Ear - Swimmer's

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DEFINITION

• Painful or itchy ear
• Pain increases when ear moved up and down
• Swimming recently or use Q-tips frequently

General Information

• Otitis externa is an infection of the skin that lines the ear canal. It is also referred to as Swimmer's Ear.
• When water repeatedly gets trapped in the ear canal, the lining becomes wet and swollen. This makes it prone to superficial infection (Swimmer's Ear). Ear canals are meant to be dry.
• Wax (cerumen) is produced by the ear canal as a natural water-proofing agent. Frequent use of cotton ear swabs depletes the wax barrier and increases the likelihood of developing otitis externa. On the other hand, excessive amounts of ear wax can inhibit water drainage from the ear, leading to skin break down, which leads to development of otitis externa.  

See More Appropriate Topic (instead of this one) If

• EARACHE and your symptoms do not match the Main Symptoms described above

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Severe pain
• Fever
• Redness and swelling of outer ear
• Have diabetes mellitus or a weakened immune system (e.g. HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen
• Yellow discharge from ear canal
• Blocked ear canal or decreased hearing
• Swollen lymph node near ear
• Cause is uncertain

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Self Care at Home If

• Swimmer's ear with no complications and you don't think you need to be seen

HOME CARE ADVICE FOR MILD SWIMMER'S EAR

1. White Vinegar Rinses:
   • Rinse the ear canals twice a day with ½-strength white vinegar (dilute it with equal parts warm water).  Fill the ear canal.  After 5 minutes, remove it by turning the head to the side and moving the ear.
   • Exception: Don't do this if you have ear tubes or hole in eardrum. (Reason: restores the normal acid pH of the ear canal and reduces swelling.)
2. Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
   • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
3. Local Heat: If pain is moderate to severe, apply a heating pad (set on low) or hot water bottle (wrapped in a towel) to outer ear for 20 minutes. (Caution: avoid burns.) This will also increase drainage.
4. Avoid Earplugs: If pus or cloudy fluid is draining from the ear canal, wipe the pus away as it appears. Avoid plugging with cotton. (Reason: retained pus causes irritation or infection of the ear canal.)
5. Prevention of Recurrences: Try to keep the ear canals dry. After showers, hair washing, and swimming, help the water run out by turning the head. Avoid cotton swabs. (Reason: removes the protective earwax of the ear canal)
6. Avoid Swimming: Try to avoid swimming until symptoms are gone.
7. Contagiousness: Swimmer's ear is not contagious.
8. Expected Course: With treatment, symptoms should improve in 3 days and resolve within 7days.
9. Call Your Doctor If:
   • Ear symptoms last longer than 7 days with treatment
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.