Disease: Swimmer's Ear Infection
(External Otitis)

    Swimmer's ear facts

    • Swimmer's ear, or external otitis, is typically a bacterial infection of the skin of the outer ear canal.
    • Swimmer's ear can occur in both acute and chronic forms.
    • Excessive water exposure and frequent instrumentation (usually with cotton swabs) of the ear canal are important causative factors.
    • Early symptoms include itchy ears, a feeling of fullness, swelling, drainage, and pain.
    • Antibiotic ear drops and avoidance of water are frequently necessary for treatment.
    • Proper ear care can avoid most infections.

    What is "swimmer's ear" or acute external otitis?

    External otitis or "swimmer's ear" is an infection of the skin covering the outer ear and ear canal. Acute external otitis is commonly a bacterial infection caused by streptococcus, staphylococcus, or pseudomonas types of bacteria. The swimmer's ear infection is usually caused by excessive water exposure from swimming, diving, surfing, kayaking, or other water sports. When water collects in the ear canal (frequently trapped by wax), the skin can become soggy and serve as an inviting area for bacteria to grow. Cuts or abrasions in the lining of the ear canal (for example, from cotton swab injury) can also predispose to bacterial infection of the ear canal.

    What are symptoms of swimmer's ear?

    The first symptom of infection is that the ear will feel full, and it may itch. Next, the ear canal will swell, and ear drainage will follow. At this stage the ear will be very painful, especially with movement of the outside portion of the ear. The ear canal can swell shut, and the side of the face can become swollen. Finally, the lymph nodes (glands) of the neck may enlarge, making it difficult or painful to open the jaw. People with swimmer's ear may experience some temporary hearing loss in the affected ear.

    What is chronic swimmer's ear?

    Chronic (long-term) swimmer's ear is otitis externa that persists for longer than four weeks or that occurs more than four times a year. This condition can be caused by a bacterial infection, a skin condition (eczema or seborrhea), fungal infection (Aspergillosis), chronic irritation (such as from the use of hearing aids, insertion of cotton swabs, etc), allergy, chronic drainage from middle ear disease, tumors (rare), or it may simply follow from a nervous habit of frequently scratching the ear. In some people, more than one factor may be involved. For example, a person with eczema may subsequently develop black ear drainage. This would suggest of an accompanying fungal infection.

    The standard treatments and preventative measures, as noted below, are often all that is needed to treat even a case of chronic otitis externa. However, in people with diabetes or those with suppressed immune systems, chronic swimmer's ear can become a serious disease (malignant external otitis). Malignant external otitis is a misnomer because it is not a tumor or a cancer, but rather an aggressive bacterial (typically Pseudomonas) infection of the base of the skull.

    What is the treatment for swimmer's ear?

    Regardless of the cause, moisture and irritation will prolong the course of the problem. For this reason, the ear should be kept dry. While showering or swimming use an ear plug (one that is designed to keep water out), or use cotton with Vaseline on the outside to plug the ears.

    Scratching the inside of the ear or using cotton swabs should be avoided. This will only aggravate the irritated skin, and in most situations will make the condition worse. In fact, scratching the inside of the ear will just make the ear itch more, and any medications prescribed will be ineffective. A hearing aid should be left out as much as possible until swelling and discharge stops.

    The most common treatment consists of ear drops containing antibiotics or antibiotics with corticosteroids to reduce inflammation. Oral antibiotics may also be required in some cases. These should be used as directed. In some situations, a "wick" will need to be placed in the ear canal to stent it open and serve as a conduit for the ear drops. Periodic, and sometimes frequent, suctioning of the ear canal helps to keep it open, remove debris, and decrease bacterial counts.

    Pain-relieving medications such as acetaminophen or antihistamines to decrease itching may also be recommended along with antibiotics.

    How can swimmer's ear be prevented?

    1. Decrease exposure to water. If you are prone to infections it is advisable that you use an ear plug when you bathe or swim. Swimmer's ear drops or alcohol drops (Swim-EAR®) used in the ear after water exposure followed by drying the ear with a hair dryer held at arms length will often help keep the ear free of moisture
    2. Do not insert instruments, scratch, or use cotton swabs in the ears.
    3. Try to keep the ear free of wax. This may require visits to the doctor to have your ears cleaned.
    4. You should not attempt to put anything into the ear canal (such as a swab) to try to remove ear wax that is deep within the ear canal.
    5. If you already have an ear infection, or if you have a hole in your eardrum, or if you have had ear surgery or ear tubes, first consult your doctor prior to swimming and before you use any type of ear drop.
    6. A preventative ear drop solution can be cheaply and easily made by mixing equal parts of rubbing alcohol and white vinegar (50:50 mixture). This solution will increase the rate of evaporation of water in the ear canal and has antibacterial properties. Using this solution to rinse the ear before and after water exposure can serve as a protective measure against infection.
    7. Mineral oil ear drops can be used to protect the ear from water when a dry crusty skin condition exists.

    What is the prognosis for swimmer's ear?

