Swimmers ear

Swimmers ear or acute otitis externa is a painful condition of the outer (external) ear. The name is derived from the fact that swimmers are usually those affected. It occurs when water gets trapped in the ear. This leads to infection from naturally occurring bacteria and fungi in the ear canal.

Swimmers ear, a painful condition.

Swimmers ear, a painful condition.

Swimmers ear is most commonly seen in relation to warm water exposure at mineral baths and spas. Especially those with trapped earwax and skin conditions, like eczema are at risk. It occurs more often when the skin of the ear canal is damaged. The bacteria, which are normally found in the ear canal, multiply under moist conditions. It then spreads and causes inflammation and infection.

Regarded as one of the most painful ear conditions, swimmers ear usually requires treatment. Early on in the disease process mild acidic eardrops such as boric acid or acetic acid may be enough to stop the infection. Changing the acidity of the ear canal is very effective.

Pain medication, anti-biotics and anti inflammatories are often prescribed. Antibiotics may be administered as drops. Care should be taken before using any ear drops in an ear, which may have a perforation of the eardrum. Drops that enter the middle ear may cause hearing loss. All debri and infected material should be removed from the ear canal by a trained medical professional as part of the treatment. This may be painful, requiring a local anaesthetic beforehand. An ear swab may be taken to culture and determine the organism and anti biotic sensitivity.

Sometimes the swelling may be so severe that an earwig, impregnated with antibiotic drops and steroids may be needed to reduce the swelling.

Swimmers ear may furthermore cause hearing loss, tinnitus, vertigo, discharge and fever. Without treatment the infection may spread to involve the glands. It may cause permanent destruction of soft tissue, cartilage and bone of the ear canal and skull base. Patients should avoid water in their ears until the condition has resolved.

In those with recurrent episodes water should be kept out of the ears at all times. Custom made earplugs usually work better than other means to prevent water contamination. Ears should not be cleaned and hair spray, shampoo and soap should be kept out of the ear.

Patients with recurrent swimmer ears should be investigated for diabetes, immunosuppression, allergy and skin conditions such as eczema.