What is Acute Otitis Externa (Swimmer's Ear)?
Written by Mike Cohen
Sunday, 04 October 2009
Swimmer's ear is an inflammation or infection of the tissues of the outer ear and the external ear canal. The ear canal is the narrow tube that extends from the outer ear to the eardrum.
What is going on in the body?
Swimmer's ear is an inflammation or infection of the outer ear and the external canal. The ear canal contains glands that produce oil, sweat, and ear wax. Ear wax helps maintain an acidic environment in the ear canal.
If the ear canal loses its acidity, bacteria can grow more easily. Some people, such as individuals with diabetes, have a less acid environment. A wet environment in the ear canal also makes it a breeding ground for bacteria. Water that is left in the ear after swimming or bathing can promote infection.
What are the causes and risks of the infection?
Conditions that can lead to swimmer's ear include:
- benign ear growths in the ear canal that do not allow water to drain out effectively
- chronic otitis externa, or chronic irritation of the ear canal
- dermatitis due to allergic reactions to hair spray, dyes, or other chemicals
- dermatitis due to conditions such as psoriasis and eczema
- lower levels of acidity in the ear wax, such as in people with diabetes
- using cotton-tipped swabs, which may injure the ear canal or pack the wax tightly
- very narrow openings into the ear canal, such as in people with Down syndrome
- water left in the ear after bathing or swimming, which is why it is also called swimmer's ear
Most episodes of swimmer's ear are caused by bacteria. Fungal infections may also occur in the ear canal, although they are less painful. These often do not respond as quickly to antibiotics and may require specific antifungal medicines.
What are the treatments for the infection?
Swimmer's ear is usually treated with ear drops that contain antibiotics and steroids. One common medicine is hydrocortisone/neomycin/polymixin B. It is also very important to have the ear wax removed. If the infection spreads into the soft tissues around the ear, oral antibiotics may be needed. If the ear canal is particularly swollen, a wick may be inserted to draw the ear drops in.
Antifungal medicines will be prescribed for fungal infections. Over-the-counter pain medicines may be used for discomfort.
What are the side effects of the treatments?
Some people have a neomycin skin sensitivity. This can cause a reaction in the ear canal very similar to poison ivy dermatitis. If the person continues to have itching and a lot of swelling of the ear canal, then the neomycin needs to be stopped. Other treatments that do not contain neomycin may be used.
What happens after treatment for the infection?
Successful treatment completely heals the ear canal.
How is the infection monitored?
Any new or worsening symptoms should be reported to the healthcare provider.