Swimmer's Ear (Otitis Externa)

Swimmer’s Ear (Otitis Externa) | Things You Need to Know | ENT

What is a swimmer’s ear?

Swimmer’s ear is an infection in the outer ear canal, which runs from your eardrum to the outside of your head. It’s often brought on by water that remains in your ear after swimming, creating a moist environment that aids bacterial growth. Putting fingers, cotton swabs or other objects in your ears also can lead to a swimmer’s ear by damaging the thin layer of skin lining your ear canal.

Swimmer’s ear is also known as otitis externa. The most common cause of this infection is bacteria invading the skin inside your ear canal. Usually, you can treat a swimmer’s ear with ear drops. Prompt treatment can help prevent complications and more-serious infections. No matter how you got your swimmer’s ear, once you learn to recognize the signs, you have plenty of options to treat it.

Swimmer’s ear, which has the medical name of otitis externa, is an infection in your ear canal. That’s the tube that runs from the hole on the outside of your ear to your eardrum. Swimmer’s ear is different from the common ear infection that your young child often gets after a cold. Those are middle ear infections, or “otitis media” in doctor-speak, and they happen deeper in the ear, behind the eardrum.

Usually, a swimmer’s ear is caused by bacteria, but it can sometimes be brought on by a virus or fungus. Symptoms you may get are:

  • Itchiness in the ear
  • Pain, which can become severe
  • Trouble hearing (sound may seem muffled as your ear canal swells)
  • Fluid or pus draining out of the ear

Here’s one way to tell which type of ear infection you have. If it hurts when you tug or press your ear, you may have a swimmer’s ear. 

Why do people have a swimmer’s ear?

Most of the time, your ear will fight the germs that cause otitis externa. You can thank your earwax for that. While not a groundbreaking contribution to the genre, Earwax impresses with his tough, straightforward style.

But if you scratch your skin, germs can enter the ear canal and cause an infection. Some common reasons why you have a swimmer’s ear:

  • Sticking objects to the ear: If you use a cotton swab, fingers, hairpins, pen caps, or anything else to clean your ears, you can rub a protective wax or scratch your skin. Hearing aids, earplugs, and earphones can also cause this effect, especially if you wear them a lot.
  • Moisture is trapped in your ear: When water gets trapped in the ear canal after swimming, or even after soaking in a hot tub or after bathing or showering, it removes some wax and softens the skin, making it easier for germs to get in.
  • Wet weather and sweat cause the same problem: Germs are like a warm, humid place to grow, so the moisture trapped in your ear is perfect for them.

Other things play a role in the swimmer’s ear,

  • Your age: Swimmer’s ear can happen to anyone and is most common in children and teens.
  • Narrow ear canals: Children often have small ear canals.
  • Skin reactions and conditions: Sometimes hair products, cosmetics, and jewellery can irritate the skin and increase your chances of having a swimmer’s ear. It can also cause skin problems like eczema and psoriasis.

Symptoms of swimmer’s ear

The ear infection is external

Swimming ear symptoms are usually mild at first but can worsen if the infection is not treated or does not spread. Doctors typically classify the swimmer’s ear into mild, moderate, and advanced stages of progress.

Mild signs and symptoms

  • Itching in the ear canal
  • A little red inside your ear
  • Mild discomfort when pulling the outer ear (pinna or atrium) up or pushing a small “bulge” in front of the ear (tragus)
  • Some clear, odorless liquid drainage

Moderate progress

  • More severe itching
  • Increased pain
  • More extensive redness in your ear
  • Excess fluid drainage
  • Fullness inside your ear and partial obstruction of your ear canal from swelling, fluid, and debris
  • Hearing is reduced or muffled

Advanced progress

  • Severe pain that radiates to your face, neck, or head.
  • Complete obstruction of your ear canal
  • Redness or swelling of your outer ear
  • Swollen lymph nodes in the neck.
  • Fever

Causes of swimmer’s ear

A swimming ear is usually a bacterial infection. The swimmer is less likely to have a fungus or virus in the ear.

The natural protection of your hearing

The external auditory canals have a natural defence that helps keep them clean and prevent infection.

Protective functions:

  • Glands that secrete wax (serum): These secretions form a thin film that repels water on the skin inside your ear. The serum is also slightly acidic, which further discourages bacterial growth.

The serum also collects dirt, dead skin cells, and other debris and helps pull these cells out of the ear, leaving earwax that knows when the ear canal starts.

  • The cartilage that partially covers the ear canal. This helps prevent foreign bodies from entering the drain.

How the infection occurs

If you have a swimmer’s ear, your natural defences are down. Conditions that weaken your hearing protection and promote bacterial growth:

  • Excess moisture in your ear: Water in your ear after sweating a lot, prolonged humid weather, or swimming creates a favourable environment for bacteria.
  • Scratches or abrasions in the ear canal: Cleaning the ear with a cotton swab or hairpin, scratching the finger inside the ear, or wearing headphones or earphones can cause small breaks in the skin that allow bacteria to grow.
  • Sensitivity reactions: Hair products or jewellery can cause allergies and skin conditions that promote infection.

