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Dermatology Information and Resources

External Otitis/Swimmer’s Ear

External Otitis or Swimmer’s Ear is a bacterial acute infection of the external ear canal tube between the outer ear and eardrum. Swimmer’s ear is more common in children, but is present in all age groups depending on their level of exposure to water.[1]

 

Common Symptoms: The onset of symptoms usually occurs within a few days of swimming. Severe ear pain is a common symptom of external otitis, discharge or pus, itchiness and inflammation of the ear canal, and possible temporary hearing loss if the ear canal swells.[2] Normally, just one ear is affected by external otitis and it can be easily reversed with prompt treatment.

 

Causes: Pools in particular, are places where germs carried through water can infect the ear canal. The more frequent an individual spends time in a pool, the more likely he or she will be contract swimmer’s ear. Getting water in your ear constantly allows for bacteria to collect inside the ear canal, eventually leading to infection.[3] External Otitis is not contagious, and those with eczema, asthma, and allergies have a greater likelihood of developing the condition. Recurring fungal infections or the use of ear plugs and other devices can also increase the risks since they can damage or scratch the inner ear, allowing bacteria to grow inside.[4]

 

Treatment: Diagnosis is based on inspection of the ear canal, and treatment utilizes debridement and topical drugs, including antibiotics, corticosteroids, and acetic acid.

In more severe cases, an oral antibiotic may be prescribed along with NSAIDs to reduce pain.[5] Preventative measures include wearing swim caps or earplugs while swimming to minimize water traveling into the ear canal. A good tip is to apply a few drops of a 1:1 mixture of rubbing alcohol and vinegar immediately after swimming to evaporate) water and restore the balance of PH.[6] Tilting your head to the right and left to drain the water from your ears after swimming is also recommended, as well as not removing ear wax from the ear if you are a frequent swimmer as this protects the inner ear. Use of cotton swabs are highly discouraged.

 

 

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References

[1] https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/otitis-externa
[2] https://www.cdc.gov/healthywater/pdf/swimming/resources/pseudomonas-factsheet_swimmers_ear.pdf
[3] https://www.aafp.org/afp/2012/1201/p1055.html
[4] https://www.cdc.gov/healthywater/pdf/swimming/resources/pseudomonas-factsheet_swimmers_ear.pdf
[5] https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/external-ear-disorders/external-otitis-acute
[6] https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/external-ear-disorders/external-otitis-acute