning is painful and causes bleeding
  • If cotton swabs are excessively used
  • If the skin in the ear canal is injured
  • As a consequence of skin conditions such as psoriasis, eczema, seborrhea, acne, or lupus erythematosus, that also can occur in the ear canal
Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing otitis externa:

  • Frequent swimming or showering, particularly in young children who have narrow ear canals
  • Insertion of any object into the ear canal causing damage to the lining
  • Skin conditions causing breaks in the skin of the ear canal
  • Diabetes
  • Medical conditions resulting in a compromised immune system

People with weak immune systems or who have a chronic illness, such as diabetes or AIDS, may suffer an aggressive form of the condition called malignant otitis externa. Malignant otitis externa is a disorder causing severe damage of the bones and cartilage of the base of the skull. It is caused by the spread of an untreated or poorly treated otitis externa infection in susceptible people. This life-threatening condition requires immediate treatment.

Symptoms:
If you experience any of these symptoms do not assume it is due to otitis externa. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.
  • Redness and/or itching inside the ear canal
  • Pain in the ear, sometimes severe, that may worsen when chewing or talking, and with pulling on the ear
  • Hearing loss or a plugged-up or pressure sensation of the ear
  • Drainage from the ear
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a visual exam of the ear, including the ear canal and inner ear, using a lighted device called an otoscope.

Treatment:
Treatment options include the following:

Drainage
Your doctor will remove any drainage or pus from the ear canal if present using a suction.

Drug Treatment
Prescription ear drops containing infection-fighting medications and inflammation reducers like antibiotics and corticosteroids are the usual treatment for otitis externa. Sometimes, antibiotic or antifungal pills are prescribed. With treatment, symptoms of otitis externa usually decrease in severity within 24 hours to three days.

Other Suggestions Your Doctor May Recommend:
  • Keep the ear dry for 7-10 days.
  • Take baths instead of showers.
  • Avoid swimming.
  • Do not rub or scratch the ear or inside the ear canal.
Prevention:
To help reduce your chances of getting otitis externa, or from having the condition recur, take the following steps:
  • Avoid swimming in unclean water.
  • Thoroughly drain and dry the ear and ear canal after swimming or showering.
  • When showering, gently place a cotton ball lightly coated with petroleum jelly into the outer ear to prevent water collection.
  • Do not insert anything into the ear canal, including your finger or cotton swabs.
  • Do not remove ear wax. If you are having problems hearing, see a doctor first.
  • Avoid using ear plugs since they can irritate the lining of the ear canal and can trap water inside the ear.
  • Consider using a tight-fitting swimming cap.
  • Using a white vinegar/rubbing alcohol eardrop solution following swimming will help restore the natural healthy environment inside the ear canal.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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