Dealing with Swimmer's Ear (Ear Canal Problems)

Swimmer's ear (otitis externa) is an inflammation and infection of the ear canal. It occurs when the protective film that covers the ear canal (lipid layer) is removed. This causes the ear canal to look red and swollen; it may be narrower than normal and is tender when the outside of the ear is gently pulled up and back.

Swimmer's ear develops more frequently in people who have a very narrow or hairy ear canal, live in a warm, humid climate, have impacted earwax or have had a head injury that involves the ear. Swimmer's ear may develop when water, sand, dirt, or other debris gets into the ear canal. Since it often occurs when excess water enters the ear canal, a common name for this inflammation is "swimmer's ear. " If you have had swimmer's ear in the past, you have a higher risk of having it again.

Otitis externa is usually preventable and the inflammation or infection often clears up with home treatment.

Symptoms of Swimmer's Ear:

Symptoms of ear canal inflammation include itching, pain, and a feeling of fullness in the ear. The ear canal may be swollen. Severe inflammation or infection can cause moderate to severe pain, discharge, or hearing loss. Unlike a middle ear infection (acute otitis media), the pain of an ear canal inflammation or infection is worse when you chew, press on the "tag" in front of the ear, or wiggle your earlobe.

• Other causes of inflammation or infection of the ear canal include:
• Scratching the ear canal with a cotton swab, bobby pin, fingernail, or other sharp object
• Cleaning the ear canal harshly or with a sharp object
• Use of earplugs
• Bubble baths, soaps, and shampoos
• Chronic skin conditions, such as eczema, psoriasis or seborrhea
• Allergies
• Use of stereo headphones inserted into the ear
• Excessive sweating from physical activity

Prevention

In most cases, it is best to leave your ears alone and let them maintain their own healthy, natural balance.

• Do not scratch or clean the inside of the ear with cotton swabs, bobby pins, your fingernail or other objects.
• Avoid prolonged use of earplugs. Both cotton swabs and earplugs can cause irritation, itching and plug the ear with wax.
• Keep soap, bubble bath, and shampoo out of the ear canal. These products can cause itching and irritation.
• Keep your ears dry:
  • ​After swimming or showering, shake your head to remove water from the ear canal.
  • Gently dry your ears with the corner of a tissue or towel, or use a blow-dryer on its lowest setting. Hold the dryer several inches from the ear.
  • Put a few drops of rubbing (isopropyl) alcohol or rubbing alcohol mixed with an equal amount of distilled white vinegar into the ear after swimming or showering. Wiggle the outside of the ear to let the liquid enter the ear canal, then tilt your head and let it drain out.
  • You can also use nonprescription drops, such as Star-Otic or Swim-Ear, to prevent swimmer's ear.

Home Treatment

If you already have an ear canal problem, you may be able to relieve it with home treatment. If you are quite sure that you do not have a ruptured ear drum:

• Gently rinse the ear using a bulb syringe and warm saline solution or a half-and-half solution of distilled white vinegar and warm water. Make sure the flushing solution is body temperature. Inserting cool or hot fluids in the ear may cause dizziness.
• Avoid getting any more water in your ear until the irritation clears up.
• Cotton coated with petroleum jelly can be used as an earplug. Do not use plastic earplugs.
• If your ear is itchy, try nonprescription swimmer's eardrops, such as Star-Otic or Swim-Ear or the homemade isopropyl (rubbing) alcohol & distilled white vinegar solution. Use them before and after swimming or getting your ears wet.
• To ease ear pain, apply a warm washcloth or a heating pad set on low.
  • There may be some drainage when the heat melts earwax.
  • Do not use a heating pad when you are in bed. You may fall asleep and burn yourself.
  • Do not use a heating pad on a child.
• Try a nonprescription pain medication (Tylenol, Advil, Motrin, etc) to help relieve your ear canal problem.

To Insert Eardrops

• First, warm the drops to body temperature by rolling the container in your hands or placing it in a cup of warm water for a few minutes. Inserting cold eardrops can cause pain and dizziness.
• Have the person lie down, ear facing up.
• Place 2 or 3 drops on the wall of the ear canal so air can escape and drops can get into the ear. Gently wiggling the outer ear will help.
• You may find it easier to insert eardrops in a small child's ear by holding the child on your lap with his or her legs around your waist and head down on your knees. If possible, remain in this position for 2 to 3 minutes.

Symptoms to Watch For During Home Treatment

You may need to consult your physician if any of the following occur during home treatment:

• Ear pain and itching persist or get worse after 3 days of home treatment.
• The ear canal, the opening to the ear canal, the external ear, or the skin around the external ear becomes swollen, red, or very painful.
• Discharge from the ear that does not appear to be earwax develops.
• Discharge from the ear that is foul-smelling develops.
• Fever develops.
• Dizziness or unsteadiness develops.
• Ear discomfort lasts for longer than 2 weeks.
• Symptoms become more severe or frequent.