Swimmer’s ear, also known as external otitis, is an inflammation, or infection of the ear canal, the area between the external ear, and the eardrum. It’s called “swimmer’s ear” because it’s often initiated by water trapped in the ear canal after swimming or bathing, which creates a friendly environment for bacteria, and fungi to grow.
Symptoms
Symptoms vary from mild discomfort to excruciating pain. People may complain of an itchy, red, swollen ear canal with clear fluid, or pus draining from the ear. People may also experience a sensation of ear fullness, at times associated with loss of hearing. The infection may extend to the external ear causing it to swell, and making it very sensitive to touch. The pain is aggravated by chewing, and manipulation.
Causes
Several factors can contribute to the development of swimmer’s ear, including
- Water:
Water is the moist, friendly environment that contributes to bacterial, and fungal growth in the ear canal. - Trauma:
Scratching the ear canal with cotton swabs, bobby pins, or other objects can cause microabrasions allowing bacteria, and fungi to enter the ear canal and multiply. - Medical Conditions:
Conditions like eczema, and psoriasis as well as diabetes, and weakened immune system can make the ear canal more susceptible to infection. - Bacterial Infections:
Pseudomonas aeruginosa, and Staphylococcus are common causes of this infection - Fungal Infections:
Infections like otomycosis, due to Aspergillus, or Candida can cause swimmer’s ear. - Other Factors:
Narrowed ear canals, excessive ear wax, or a foreign body in the ear canal can increase the risk of developing swimmer’s ear.
Treatment
Ear Drops
For uncomplicated swimmer’s ear, treatment typically involves the use of ear drops, and pain medication. Antibiotic, or antifungal ear drops are prescribed depending on the cause of the infection. At times, the ear canal is severely swollen and almost totally occluded. In this situation, an ear wick is inserted into the canal to help the medication reach the infected area.
Pain Management
Over the counter pain medications like acetaminophen or ibuprofen are often sufficient for mild to moderate pain. Opioids may be prescribed for severe pain.
Systemic Antibiotics
Oral antibiotics are generally prescribed for cases where the infection has spread beyond the ear canal, or in individuals with specific risk factors, such as diabetes or immunosuppression.
Complications
Most cases of swimmer’s ear resolve with topical medications (ear drops), and over the counter pain medication. If left untreated, several complications have occurred, which include recurrent ear infections, temporary hearing loss, spread of the infection to surrounding tissue and bone.
Prevention
To prevent future infections, dry the ears thoroughly after bathing or swimming, avoid traumatizing the ear with cotton swabs, or other object, and try using ear plugs and a bathing cap while swimming. The above measures can minimize future episode of swimmer’s ear.
REFERENCES
- Yi. Medina-Blasini; T. Sharman.; Otitis Externa, July 31, 2023
“Personal Experience”