Cure for swimmer's ear

Ear canal infection (otitis externa) is an inflammation or infection of the outer ear canal, the passage leading from the external ear to the eardrum. Since it is often associated with excess water in the ear canal, and frequently occurs in children who swim a great deal, the common name for this inflammation is "swimmer's ear".

When water pools in the ear canal (frequently trapped by wax), the skin becomes soggy and serves as a culture medium for bacteria. The moisture can cause the skin inside the ear canal to flake - a condition known as seborrhoea. A break in the skin, which may result from scratching, can allow bacteria or fungi to invade the tissue of the ear canal and cause an infection.

One of the most common causes of otitis externa is a reaction to the use of alkaline shampoos which may affect the lining of the ear canals and result in the itching and discomfort of otitis externa. Dandruff which is a form of seborrhoea can lead to otitis externa.

There may be specific often rather painful bacterial infections by staphylococcus or less commonly by pseudomonas. Diabetics are more prone to these infections.

Persistent or chronic otitis externa is often caused by fungal infections which require special treatment.

Psoriasis sufferers should be aware that this skin condition may involve the ear canals causing rather severe otitis externa which requires special treatment.

Common symptoms include:

• Itching and a feeling of fullness inside the ear
• Swelling of the ear canal
• Watery discharge from the ear
• Severe pain and tenderness in the ear - especially when moving the head and jaw, or gently pulling the earlobe. Unlike a middle ear infection, the pain of an ear canal infection is worse when you chew, when you press on the "tag" in front of the ear, or when you wiggle your earlobe.
• A foul-smelling, yellowish discharge from the ear
• Temporarily muffled hearing
• Enlarged neck glands

Swimmer's ear is usually not dangerous and often resolves by itself within a few days.

Try these home treatment methods:

• Moisture and irritation will prolong the course of the problem. Avoid getting any more water in the ear until the infection clears up.
• Make sure there are no foreign objects in the ear. Objects should only be removed by a doctor.
• If you suspect a ruptured eardrum, do not insert anything into the ear.
• Gently rinse the ear using a bulb syringe and warm saline solution or a half-and-half solution of white vinegar and warm water. Make sure the flushing solution is at body temperature.
• To ease ear pain, apply a warm washcloth or a heating pad. There may be some drainage when the heat melts earwax. Do not leave a child alone with a heating pad.
• Avoid scratching the inside of the ear or using ear buds.
• A hearing aid should be left out as much as possible until swelling and discharge stops.

Symptoms to watch for during home treatment:

• Ear pain and itching that persists or worsens after five days of home treatment.
• Swelling, redness or extreme pain in the ear canal, the opening to the ear canal, the external ear, or the skin around the external ear.
• Discharge from the ear that does not appear to be earwax.
• Ear symptoms accompanied by a fever (38 degrees C or higher).
• Dizziness or unsteadiness.

Consult your doctor if the pain worsens or does not improve within 24 hours; your child experiences dizziness or ringing in the ears or there is a rash on the scalp or near the ear.

(Article reviewed by paediatrician Prof Eugene Weinberg,December 2009)