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Swimmer’s Ear (Acute Otitis Externa)

By Jeffrey Sterling, MD July 19, 2019

Introduction

This Straight, No Chaser post is about swimmer’s ear, formally known as Acute Otitis Externa.

swimmers ear

It’s that time of year. Whether you’re getting purified in Lake Minnetonka (obscure pop culture reference alert) or your local watering hole, as the weather warms, a lot of people end up with swimmer’s ear. This is the time of year when certain bacteria and other organisms have their day in the (dirty) water and are waiting to infect you.

 swimmers-ear qtip

Swimmer’s Ear

Acute otitis externa (aka swimmer’s ear) is an infection or inflammation of the outer ear and ear canal. It is a different infection that those inner ear infections that kids seem to get all the time. That condition is otitis media. Those two infections may occur at the same time, although it isn’t likely. Otitis externa isn’t just caused by polluted water. Anything that causes inflammation or infection can cause it. For example, otitis externa may be a consequence of a bite or scratch to the ear or a foreign body in the ear. This is yet another reason for not inserting cotton swabs or other objects into the ear.

 swimmersearpain

Symptoms of Swimmer’s Ear

If you develop acute otitis externa, you’ll know it. Symptoms include itching and pain, pus-like drainage from the ear and hearing loss. Unlike those inner ear infections, in otitis externa you may notice the pain is pronounced when you pull on the outer portion of the ear.

Treatment of Swimmer’s Ear

The interesting thing about treatment of otitis externa is it isn’t that complicated and usually gets better promptly. What is complicated about it is failure to get treated can result in some serious complications. Treatment is accomplished by giving antibiotic eardrops. Some of you who have had swimmer’s ear may recall the use of an ear wick to facilitate the drops making their way to the end of the ear canal. Other treatments may include oral antibiotics, topical steroids, pain medication and vinegar eardrops (the acid in the vinegar works to prevent further growth of bacteria).

Regarding you placing vinegar in the ear yourself: it is often stated that mixing one drop of white vinegar with one drop of alcohol and placing this into the ear can help. My advice to you is regardless of any home remedies or over-the-counter measures you take, you should get evaluated because of the risk of complications if not adequately treated. Placing any object – even fluid – in your ear presents additional risks, particularly in those rare instances in which the eardrum has ruptured. I subscribe to the old adage that you shouldn’t place anything in your ear smaller than your elbow.

Complications of Swimmer’s Ear

 swimmersear

Regarding complications, because of the aggressive nature of the bacteria causing acute otitis externa (named Pseudomonas), things can take a dramatic turn for the worst.

  • Infectious acute otitis externa may spread to other areas including the skull bone, causing an infection known as osteomyelitis.
  • In those with reduced immunity, diabetics or the elderly, the infection may become severe and life threatening. This is called malignant otitis externa.

Prevention and Protection

Protecting yourself from swimmer’s ear isn’t that difficult. It mainly requires you to think about the possibility, mostly when you’re getting water in your ears.

  • Avoid swimming in polluted water.
  • Avoid placing any objects such as cotton swabs in your ears. It’s ok and helpful to use earplugs when swimming.
  • Ensure water doesn’t get into your ears when bathing, shampooing or showering. Thoroughly dry the ear after exposure to moisture.

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