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April 30, 2019

Oh Ear! Swimmer’s Ear – Symptoms and Fixes

By Kathleen M. Wasylik, MD, Pediatric Ear, Nose & Throat Specialists

One of the best ways to enjoy Florida summers is by cooling off in the pool or ocean. Swimming can be refreshing and great exercise for kids! Unfortunately, increased water exposure brings an increased likelihood of getting swimmer’s ear. Formally called otitis externa, swimmer’s ear is an infection of the outer ear canal, which is the part of the ear that extends from the ear opening down to the eardrum.

There are multiple causes of otitis externa.  Most commonly, water is retained in the ear canal after swimming. This creates a moist environment that allows bacteria to grow and irritate the ear canal, causing swelling and often foul-smelling discharge. Other types of water exposure like showering, bathing and sweating can also create this vulnerable moist environment. Earwax is a protective element serving as a barrier to moisture and bacteria, so a lack of it can also increase your vulnerability to getting external ear infections. This is why Q-tip use and aggressive ear canal cleaning is discouraged. Certain conditions like allergies and eczema can increase one’s risk for otitis externa.

 

How do you know if you have swimmer’s ear? Initial symptoms include mild discomfort, itching, and slight redness or swelling of the canal. If it progresses, the ear canal and outside ear can be very panful to touch. The ear canal can be swollen, and moist malodorous drainage can occur.  Some people will complain of hearing loss.

It is important to note that otitis externa or “swimmer’s ear” is different from middle ear infections, which commonly occur in young children. A middle ear infection is an inflamed fluid collection in the space located behind the eardrum. The distinction is important because the treatments are different.

The good news is that otitis externa can be easily treated. Patients can be diagnosed relatively easily with a physical exam and medical history.  The first line of treatment is prescription topical ear drops that consist of antibiotics and steroids. Symptoms usually improve in 2-3 days but can often take 1-2 weeks to completely return to baseline. In some cases, oral antibiotics need to be added for resolution.  The drainage can be sampled to help direct therapy if needed.

Patients with active swimmer’s ear should typically not submerge under water until they feel better and their doctor clears them to do this. If your child gets external ear infections often, preventative measures include wearing earplugs and keeping the ear canal dry after water exposure, either with drying acidic drops like acetic acid/vinegar, or by using a hair dryer on a low heat setting.

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