Swimmers Ear

Swimmers ear is a common malady affecting both children and adults. Medically it’s called external otitis because it is an infection of the ear canal external to the ear drum. It occurs more often in summer because of swimming. When moisture gets in the ear, not only does it soften the skin allowing easier penetration by germs, it often brings bacteria with it into the ear canal. Some of the worst infections are caused by pond and creek water which has more germs than pool water where chlorine kills most germs. Also, Q-tips often abrade the delicate canal skin allowing penetration by germs and infection.

The symptoms of external otitis are tenderness and pain in the ear canal and sometimes decreased hearing if the canal swells shut. Tenderness when pulling on the outer ear which tugs on the canal is usually present with swimmers ear but not with otitis media, which is an infection behind the ear drum. The pain can be quite severe at times and may require pain medication for relief. Fever is rarely present with swimmers ear, but can be present in otitis media. Although usually not serious, external otitis can rarely be life threatening in immune compromised patients.

Treatment is usually successful with a number of different antibiotic drops so cultures are rarely indicated. Oral antibiotics are not very effective but are occasionally needed for more severe cases. When the canal swells enough to prevent drops from going in, sometimes a wick is inserted for a few days to allow drops to soak down into the infected deeper canal. Also, sometimes wax and dead skin needs to be washed out of the canal before drops can be effective.

Prevention is usually pretty simple. Keeping water out of the ear with plugs is one way. Either wax plugs or silly putty both work well. Instillation of a mixture of ½ rubbing alcohol and ½ white vinegar mixed together works great as well. This mixture can be instilled immediately after swimming or bathing and also works for those with chronic moist, itching ears if done daily.

Its VERY important that alcohol NOT be put in ears with PE tubes or holes in the ear drum. If you have a hole or PE tube in the ear drum, you should always consult with your physician before putting anything in the ear. Also because alcohol burns with more advanced swimmers ear, it works better for prevention that treatment. Last, sometimes a short course of steroids more quickly reduces pain and swelling. More complicated cases obviously require treatment by a specialist.

I hope this helps everyone have a great summer and be sure to see your physician for more serious problems.

Dr. Chuck Guice is a local Ear, Nose and Throat-Facial Plastic Surgeon and can be reached at ceg@ent-fps.com.