    Swimmer's ear is a treatable condition that usually resolves quickly with appropriate treatment. Most often, swimmer's ear can be easily treated with antibiotic ear drops. Chronic swimmer's ear may require more intensive treatment. Swimmer's ear typically does not have any long-term or serious complications.

    What is chronic swimmer's ear?

    Chronic (long-term) swimmer's ear is otitis externa that persists for longer than four weeks or that occurs more than four times a year. This condition can be caused by a bacterial infection, a skin condition (eczema or seborrhea), fungal infection (Aspergillosis), chronic irritation (such as from the use of hearing aids, insertion of cotton swabs, etc), allergy, chronic drainage from middle ear disease, tumors (rare), or it may simply follow from a nervous habit of frequently scratching the ear. In some people, more than one factor may be involved. For example, a person with eczema may subsequently develop black ear drainage. This would suggest of an accompanying fungal infection.

    The standard treatments and preventative measures, as noted below, are often all that is needed to treat even a case of chronic otitis externa. However, in people with diabetes or those with suppressed immune systems, chronic swimmer's ear can become a serious disease (malignant external otitis). Malignant external otitis is a misnomer because it is not a tumor or a cancer, but rather an aggressive bacterial (typically Pseudomonas) infection of the base of the skull.

    What is the treatment for swimmer's ear?

    Regardless of the cause, moisture and irritation will prolong the course of the problem. For this reason, the ear should be kept dry. While showering or swimming use an ear plug (one that is designed to keep water out), or use cotton with Vaseline on the outside to plug the ears.

    Scratching the inside of the ear or using cotton swabs should be avoided. This will only aggravate the irritated skin, and in most situations will make the condition worse. In fact, scratching the inside of the ear will just make the ear itch more, and any medications prescribed will be ineffective. A hearing aid should be left out as much as possible until swelling and discharge stops.

    The most common treatment consists of ear drops containing antibiotics or antibiotics with corticosteroids to reduce inflammation. Oral antibiotics may also be required in some cases. These should be used as directed. In some situations, a "wick" will need to be placed in the ear canal to stent it open and serve as a conduit for the ear drops. Periodic, and sometimes frequent, suctioning of the ear canal helps to keep it open, remove debris, and decrease bacterial counts.

    Pain-relieving medications such as acetaminophen or antihistamines to decrease itching may also be recommended along with antibiotics.

    How can swimmer's ear be prevented?

    1. Decrease exposure to water. If you are prone to infections it is advisable that you use an ear plug when you bathe or swim. Swimmer's ear drops or alcohol drops (Swim-EAR®) used in the ear after water exposure followed by drying the ear with a hair dryer held at arms length will often help keep the ear free of moisture
    2. Do not insert instruments, scratch, or use cotton swabs in the ears.
    3. Try to keep the ear free of wax. This may require visits to the doctor to have your ears cleaned.
    4. You should not attempt to put anything into the ear canal (such as a swab) to try to remove ear wax that is deep within the ear canal.
    5. If you already have an ear infection, or if you have a hole in your eardrum, or if you have had ear surgery or ear tubes, first consult your doctor prior to swimming and before you use any type of ear drop.
    6. A preventative ear drop solution can be cheaply and easily made by mixing equal parts of rubbing alcohol and white vinegar (50:50 mixture). This solution will increase the rate of evaporation of water in the ear canal and has antibacterial properties. Using this solution to rinse the ear before and after water exposure can serve as a protective measure against infection.
    7. Mineral oil ear drops can be used to protect the ear from water when a dry crusty skin condition exists.

    What is the prognosis for swimmer's ear?

    Swimmer's ear is a treatable condition that usually resolves quickly with appropriate treatment. Most often, swimmer's ear can be easily treated with antibiotic ear drops. Chronic swimmer's ear may require more intensive treatment. Swimmer's ear typically does not have any long-term or serious complications.

    Source: http://www.rxlist.com

    Regardless of the cause, moisture and irritation will prolong the course of the problem. For this reason, the ear should be kept dry. While showering or swimming use an ear plug (one that is designed to keep water out), or use cotton with Vaseline on the outside to plug the ears.

    Scratching the inside of the ear or using cotton swabs should be avoided. This will only aggravate the irritated skin, and in most situations will make the condition worse. In fact, scratching the inside of the ear will just make the ear itch more, and any medications prescribed will be ineffective. A hearing aid should be left out as much as possible until swelling and discharge stops.

    The most common treatment consists of ear drops containing antibiotics or antibiotics with corticosteroids to reduce inflammation. Oral antibiotics may also be required in some cases. These should be used as directed. In some situations, a "wick" will need to be placed in the ear canal to stent it open and serve as a conduit for the ear drops. Periodic, and sometimes frequent, suctioning of the ear canal helps to keep it open, remove debris, and decrease bacterial counts.

    Pain-relieving medications such as acetaminophen or antihistamines to decrease itching may also be recommended along with antibiotics.

    Source: http://www.rxlist.com

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