SWIMMER’S EAR

Affecting the outer ear, swimmer’s ear is a painful condition resulting from inflammation, irritation or infection. These symptoms often occur after water gets trapped in your ear, with subsequent spread of bacteria or fungal organisms. Because this condition commonly affects swimmers, it is known as swimmer’s ear. Swimmer’s ear (also called acute otitis externa) often affects children and teenagers, but can also affect those with eczema (a condition that causes the skin to itch) or excess earwax. Your doctor will prescribe treatment to reduce your pain and to treat the infection.

A common source of the infection is increased moisture trapped in the ear canal, from baths, showers, swimming or moist environments. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection of the ear canal. Swimmer’s ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing, as well as to prevent the spread of infection.

Other factors that may contribute to swimmer’s ear include:

• Contact with excessive bacteria that may be present in hot tubs or polluted water.
• Excessive cleaning of the ear canal with cotton swabs.
• Contact with certain chemicals such as hair spray or hair dye (Avoid this by placing cotton balls in your ears when using these products).
• Damage to the skin of the ear canal following water irrigation to remove wax.
• A cut in the skin of the ear canal.
• Other skin conditions affecting the ear canal, such as eczema or seborrhea.

The most common symptoms of swimmer’s ear are itching inside the ear and pain that gets worse when you tug on the auricle (outer ear). Other signs and symptoms may include any of the following:

• Sensation that the ear is blocked or full.
• Drainage.
• Fever.
• Decreased hearing.
• Intense pain that may radiate to the neck, face or side of the head.
• Swollen lymph nodes around the ear or in the upper neck (redness and swelling of the skin around the ear).

If left untreated, complications resulting from swimmer’s ear may include:

• Hearing loss. When the infection clears up, hearing usually returns to normal.
• Recurring ear infections (chronic otitis externa). Without treatment, infection can continue.
• Bone and cartilage damage (malignant otitis externa). Ear infections when not treated can spread to the base of your skull, brain, or cranial nerves. Diabetics and older adults are at higher risk for such dangerous complications.

To evaluate you for swimmer’s ear, your doctor will look for redness and swelling in your ear canal. Your doctor also may take a sample of any abnormal fluid or discharge in your ear to test for the presence of bacteria or fungus (ear culture) if you have recurrent or severe infections.

Treatment for the early stages of swimmer’s ear includes careful cleaning of the ear canal and use of eardrops that inhibit bacterial or fungal growth and reduce inflammation. Mildly acidic solutions containing boric or acetic acid are effective for early infections.

An itchy ear may be caused by a fungus or allergy, but more often from chronic dermatitis (skin inflammation) of the ear canal. Otolaryngologists also treat allergies, and they can often prescribe an eardrop, cream or ointment to treat the problem.

• A dry ear is unlikely to become infected, so it is important to keep the ears free of moisture during swimming or bathing.
• Use ear plugs when swimming.
• Use a dry towel or hair dryer to dry your ears.
• Have your ears cleaned periodically by an otolaryngologist if you have itchy, flaky or scaly ears, or extensive earwax.
• Don’t use cotton swabs to remove ear wax. They may pack ear wax and dirt deeper into the ear canal, remove the layer of earwax that protects your ear, and irritate the thin skin of the ear canal. This creates an ideal environment for infection.