Swimmer's Ear

Overview

Swimmer's ear, also known as otitis externa, is an infection in the outer ear canal, which runs from your eardrum to the outside of your head. It is often caused by water remaining in the ear, creating a moist environment that aids the growth of bacteria. Swimmer's ear can also be caused by damage to the thin layer of skin lining the ear canal by inserting fingers, cotton swabs, or other objects. Symptoms can range from mild itching and redness to severe pain, blockage, and hearing loss. It is important to contact a doctor for even mild symptoms and to seek immediate medical attention for severe pain, fever, or other complications. Prompt treatment with eardrops can help prevent complications and more-serious infections.

Understanding the disease

Symptoms

The symptoms of swimmer's ear typically include itching in your ear canal, slight redness inside your ear, mild discomfort made worse by pulling on your outer ear or pushing on the little "bump" in front of your ear, some drainage of clear, odorless fluid, and a feeling of fullness inside your ear. As the infection progresses, symptoms can become more severe, including increased pain, more extensive redness in your ear, excessive fluid drainage, decreased or muffled hearing, and complete blockage of your ear canal. In advanced stages, swimmer's ear can cause severe pain that may radiate to your face, neck, or side of your head, redness or swelling of your outer ear, swelling in the lymph nodes in your neck, and fever. It's important to contact your doctor if you experience any mild signs or symptoms of swimmer's ear, and to seek immediate medical attention if you have severe pain or fever.

Risk Factors

Risk factors for developing swimmer's ear include:

1. Excess moisture in the ear canal from heavy perspiration, prolonged humid weather, or water remaining in the ear after swimming.
2. Exposure to high bacteria levels in contaminated water.
3. Cleaning the ear canal with cotton swabs, hairpins, or fingernails, which can cause scratches or abrasions.
4. Using earbuds or hearing aids, as these devices can cause tiny breaks in the skin.

Development

Swimmer's ear is an infection of the outer ear canal caused by bacteria. It is often the result of water remaining in the ear, which creates a moist environment that aids bacterial growth. Various factors contribute to the development of swimmer's ear, including:

1. Moisture in the ear canal: Excess moisture from heavy perspiration, prolonged humid weather, or water remaining in the ear after swimming can create an ideal environment for bacterial growth.
2. Exposure to contaminated water: Swimming in contaminated water, such as lakes, rivers, or pools that are not properly maintained, can expose the ears to high levels of bacteria.
3. Damage to the ear canal: Inserting fingers, cotton swabs, or other objects into the ear canal can damage the sensitive skin, creating an opening for infection.
4. Ear devices: Wearing earbuds, hearing aids, or other devices can cause tiny breaks in the skin of the ear canal, allowing bacteria to enter.
5. Poor ear hygiene: Not properly cleaning the ears or using cotton swabs, hairpins, or fingernails to clean the ear canal can cause scratches or abrasions, increasing the risk of infection. Prompt treatment with eardrops can help prevent complications and more severe infections. If you experience symptoms of swimmer's ear, it's important to contact your doctor for proper diagnosis and treatment.

Assessment and Diagnosis

Triage

You should contact your doctor if you have even mild signs or symptoms of swimmer's ear. If you experience severe pain, fever, or any other related symptoms , you should call your doctor immediately or visit the emergency room.

Diagnosis

Swimmer's ear is typically diagnosed during an office visit based on the symptoms reported by the patient, questions asked by the doctor, and an examination of the ear canal. Doctors may use an otoscope to examine the ear canal, checking for signs of redness, swelling, scaliness, skin flakes, or other debris. They will also assess the condition of the eardrum to ensure it's not torn or damaged. If the infection is advanced or persistent, further evaluation, such as a lab test, might be recommended. If the eardrum is damaged or torn, a referral to an ear, nose, and throat specialist may be made. To prevent future occurrences of swimmer's ear, avoid swimming or using cotton swabs in the ear, keep the ears dry, and use petroleum jelly to protect the ears while showering or bathing.

Management and Treatment

Complications

Potential complications of swimmer's ear include temporary hearing loss, long-term infection (chronic otitis externa), deep tissue infection (cellulitis), and in rare cases, complications related to the spreading of the infection. If left untreated, swimmer's ear can lead to serious complications. Therefore, it is essential to seek medical attention and promptly treat any symptoms of swimmer's ear.

Prevention

To prevent swimmer's ear, you should keep your ears dry and protect them from moisture, bacteria, and irritants. Follow these tips:

1. Dry your ears properly: After swimming or bathing, tip your head to the side to help water drain from your ear canal. Dry only your outer ear, wiping it gently with a soft towel. If you want to dry your outer ear canal, you can use a blow-dryer on the lowest setting, holding it at least a foot (about 0.3 meters) away from the ear.
2. Use homemade eardrops: If you know you don't have a punctured eardrum, you can make homemade preventive eardrops with a solution of 1 part white vinegar to 1 part rubbing alcohol. This solution promotes drying and helps prevent the growth of bacteria and fungi. Use it before and after swimming by pouring 1 teaspoon (about 5 milliliters) of the solution into each ear and letting it drain back out.
3. Swim wisely: Avoid swimming in lakes or rivers when warnings of high bacteria counts are posted.
4. Protect your ears while swimming: Wear earplugs or a swimming cap to keep your ears dry.
5. Protect your ears from irritants: Use cotton balls in your ears while applying products such as hair sprays and hair dyes.
6. Be cautious after an ear infection or surgery: Consult your doctor before swimming if you have recently had an ear infection or ear surgery.
7. Avoid putting foreign objects in your ear: Do not scratch an itch or dig out earwax with items like cotton swabs, paper clips, or hairpins, as they can cause irritation or break the skin. By following these preventive measures, you can significantly reduce the risk of developing swimmer's ear.

Home Remedies

Home remedies for swimmer's ear include using homemade preventive eardrops, avoiding the use of cotton swabs or other objects in the ear, and keeping the ears dry after swimming or bathing. You can make homemade preventive eardrops by mixing 1 part white vinegar to 1 part rubbing alcohol. Before and after swimming, pour 1 teaspoon (about 5 milliliters) of the solution into each ear to promote drying and prevent the growth of bacteria and fungi.

Treatment

The treatments for swimmer's ear typically involve using eardrops. If the eardrum is not punctured, homemade preventive eardrops can be made using a solution of one part white vinegar to one part rubbing alcohol. This solution helps dry the ear and prevent the growth of bacteria and fungi. Over-the-counter solutions may also be available at a drugstore. Prompt treatment is important to prevent complications and more-serious infections.

Preparing for medical consultation