Swimmer’s ear

Otitis externa, also known as swimmer’s ear or tropical ear,
is an inflammation of the external ear canal.

CAUSE

The inflammation may be caused by infection, allergy, or other
causes. Otitis externa can be caused by water getting inside the
ear canal, and it is often more common in humid conditions.
However, in many cases, the cause remains unknown.

 

Some of the known causes and risk factors for Otitis externa
include: 

• Water – contaminated water can deliver bacteria to the ear
  canal. A wet ear canal is also prone to dermatitis. Tiny cracks or
  splits in the skin can allow bacteria to enter. 
• Mechanical damage – attempts to clean the ears using
  fingernails, cotton buds or other objects may cut the delicate
  tissues of the ear canal and lead to infection. 
• Chemical irritation – hairsprays, shampoos and hair dyes may
  get into the ear canal and irritate the tissues. 
• Middle ear infection (otitis media) – an infection within the
  middle ear can trigger an infection or inflammation in the external
  ear canal. 
• Diabetes – this condition can create an alkaline environment in
  the ear canal which increases the risk of infection. 
• Folliculitis – an infected hair follicle within the ear canal
  can trigger a generalised infection. 
• Narrow ear canals – some people have narrow ear canals and this
  means that water cannot drain as effectively.

SIGNS AND SYMPTOMS

Some of the symptoms of Otitis externa include:

• Pain
• The pain may be exacerbated by moving the head or pulling at
  the ear
• Itchiness
• Foul-smelling yellow or green pus in the ear canal
• Reduced hearing
• Noises inside the ear, such as buzzing or humming.

TREATMENT OPTIONS

As with all medical conditions it is advisable to consult your
Doctor for an accurate diagnosis and treatment. Antibiotic ear
drops or spray may be prescribed to clear any infection and a
steroid to reduce the inflammation and itch. Oral antibiotics may
be prescribed if the infection is severe. Paracetamol or ibuprofen
will help to ease any pain. Holding a hot flannel against the ear
may also ease pain.

PREVENTION

If you are prone to Otitis externa, it is important to keep
your ears dry and touch them as little as possible. This
means:

• Try not to let soap or shampoo get into your ear canal. You can
  do this when you have a shower by placing a piece of cotton wool
  coated in soft white paraffin into the outer ear. 
• Avoid using corners of towels or cotton buds to dry any water
  that does get in the ear canal. This will push things further in.
  Let the ear dry naturally. 
• Try not to scratch or poke the ear canal with fingers, cotton
  wool buds, towels, etc. 
• Do not use cotton buds to clean the ear canal. These can
  scratch and irritate the outer ear and push wax or dirt further
  into the ear. 
• Keep your ears dry when swimming. You can do this by wearing a
  tightly fitting cap that covers the ears. Some swimmers use
  silicone rubber earplugs, which are only suitable if they do not
  irritate the skin in your ear canal.

VITAMINS/MINERALS/HERBS

Nutritional supplements may be of use if dietary intake is
inadequate.

• Vitamins A, C, E and the mineral, zinc, are antioxidant
  nutrients. These help to keep the body’s immune system healthy and
  able to combat infection. See the Antioxidants topic.
• Tea tree essential oil is made from the herb Melaleuca
  alternifolia. This oil has antimicrobial properties which make it
  effective against many common bacteria and fungi. It may also help
  to relieve itching. A few drops may be added to 10mls of clean
  water and applied to the ear with a sterile cotton bud to help
  prevent and treat Otitis Externa. See the tea tree oil topic.
• Propolis is a natural bee product which has anti-bacterial
  properties. A few drops of propolis liquid may be added to 10mls of
  clean water and applied to the ear with a sterile cotton bud to
  help prevent and treat Otitis Externa. It may also be taken
  internally to boost the immune system.

 

Ask your Pharmacist for advice.

1. Follow the Diet Hints. It is believed that a balanced diet
   helps the body to recover from infections.
2. If you have any queries about prescribed medication be sure to
   ask your Pharmacist.
3. If a painkiller is required ask your Pharmacist for the most
   suitable brand and how it should be taken. Products containing
   paracetamol and ibuprofen may be used.
4. In any treatment it is important to keep the infected ears as
   dry as possible and no swimming should be undertaken until the
   infection has cleared up. Before using ear drops it is important to
   ensure that the ear is thoroughly cleaned. If the ear is not
   cleaned properly between applications of ear drops a build up of
   debris may cause the drops to run out of the ear. Tilting the head
   to the side whilst instilling the drops will help to keep the drops
   in the ear canal. 
5. Try to avoid scratching or rubbing the ear as this may
   aggravate the condition and/or expose the ear canal to further
   infection by possibly moving the debris around or introducing
   further bacteria into the canal.
6. If you are prone to swimmer’s ear, ask your Pharmacist about
   suitable ear plugs that can be inserted before swimming and
   showering to keep the ear canal clean and dry to prevent further
   infections. 
7. To help keep the ear clean and dry your Pharmacist may
   recommend special ear drops made up of a solution of acetic
   acid/isopropyl alcohol. These drops promote an acid pH in the ear
   canal and at the same time help kill unwanted bacteria. Sometimes
   it is a good idea to use the drops both before and after swimming.
   Never use these drops if the ear is inflamed.
8. If an infection is present consider using a hot pack over the
   ear to gain relief. Use a higher pillow to help raise the
   head.
9. Never push cotton buds into the ears to clean them as it may
   disrupt the natural cleaning mechanisms and push debris further
   into the ear.