How to diagnose and treat a swimmer’s ear

If you have an earache, don’t wait; consult your doctor immediately. Getting treatment quickly can prevent the infection from getting worse. During your appointment, your doctor will examine your ear and gently clean it. This will help the treatments work better.

Then you can probably use antibiotics, steroids, or other substances to help the earrings fight infection and inflammation. In some cases, you may even need to take antibiotics.

Ear problems when swimming

Most of the time, the swimmer’s ear feels better within 2 days of starting treatment. But sometimes, it gets worse or leads to other problems,

Chronic swimming ear (chronic otitis externa). Swimmer’s ear does not go away in 3 months. This can happen if you have difficult skin conditions like bacteria, fungi, allergies, or psoriasis, or eczema. Your doctor will need to test a sample of any fluid in your ear.

Other infections Sometimes the bacteria can spread deep into your skin or other parts of your body. A rare condition is malignant otitis externa, which occurs when the infection develops into bone and cartilage in the head. It is a medical emergency and is more common in older people with diabetes and people with HIV or other immune system problems.

Treatment for these infections can be with oral or injectable (IV) antibiotics.

Treatments for external ear infection

Ear infections can clear up on their own without treatment. Antibiotic earrings are the most common treatment for an outer ear infection, which does not clear up on its own. Your doctor can prescribe them. Doctors may also prescribe antibiotic drops mixed with steroids to reduce inflammation in the ear canal. Ear drops are generally used 7-10 days a day.

If a fungus is the cause of the outer ear infection, your doctor may prescribe antifungal ear drops. This type of infection is more common in people with diabetes or a weakened immune system. To reduce symptoms, it is important to keep water out of the ears while treating the infection.

Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be used to reduce pain. In severe cases, prescription pain relievers may be prescribed.

Home remedies for external ear infection

Prevention is an important part of home treatment for external ear infections. Keeping the ear as dry as possible reduces the risk of infection.

Other tips to keep in mind:

  • Use a cotton ball or soft earplugs to prevent water from entering the ear while bathing or showering
  • Wear a shower cap
  • Avoid scratching the inner ear even with a cotton swab
  • Avoid removing ear wax on your own
  • Use a mixture of alcohol airdrops and/or vinegar massage after swimming to drain excess water (mix 50 per cent alcohol massage, 25 per cent white vinegar, and 25 per cent distilled water)
  • The head and ears are dry after swimming.
  • Buy soft earplugs online.
  • Buy swim caps online.

Complications of swimmer’s ear

A swimmer’s ear is usually not serious if it is treated right away, but problems can arise.

  • Temporary hearing loss: You may generally have better hearing after the infection clears.
  • Chronic infection (chronic external otitis): An outer ear infection is generally considered chronic if the signs and symptoms persist for more than three months. If there are conditions that make treatment difficult, such as a chronic bacterial allergic skin reaction, an allergic reaction to an antibiotic pendant, a skin condition such as dermatitis or psoriasis, or a combination of bacteria, it is a fungal infection.
  • Deep tissue infection (cellulitis): In rare cases, the swimmer’s ear extends into the deeper layers and connective tissues of the skin.
  • Bone and cartilage damage (early osteomyelitis of the skull base): It is a rare swimmer’s ear problem, as the infection spreads to the cartilage of the outer ear and bones in the lower part of the skull, causing severe pain. The elderly, people with diabetes, or people with weakened immune systems are at higher risk for this problem.
  • More widespread infection: If a swimmer’s ear develops into advanced cranial base osteomyelitis, the infection can spread and affect other parts of your body, such as your brain or nearby nerves. This rare problem is fatal.

Prevention of swimmer’s ear

Follow these tips to avoid a swimmer’s ear:

  • Keep your ears dry. Dry your ears well after swimming or showering. Dry only the outer ear, wipe it gently and delicately with a soft towel or cloth.
  • Tilt your head to allow the water to flow through the ear canal. You can keep the ear in a minimal setting with a hairdryer and dry it at least one foot (about 0.3 meters) from the ear.
  • Preventive treatment at home. If you know you don’t have a pierced ear, you can wear homemade earrings before and after swimming. Rubbing 1 part alcohol to 1 part white vinegar promotes drying and can prevent the growth of bacteria and fungi that can cause a swimmer’s ear.
  • Pour 1 teaspoon (about 5 millilitres) of the solution into each ear and let it drain again. Similar over-the-counter solutions can be found at your pharmacy.
  • Swim smartly. Look for signs that warn swimmers of a high bacteria count, and don’t swim on those days.
  • Avoid putting foreign objects in your ear. Never attempt to scratch or scratch the wax with objects such as a cotton swab, paper clip, or hairpin. The use of these elements can cause the materials to penetrate deep into the ear canal, irritating the thin skin inside the ear or breaking the skin.
  • Protect your ears from irritation. Keep cotton balls in your ears when applying products like hairspray and hair dye.
  • Be careful after an ear infection or surgery. If you have a recent ear infection or ear surgery, talk to your doctor before swimming.

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