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The external ear is the site of many infections and inflammatory conditions. One of which causes a frequent troublesome malady called swimmer’s ear or diffuse external otitis. Swimmer’s ear usually occurs in the summer and can present symptoms within 24 to 48 hours after swimming.

What are the most common symptoms and signs of swimmer’s ear?

During the early stages of swimmer’s ear, patients experience pain and tenderness of the auricle or ear. They may also note a purulent or yellow discharge from the ear. On examination, erythema or redness and swelling of the ear canal are noted. Patients also frequently note a decrease in hearing with the ear involved.

When should I seek medical attention?

If a person experiences pain, discharge, and diminished hearing in an ear, he or she should seek immediate medical attention for a complete evaluation. What is the treatment for swimmer’s ear? The treatment is based on three principles:

  1. Thorough atraumatic cleaning of the ear canal
  2. Judicious use of topical and occasionally oral antibiotics
  3. Giving appropriate advice regarding ear hygiene and infection prevention

The first principle of treatment is preformed by the patient’s physician. Careful cleaning of the ear canal removes debris and helps eradicate bacteria. Occasionally, the ear is irrigated with an antiseptic solution in the physician’s office. This can further aid in removing pathogenic bacteria. Antibiotic drops, and depending on the severity of the infection, oral antibiotics are prescribed. If the ear canal is very swollen, then a small ear wick or pack is placed in the ear canal by the physician. This wick is usually removed in 24 to 48 hours.

What is the best way to instill drops in the ear?

It is preferable to have someone else instill the drops while the patient is lying on their side with their head turned and affected ear facing up. This procedure is repeated 2-3 times daily depending on the type of drops prescribed, and continued for usually ten days. Generally, symptoms subside fairly quickly after institution of medical therapy. If not, the patient should seek follow-up with his or her physician.

What are some ways to prevent swimmer’s ear?

Preventative measures are important to review. Patients are encouraged not to place any object or instrument in their ear canal, even the use of cotton tipped applicators are not advised. These instruments can push debris closer to the ear drum and further injure the canal skin. Patients who frequently get their ear canals wet, like swimmers, are encouraged to dry them promptly and atraumatically. I recommend blow drying the ears with a hairdryer set on low heat after bathing or showering.

In patients with a history of frequent external ear infections, I do recommend using an over the counter brand of ethyl alcohol drops, such as Swim Ear, followed by gentle blow drying. Also, custom made ear molds can be made for these patients as a means of keeping water out of the ear canals.

In summary, swimmer’s ear or external otitis is a common summer illness. It generally presents with ear pain and discharge. Patients should seek medical attention. This illness usually responds well to medical therapy and can often be prevented by taking the steps outlined in this discussion.

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