USF-COM
Department
of Family Medicine
Patient Education Information on...
Otitis Externa
"Swimmer's Ear"
by Saxton Moss, Class of 1999
What
is otitis externa?
What
causes it ?
What
are the symptoms ?
How
is it diagnosed ?
What
is the treatment ?
What
are some of the side effects of treatment ?
How
can "swimmer's ear" be prevented ?
Are
there any complications ?
Sources
of more information on otitis externa
Index of
Patient Education Topics
What is otitis externa ?
Otitis externa (swimmer’s ear) is an infection or inflammation of the external
ear and ear canal.
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Who develops otitis externa
and what causes it?
Although anyone can develop otitis externa, this condition is most common
in swimmers, young adults and teenagers, and in regions with warm, humid
climates. Swimmer’s ear usually results from the loss of protective cerumen
(wax), irritation or mechanical trauma within the ear canal, and exposure
to excessive moisture. These conditions can lead to a bacterial or
fungal infection of the skin lining the ear canal.
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What are the symptoms?
-
Discharge of pus from the ear.
-
Ear pain that worsens when the earlobe is pulled or pressed.
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Itching in the ear.
-
Slight fever (sometimes).
-
Short-term hearing loss on the affected side.
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How is the diagnosis made?
Examination of the ear reveals a red and swollen canal frequently
containing a whitish discharge. Pain will increase when the ear lobe
is pulled. These findings combined with the above symptoms enables
the physician to make the diagnosis of otitis externa.
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What is the treatment?
-
Treatment should begin with a gentle cleaning of the ear canal.
-
The doctor is likely to prescribe ear drops containing a combination of
an antibiotic and a steroid to treat the infection and to relieve the inflammation.
The drops may be administered by tilting the head to the side with the
infected ear up. If the doctor has recommended a wick, place the
drops directly onto the wick in order to keep the medication in contact
with the skin of the ear canal.
-
If the doctor has prescribed oral antibiotics, be certain to use them as
long as directed.
-
Be patient while the pain and infection run their course, the pain will
not subside overnight. Symptoms should improve over two to three
days, but the infection may take 7-10 days to completely resolve. Call
your health provider if the symptoms worsen or persist despite treatment.
-
No water, soap, shampoo, or other irritating agents should be allowed to
enter the ear during the infection. Ideally, swimming should be avoided
for 2-3 weeks after the infection has resolved.
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What are the side effects
of treatment?
Most cases of swimmer’s ear completely resolves without any side effects.
However, there is a possibility of a reaction to the ear drops or to an
oral antibiotic if it was prescribed. If a rash develops, stop the
antibiotic and call your physician. If a severe reaction occurs such
as shortness of breath or swelling of the face and body, seek medical attention
immediately.
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How can swimmer’s ear be
prevented?
-
Dry the ear thoroughly after exposure to moisture.
-
Avoid swimming in polluted water.
-
Protect the ear canal with cotton while applying hair spray or hair dye.
-
After swimming, place 1 to 2 drops of a mixture of 50% alcohol and
50% vinegar in each ear. This will help to dry the ear and prevent
infection.
-
Do not introduce objects (cotton swabs, pencils, etc.) into the ear. This
will only scratch and irritate the delicate skin of the ear canal leading
to a possible infection. The glands within the ear canal secrete cerumen
(wax) to protect the canal and minimize the growth of bacteria. This wax
is necessary and should not be removed.
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Are there any complications?
Malignant otitis externa is a severe complication of otitis externa usually
occurring in diabetic patients or in patients with suppressed immune systems.
Malignant otitis externa occurs when the infection spreads either to the
cartilage of the ear or to the skull behind the ear. The patient
will usually experience fevers, severe pain, and tenderness at these sites.
Treatment requires oral antibiotics and close observation by your physician.
If the infection is severe, hospitalization may be required.
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Sources of more information
on otitis externa