Swimmer’s Ear

Swimmer’s ear, outer ear infection or otitis externa is an infection in the outer ear canal.  It’s often brought on by water that remains in your ear after swimming, creating a moist environment that aids bacterial growth. Putting fingers, cotton swabs or other objects in your ears can damage the skin lining your ear canal causing otitis externa.

Signs and symptoms

• Itching or pain in your ear canal
• Slight redness inside your ear
• Mild discomfort that’s made worse by pulling on your outer ear
• Drainage of clear, odorless fluid or pus
• Decreased or muffled hearing
• Swelling in the lymph nodes in your neck
• Fever

Causes

• Excess moisture in your ear. Heavy perspiration, prolonged humid weather or water that remains in your ear after swimming can create a favorable environment for bacteria.
• Scratches or abrasions in your ear canal. Cleaning your ear with a cotton swab or hairpin, scratching inside your ear with a finger, or wearing headphones or hearing aids can cause small breaks in the skin that allow bacteria to grow.
• Sensitivity reactions. Hair products or jewelry can cause allergies and skin conditions that promote infection.

Risk factors

• Swimming
• Swimming in water with elevated bacteria levels, such as a lake rather than a well-maintained pool
• A narrow ear canal — for example, in a child — that can more easily trap water
• Aggressive cleaning of the ear canal with cotton swabs or other objects
• Use of certain devices, such as headphones or a hearing aid
• Skin allergies or irritation from jewelry, hair spray or hair dyes

Treatment

For most cases, doctor will prescribe eardrops that have some combination of the following ingredients,

• Acidic solution to help restore your ear’s normal antibacterial environment
• Steroid to reduce inflammation
• Antibiotic to fight bacteria
• Antifungal medication to fight an infection caused by a fungus

If your ear canal is completely blocked by swelling, inflammation or excess discharge, your doctor may insert a wick made of cotton or gauze to promote drainage and help draw medication into your ear canal.

If your infection is more advanced or doesn’t respond to treatment with eardrops, your doctor may prescribe oral antibiotics.

The doctor may also give you pain medication for the pain and fever.

During treatment, the following steps will help keep your ears dry and avoid further irritation:

• Don’t swim or scuba dive.
• Avoid flying.
• Don’t wear an earplug, hearing aid or headphones before pain or discharge has stopped.
• Avoid getting water in your ear canal when bathing. Use a cotton ball coated with petroleum jelly to protect your ear during a bath.

Prevention

• Keep your ears dry. Dry your ears thoroughly after exposure to moisture from swimming or bathing. Dry only your outer ear, wiping it slowly and gently with a soft towel or cloth. Tip your head to the side to help water drain from your ear canal. You can dry your ears with a blow dryer if you put it on the lowest setting and hold it at least a foot (about 0.3 meters) away from the ear.
• Swim wisely. Watch for signs alerting swimmers to high bacterial counts and don’t swim on those days. Also use ear plug while swimming.
• Avoid putting foreign objects in your ear. Never attempt to scratch an itch or dig out earwax with items such as a cotton swab, paper clip or hairpin. Using these items can pack material deeper into your ear canal, irritate the thin skin inside your ear or break the skin.
• Protect your ears from irritants. Put cotton balls in your ears while applying products such as hair sprays and hair dyes.

(Dr Lee Chong Han. Source Mayo Clinic and WebMD)