Swimmer's ear (otitis externa) 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.
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.
Swimmer's ear generally causes discolored ear drainage and intense ear pain.
Discharge from bacterial infections may be yellow or green. Discharge from a fungal infection might appear as a mixture of dark gray, white, and yellow pus with mold on its surface. Drainage might be foul-smelling.
Sometimes, when a person's ear canal is full of dirt or swollen, his or her hearing is impaired.
The outer ear and ear canal are also very tender and painful to the touch. In addition, the person may have a fever. Sometimes the tissue in front of and below the ear can also become painful, tender, and swollen. This occurs as the infection in the ear canal moves our of the outer ear canal and then into the surrounding soft tissue.
Conditions that can lead to swimmer's ear include: benign ear growths in the ear canal that do not allow water to drain out effectivelychronic otitis externa, or chronic irritation of the ear canaldermatitis due to allergic reactions to hair spray, dyes, or other chemicalsdermatitis due to conditions such as psoriasis and eczemalower levels of acidity in the ear wax, such as in people with diabetesusing 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 syndromewater 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.
Since water is the most common cause of swimmer's ear, it is important to get all the water out of the ear canal after bathing or swimming. Some measures to keep water from collecting in the ear canal include: inserting antiseptic ear drops that can be purchased over the counter into the ear canal after swimming or bathinginserting oily or lanolin ear drops into the ear canal before swimming or bathinginserting rubbing alcohol into the ear canal after swimming or bathinginserting a vinegar and rubbing alcohol solution (1 part of vinegar and 1 part of rubbing alcohol, mixed together) into the ear canal after swimming or bathing
Swimmer's ear is diagnosed by examining the outer ear canal. Cultures can be helpful if the infection is not responding to treatments.
If swimmer's ear is not identified and treated effectively, it can cause complications such as: hearing impairment from scarring or narrowing of the ear canalinfection of soft tissues of the face and neck. This complication is seen especially in people with diabetes and in others with impaired immune systems.necrotizing external otitis, which is an infection of the bones of the ear canal and skull
Swimmer's ear is not contagious and poses no risk to others.
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.
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.
Successful treatment completely heals the ear canal.
Any new or worsening symptoms should be reported to the healthcare provider.