Hello and welcome back!
This month’s topic is Otitis Externa, also known as Swimmer’s Ear.
Swimmer’s ear is irritation to the ear canal. This irritation may be caused by infection, allergy or skin problems. This month we will focus on irritation caused by infection. Infection of the canal starts with breakdown of the skin cerumen (ear wax) barrier. This barrier can be compromised by removing the wax with cotton swabs, scratching the skin with your finger or a sharp object, or prolonged exposure to fluids such as water or unrinsed soap products.
Once this barrier is broken the pH or acidity of the canal changes making the canal environment more conducive to grow bacteria and provides an opportunity for moisture to break down the skin barrier further. With barrier loss comes inflammation and inflammation brings itchiness and, with time, the thing that spurs us on to make an appointment- pain.
After the symptoms have started from barrier breakdown you have about 2-3 days until symptoms may resolve if the cause (water, chemicals or picking) is removed. Usually, the cause is not removed during the summer months. Michiganders love pool time and the beach during our beautiful summer months, so to remove the water exposure usually will take serious symptoms.
To diagnose Swimmer’s Ear you will need to make an appointment to see your provider. They will listen to your history of symptoms and complete an exam. The diagnosis of Swimmer’s Ear is made by clinical symptoms and specific exam findings. Common findings are pain with touching the outer ear, swelling and redness of the canal when they look through the canal with the otoscope. If symptoms have gone long enough or the irritation is severe enough the canal may be completely blocked.
Treatment of this irritation is simple. If the diagnosis of Otitis Externa/Swimmer’s Ear is made your provider will send a script for antibiotic drops. The drops need to be taken daily as prescribed and water avoided. Depending on the antibiotic used, the treatment is typically 5-7 days. For best results, the ear canal should be free from new water exposure for 7-10 days. To shower, water can be blocked by using a cotton ball covered with Vaseline and placed over the canal opening.
Lastly, prevention. Keep anything smaller than your elbow out of your families ears. This sounds silly especially if you grew up enjoying the feeling of “cleaning your ears” with a cotton swab after every shower, but it’s true. The cotton swab removes the wax barrier. Plus, if you rub too hard you may cause an abrasion open the skin to infection. When you need to clean, use gentle soap to clean the outer ear and rinse thoroughly. If you feel the area is “dirty” or notice difficulty hearing a short appointment with your provider can be made. If wax build is noticed a gentle flushing of the canal may help or a small tool can be used to remove excessive wax if needed. Try to dry your ears after you get out of water by gently rubbing with towel.
Please remember when in doubt give us a call or message us through our portal and we can answer simple direct questions as needed.
Have a great August,
Garett Shook, DO