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Swimmer's Ear (External Otitis) - Symptoms And Treatment

Also known as external otitis and otitis externa, Swimmer's Ear is an inflammation of the skin of the external ear canal and auricle. It may be acute or chronic and it's most common in the summer. With treatment, acute otitis externa usually subsides within 7 days (although it may become chronic) and tends to recur.

Causes of Swimmer's Ear (External Otitis)

Otitis externa usually results from bacterial infection with an organism, such as Pseudomonas, Proteus vulgaris. streptococci, or Staphylococcus aureus; sometimes it stems from a fungus, such as Aspergillus niger or Candida albicans (fungal otitis externa is most common in the tropics). Occasionally, chronic otitis externa results from dermatologic conditions, such as seborrhea or psoriasis. Predisposing factors include:

• swimming in contaminated water; cerumen creates a culture medium for the waterborne organism
• cleaning the ear canal with a cotton swab, bobby pin, finger, or other foreign objects; this irritates the ear canal and possibly introduces the infecting microorganism
• exposure to dust, hair care products, or other irritants, which causes the patient to scratch his ear, excoriating the auricle and canal
• regular use of earphones, earplugs, or earmuffs, which trap moisture in the ear canal, creating a culture medium for infection
• chronic drainage from a perforated tympanic membrane.

Signs and symptoms of Swimmer's Ear (External Otitis)

Acute otitis externa characteristically produces moderate to severe pain that is exacerbated by manipulation of the auricle or tragus, clenching the teeth, opening the mouth, or chewing. Its other clinical effects may include fever, foul-smelling aural discharge, regional cellulitis, and partial hearing loss.

Diagnosis of Swimmer's Ear (External Otitis)

Physical examination confirms swimmer's Ear. In acute otitis externa, otoscopy reveals a swollen external ear canal (sometimes to the point of complete closure), periauricular lymphadenopathy (tender nodes in front of the tragus, behind the ear, or in the upper neck) and, occasionally, regional cellulitis.

In fungal otitis externa, removal of growth shows thick red epithelium. Microscopic examination or culture and sensitivity tests can identify the causative organism and determine antibiotic treatment. Pain on palpation of the tragus or auricle distinguishes acute otitis externa from otitis media.

In chronic otitis externa, physical examination shows thick red epithelium in the ear canal. Severe chronic otitis externa may reflect underlying diabetes mellitus, hypothyroidism, or nephritis.

Treatment of Swimmer's Ear (External Otitis)

Treatment varies, depending on the type of otitis externa

Acute otitis externa :- To relieve the pain of acute otitis externa, treatment includes heat therapy to the periauricular region (heat lamp; hot, damp compresses; heating pad), as­pirin or acetaminophen, and codeine. Instillation of antibiotic eardrops (with or without hydrocortisone) follows cleaning of the ear and removal of debris. If fever persists or regional cellulitis develops, a systemic antibiotic is necessary.

Fungal otitis externa :- As with other forms of this disorder, fungal otitis externa necessitates careful cleaning of the ear. Application of a keratolytic or 2% salicylic acid in cream containing nystatin may help treat otitis externa resulting from candidal organisms.

Instillation of slightly acidic eardrops creates an unfavorable environment in the ear canal for most fungi as well as Pseudomonas

Chronic otitis externa :- Primary treatment consists of cleaning the ear and removing debris. Supplemental therapy includes instillation of antibiotic eardrops or application of antibiotic ointment or cream (neomycin, bacitracin, or polymyxin, possibly combined with hydrocortisone). Another ointment contains phenol, salicylic acid, precipitated sulfur, and petroleum jelly and produces exfoliative and antipruritic effects.

For mild chronic otitis externa, treatment may include instilling antibiotic eardrops once or twice weekly and wearing specially fitted earplugs while showering, shampooing, or swimming

Home remedies for Swimmer's Ear

• Mix equal parts water, peroxide, and white vinegar. Use an eye dropper to put a few drops in ear. Let set for a minute. Tip head to let mix drain. Put a piece of cotton in ear. It's better to do before you go to bed. Recipe was given to me by a doctor in Florida. Works great.
• Apply heat to the outer ear with a warm towel or heating pad set on low.
• Apple cider vinegar  If you notice water stopping up your ears, put three or four drops, diluted in equal parts with water or alcohol, in your ear after showering or swimming. This is a good preventive measure against future infection.
• Atanding on one foot, the one that corrseponds with the swimmer's ear, and with the swimmer's ear facing the floor,jump up and down. the water should drain in about a minute or so.
• Take a sock, fill it with salt, microwave it until it is warm and tolerable to body. Lay your head on it. This may drain the fluid out.
• Use a hair dryer, on a low setting so that it will not burn the skin, to dry as much moisture as possible inside the ear. Keeping the dryer moving will also help to keep the ear from feeling too hot.

Prevention Of Swimmer's Ear

• Keep the water out while you're showering: use earplugs or a shower cap, or dip a cotton ball in petroleum jelly and place in the entrance to the ear canal.
• You may be able to prevent external otitis by using acid alcohol drops after you've finished swimming for the day. (You shouldn't use these drops if you have ear tubes or a hole in your eardrum.)
• Avoid swimming in polluted water.
• Avoid substances that may irritate your ear, such as hair sprays and hair dyes. Put cotton balls in your ears when applying these products.
• Warn against cleaning the ear with cotton swabs or other objects.
• Use oil or lanolin eardrops in your ears before swimming to prevent the effects of water.