On a typical summer day at the ENT office, a college student comes in after spending the weekend with friends at the beach. At first, her right ear felt itchy. Now, she can’t hear very well out of it, and it feels strangely full. She is also experiencing significant pain when she tugs on her earlobe. Later, a father brings in a young son who has been complaining of ear pain ever since they returned from vacation. Today, the ear looks angry and red, and it has started draining something that looks like mucus or pus. The parents are very worried.
Both of the above patients are experiencing typical symptoms of a condition called otitis externa, inflammation of the outer part of the ear. More commonly called swimmer’s ear, this condition is painful and has the potential to cause serious problems if not managed correctly. It is also an extremely common diagnosis in ENT offices, especially as warmer weather approaches and people start spending more time swimming, boating, surfing and visiting water parks. Because swimmer’s ear is so prevalent, it is important for everyone to understand how to prevent it and what to do if it occurs.
What Causes Swimmer’s Ear?
The most common cause of swimmer’s ear is infection by a species of bacteria called Pseudomonas aeruginosa, but the condition can also result from infection by a number of other bacterial and fungal species. These tiny organisms cannot be seen with the naked eye, so without a microscope or a specialized testing kit, you cannot tell if they are present in a body of water unless you develop an infection after swimming in it.
Once it gets inside your ear, contaminated water can remain in the ear canal for a relatively long period of time. Unfortunately for you, the microorganisms in this contaminated water love the ear canal because it is narrow, warm, dark and easily damaged. In this welcoming environment, pathogens flourish. They cause local irritation, tissue damage and an immune response. Together, these processes produce the symptoms of otitis externa.
What Are Good Strategies for Preventing Swimmer’s Ear?
The best way to prevent swimmer’s ear is to keep infected water and objects that have been contaminated with infected water out of the ears. In the summer, this can be a challenge. There are, however, several strategies that can help prevent problems. These include the following:
– Dry ears immediately after swimming with a towel or a hair dryer set to the lowest heat setting.
– Wear a tight-fitting bathing cap if you swim frequently.
– Swim only in pools with excellent chlorine and pH management.
– Avoid swimming in pools, lakes and other bodies of water that have a history of pollution.
– Do not put objects, such as cotton swabs, fingers and ill-fitting ear plugs, in your ears. Any damage to this area, even a small scratch that you cannot feel, can leave you vulnerable to infection.
What Are the Symptoms of Swimmer’s Ear?
Common mild to moderate symptoms of otitis externa include the following:
- Itching.
- Feeling like your ear is full.
- Discharge from the ear.
- Pain when you pull on the earlobe or manipulate the ear.
- Redness of the ear.
- Muffled hearing.
In more severe or advanced cases, symptoms can also include the following:
- Pain that spreads to the face or neck.
- Swollen lymph nodes.
- Fever.
- Significant redness and swelling of the ear.
- Copious discharge.
- Hearing impairment.
If you notice any symptoms of otitis externa in yourself or your children, make an appointment to see the doctor right away. Early treatment is usually quick and minimal. More advanced cases, however, have longer healing times and require more involved treatment.
How Do Doctors Diagnose Swimmer’s Ear?
A doctor can usually diagnose otitis externa during an office visit based on your history and the findings of an examination of the inside of your ear with a lighted instrument called an otoscope.
What Kinds of Treatments Are Available?
Mild cases of otitis externa typically require minimal treatment. This treatment commonly includes a thorough, gentle cleaning of the ear canal by a doctor and the use of drops to help prevent bacterial growth and keep the area dry. If the condition is advanced or you have moderate to severe symptoms, you may need additional treatment, such as antibiotics, anti inflammatories and pain medication. If your condition has caused damage to your eardrum, more intensive treatment and monitoring may also be necessary.
To make sure your ear heals, you should be sure to administer all medications as directed by your doctor and to keep follow-up appointments. Careful monitoring will ensure that treatment is working and will allow your doctor to adjust your medications if necessary.
Swimming and other aquatic activities have many benefits, including increasing physical fitness, reducing stress and improving mood. While engaging in these activities, however, it is important for you to protect and care for your ears if you want to enjoy a pain-free summer. With this in mind, make sure you take steps to prevent swimmer’s ear and to treat any early symptoms that occur.