Swimmer’s Ear / Otitis Externa

Swimmer’s ear is an infection of the ear canal. This is different from a middle ear infection that is typically caused by allergies or colds. Swimmer’s ear gets its’ name from the fact that you can get it after swimming. But you can also get it after scratching your ear canal with your finger, or after using a Q-tip or bobby pin, or for no reason at all.

 

Your ear canal is normally slightly acidic, and anytime the pH goes up, it is more prone to infections. Your ear canals are inhabited by normal harmless bacteria and fungi. Any form of water can change the environment, raising the pH, allowing pseudomona bacteria to overgrow. This is what causes the intense pain and discharge. Otitis externa is relatively straightforward when seen in the office, and is treated with one of a number of ear drops. Most doctors give a combination of topical antibiotics and anti-inflammatory steroids. Acidity also kills pseudomona bacteria. One popular ear drop is a combination of vinegar and topical steroid.

 

Sometimes the canal swelling becomes so severe that the ear canal shuts closed, preventing the drops from entering deep into the canal. In this case, a wick has to be placed to allow the drops to enter the canal; it’s taken out in 2-3 days.

 

One old fashioned home remedy is to use white vinegar (1/2 part vinegar and 1/2 part water). This can be applied using a dropper about 2-4 times every day. Some people who are prone to swimmers ear use vinegar drops once as prophylaxis after swimming.

 

One commonly seen variation of otitis externa is a fungal or mycotic otitis externa. It can occur either due to warm moist envoronments or after antibiotic abuse. Most often, it is seen after repeated antibiotic ear drop use for a presumed otitis externa that does not improve. Fungal otitis externa is not as painful and lasts a lot longer. Treatment even takes a lot longer. On examination, either black fungal spores are seen, or white cheesy material is seen. The treatment for any type of otitis externa is to suction or clean all the debris so that whatever drops you use can reach the skin.

 

Also, not all ear pain comes from the ear. Unfortunately, oral or ear drop antibiotics are routinely given for ear pain, just in case, even though the ear drum and canals are completely normal. This can lead to antibiotic resistance, or fungal otitis externa, as described earlier. Some common causes of ear pain not from the ear include TMJ and throat pain (referred ear pain).

Otolaryngology – Head & Neck Surgery

(212) 315-9058