Swimmers Ear

Otitis externa, better known as swimmers’ ear, is a common summertime ear infection. This infection is found in the outer ear, the portion of the ear canal that runs from the eardrum to outside the head. Swimmer’s ear is not the same as inner ear infection, which is also common in children.

Causes

Water left in ear canal from swimming pools, lakes and bathing are some of the most common causes of swimmer’s ear. Contaminated water carrying bacteria enters the ear, and since bacteria need a moist place to grow, the ear is an ideal environment for swimmers’ ear to thrive.

Your ear has natural defenses to prevent infection such as earwax, which accumulates dead skin cells and other debris that travels to the opening of the ear to keep it clean, a thin slightly acid watery substance that discourages bacterial growth lines the ear canal, and the small opening to the outside of the ear helps prevent foreign objects from entering the ear.

The inner ear canal has a thin layer of protective skin that can be injured by using cotton swabs, hairpins or fingernails inserted in the ear. This can lead to bacterial invasion and subsequent infection. Ear devices, such as earbuds or hearing aids, which can cause tiny breaks in the skin, can also leave the ear susceptible to bacterial invasion.

Symptoms

Symptoms are classified as mild, moderate, and advanced

Mild symptoms include redness and slight itching in the ear canal, drainage of clear odorless fluid.

Moderate symptoms include pain in ear canal, more extensive redness in the ear, feeling of fullness inside your ear, decreased or muffled hearing and excessive fluid drainage.

Advanced symptoms include redness or swelling of the outer earn fever, swelling of the lymph nodes in the neck, severe pain radiating to the face, neck, or side of head and complete blockage of ear canal.

Complications

Swimmer’s ear isn’t usually serious if treated promptly. There are some serious complications that can arise if left untreated such as:

• Temporary hearing loss- muffled hearing until infection clears
• Deep tissue infection (cellulitis) (Rare)
• Also, rare but life threatening is bone and cartilage osteomyelitis. This is an in infection of the bone and surrounding cartilage. The infection can spread to the brain and surrounding nerves. This complication is more likely to be found in the older population and diabetic patients.
• Long-term infection (chronic otitis externa). An outer ear infection is usually considered chronic if signs and symptoms persist for more than three months. Chronic infections are more common if there are conditions that make treatment difficult, such as a rare strain of bacteria, an allergic skin reaction, an allergic reaction to antibiotic eardrops, a skin condition such as dermatitis or psoriasis, or a combination of a bacterial and a fungal infection.

Prevention

To avoid swimmer’s ear, keep ears as dry as possible and:

• Use a bathing cap, ear plugs, or custom-fitted swim molds when swimming.
• Use a towel to dry ears well.
• Tilt head back and forth so that each ear faces down to allow water to escape the ear canal.
• Pull earlobe in different directions when ear faces down to help water drain out.
• If there is still water in the ear, consider using a hair dryer to move air within the ear canal.
• Put the hair dryer on the lowest heat and speed/fan setting and hold the hair dryer several inches from ear.
• Swim wisely. Don’t swim in lakes or rivers on days when warnings of high bacteria counts are posted.

Treatment

• Check with your healthcare provider about using ear-drying drops after swimming.
• DON’T use these drops if you have ear tubes, punctured ear drums, swimmer’s ear, or ear drainage.
• DON’T put objects in ear canal (including cotton-tip swabs, pencils, paperclips, or keys).
• DON’T try to remove ear wax. Ear wax helps protect the ear canal from infection.
• If you think the ear canal could be blocked by ear wax, check with your healthcare provider.
• They may recommend an in-home earwax removal kit or have you come in to have the earwax removed.
• You may be prescribed antibiotic ear drops to kill the invasive bacteria or anti-fungal eardrops to combat the infections and steroids to help reduce swelling.