Swimmers Ear

Swimmers Ear

Dr.RebecaaButlerby Dr. Rebecca Butler
Lantana Pediatrics

Acute otitis externa (AOE), also known as “swimmer’s ear”, is a common problem encountered in the summer months well into the fall here in Texas. With the heat index rising and kids out of school, the swimming pool is the best place to be for many families to hang out. This summer, as usual, we have seen many kids with complaints of worsening ear pain and a diagnosis of swimmer’s ear. This type of ear infection is most often preventable with a few routine practices during those times kids spend a good amount of time in the water.

AOE is inflammation of the outer ear canal characterized by redness, swelling, itching, occasional drainage and pain especially with touching of the outer ear. The vast majority of AOE is caused by bacteria. The most common include Pseudomonas aeruginosa and Staphylococcus species. Frequent and recurrent untreated infections can lead to complicated bacterial and fungal infections.

Factors that predispose the ear to infection include high temperature, high humidity and water exposure, especially swimming. Exposure of the skin of the ear canal to water, particularly when prolonged, can lead to skin breakdown, making it more vulnerable to minor trauma and infection. Minor trauma could be caused by anything inserted in the ear canal such as cotton-tip swabs and even one’s own finger when scratching itchy ears. Water exposure, soaps, shampoos and chlorine from pool water can irritate the skin of the external ear canal and contribute to the loss of protective wax which serves as a water-repellent coating for the skin of the canal and provides antimicrobial properties.

Treatments
Topical antibiotic drops should be used for at least a week and continuing use for a few days after symptoms resolve. Most patients have resolution of symptoms by six days after starting treatment. If no improvement is noted in 48-72 hours, or if symptoms persist beyond two weeks, please call or revisit your doctor.

Patients with AOE should avoid submerging their head in water for seven to ten days, but competitive swimmers might be able to return to the pool if pain has resolved and they use well-fitting ear plugs.

Prevention

  • Dry ears thoroughly after swimming or bathing. Use a towel to dry the ear, tilt the head to each side in turn to allow water to drain from the down-turned ear, and consider using a blow dryer set on the lowest heat and fan speed held several inches away from the ear.
  • Alcohol-based ear drops after swimming (or each morning and evening) to reduce moisture content in the ear canal, correct the ear pH and reduce bacterial growth has been recommended. Commercially prepared alcohol-based ear-drying solutions are available, or patients can make their own 1:1 mixture of rubbing alcohol and white vinegar. These drops should not be used in the presence of ear tubes, tympanic membrane perforation or acute external ear infection.
  • Use a bathing cap, ear plugs or custom-fitted swim molds when swimming to keep water out of ears.
  • Do not try to remove ear wax. It helps protect your ear canal from infection.
  • Avoid putting objects into the ear canal, including fingers and cotton-tip swabs.

Resources
For information on Recreational Water Illness and Injury Prevention Week, visit www.cdc.gov/healthywater/swimming/rwi/rwi-prevention-week/index.html.
• Information from the Centers for Disease Control and Prevention (CDC) about recreational water illnesses can be found at www.cdc.gov/healthywater/swimming/rwi.
• Information from the CDC for patients on swimmer’s ear is available at www.cdc.gov/healthywater/swimming/rwi/illnesses/swimmers-ear.html.

by Dr. Rebecca Butler, who is Board Certified in Pediatrics by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics. She is proud to be a resident of Lantana and the owner of Lantana Pediatrics. For more information on Dr. Butler or to schedule an appointment, call 940.455.7200.


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