Swimmer’s Ear – Otitis Externa

Otitis Externa or ‘swimmer’s’ ear is a common problem in tropical hot periods when there is a lot of swimming. This is a condition where the outer ear canal becomes inflamed which results in pain and swelling. The inflammation is due to infection of the canal by a bacteria.  This bacteria is quite difficult to treat and often is called pseudomonas.

Why does this occur ?

swimmersearThe ear canal is normally ‘acidic’. This acid nature acts to prevent the normal presence of bacteria from causing infection. When someone spends a considerable amount of time in the water – any water – then this acidity is reduced and the bacteria proliferate.

What are the Symptoms ?

Usually the first sign is a slight discomfort. This may be present for 24 – 48 hours until over a short period of time pain will increase until it is unbearable. Usually the sufferer will not tolerate the ear being pulled or moved and unlike a middle ear infection where the pain tends to subside after a while – the pain of otitis externa tends to persist. Sometimes there can be a fever and discharge from the affected ear. Discharge will block the ear canal and result in mild deafness. ‘Equalising’ middle ear  pressure can also be uncomfortable as the ear drum can also be inflamed.

What is the treatment ?

To treat the infection antibiotic drops are prescribed sometimes in conjunction with a small steroid. This has been shown to reduce the pain. If there is a fever then oral antibiotics are used. Often a ‘wick’ is inserted into the ear by a doctor and the ear canal is sometimes gently cleansed to remove debris. Note that healing is a slow process and painkillers are advisable. Adults should take anti – inflammatories and sometimes codeine is needed. Children should use either panadol or nurofen and may also need a stronger medicine such as painstop. (Only for those older than 2 years.)  Stop all swimming. If a person has had a bout of otitis externa he or she will be prone to suffering from this condition again for at least 3 – 4 months.

What about swimming ?

Swimming should be banned for at least 3 days and preferably longer depending on the severity. The more severe infections would be advisable not swim for at least 10 days.

How can attacks be prevented ?

Firstly make sure you swim in either seawater or properly chorinated pools. Secondly have regular breaks from swimming – especially children who should allow the ear canal to dry out. The best way of drying the canal is with eardrops that contain vinegar, methylated spirits and alcohol. These will not only dry the canal but also will acidify it preventing the growth of harmful bacteria.

Is it serious ?

Sometimes this is a very serious condition. Particularly in diabetics and in any person who’s immune system is poor – such as those who have received chemotherapy for cancer. In these people the infection can be overwhelming and hospitalisation is needed.

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