Otitis externa and swimmers ear

Otitis externa and swimmers ear will affect many patients in South Africa this year! With the winter approaching a lot of people are planning a holiday or breakaway weekend at a resort with mineral baths and hot springs. This is can be very nice but be aware of ear infection. Hot springs have some of the most contaminated water around. Bacteria thrive in the warm water.

Otitis externa and swimmers ear due to fungal infections.
Fungal otitis externa with the “wet newspaper” look.

The risk of contaminated hot spring water is ear infection. Otitis externa and swimmers ear are common ear conditions that occur in patients after being infected with contaminated water.  It is a painful condition, characterized by inflammation of the skin of the external (outer) ear canal.  Acute otitis externa after water exposure is often referred to as “swimmers ear“. In patients with wax build up in the ear, fungal infections can occur with more longstanding symptoms as bacteria. This may cause chronic otitis externa. Aspergillus is a fungus that can infect the ear canal and when combined with the pus and wax in the ear has the appearance of a wet newspaper.

Besides pain the patient may also have hearing loss, discharge, vertigo, dizziness, swelling of glands and redness or crusting of the ear. Slight pulling of the ear on examination causes an increase in the pain.

The treatment of otitis externa and swimmers ear consists of pain medication, cleaning of the ear canal and antibiotics. Topical antiseptic ear drops and topical antibiotic ear drops are more affective than oral antibiotics. Some drops contain steroids. If swelling is severe a wick may be placed for a few days to keep the drops in constant contact with the inflamed skin.

Prevention is always better than cure. Try and keep the ears free of water. If you have to swim under water use ear plugs. Do not scratch in the ears and do not attempt to remove the wax with any instruments. Ear buds can damage the skin and create an entry to bacteria. It can also compact wax deeper in the canal, increasing the risk of infection. Eardrops are available on the market that can be used before swimming, protecting the ear against infection.