Swimmer’s Ear & Common Symptoms
Otitis externa, or swimmer’s ear, occurs when the area between the eardrum and the outer ear becomes inflamed. It is usually the result of an infection by fungi or bacteria, but can be triggered by exposure to water, or physical trauma due to over-enthusiastic cleaning.
Common symptoms of swimmers ear include:
- Pain – this may be worsened by pulling at the ear or moving your head
- Itchiness – especially an itching sensation deep inside the ear
- Discharge – Unpleasant smelling yellow or green discharge from the ear canal
- Reduced hearing – this can be either overall reduced volume or sounds appear muffled and unclear
- Tinnitus – sudden onset of tinnitus (ringing or other sounds, such as buzzing or humming).
There are several causes or triggers of swimmer’s ear, which can often be easily avoided. These commonly include:
- Water – contaminated water (even chlorinated pool water) can introduce bacteria or fungi to the ear canal, where cracks or splits in the skin can become infected. Moisture in the ear canal can also lead to dermatitis and increased chance of infections.
- Mechanical damage – The delicate skin inside the ear canal can be damaged easily through attempts to clean it with cotton tips, fingers or other objects, leading to cuts and infections.
- Chemical irritation – perfume, hairsprays, soaps and shampoos or hair dyes can irritate the ear canal tissues.
- Ear canal shape – particularly narrow ear canals are more likely to be affected to the limited ability of water to drain properly, leading to a warm moist environment that is more likely to develop infections
- Certain diseases – Diabetes, for example, can make earwax overly alkaline, leading to a higher chance of infection.
- Other ear infections – Middle ear infections (otitis media) or infected hair follicles (folliculitis) can spread into the ear canal and lead to inflammation or infection there’.
Your audiologist or doctor will be able to diagnose whether you have swimmer’s ear by examining your ear with an otoscope. The ear canal and/or eardrum may appear red, inflamed and scaly, and discharge may be present. A sample may be collected for analysis to determine whether the infection is bacterial or fungal, as treatment will vary. Further tests are only required in severe chronic cases where there is a risk of infection spreading to other tissues.
Treatment of swimmer’s ear is usually simple and focuses of pain relief (through heat packs on the ear or analgesics), drainage of the ear canal and keeping it clean and dry, such as by using earplugs or a shower cap. Antibiotic, antifungal or steroid drops may be required. More severe infections may require oral or IV antibiotics or even surgery to drain infected areas.
For the majority of people, swimmer’s ear is a minor annoyance that can be easily treated, however there is a potential for complications. These can include chronic infections (either from recurring infections, or a long term persistent one) leading scar tissue and narrowing of the ear canal, resulting in decreased drainage, further infections and reduced hearing. There is also a possibility of severe infections spreading to surrounding tissues of the face, including soft tissues, cartilage and bones of the skull. Infection of the bones in the ear canal and skull is painful, dangerous and can result in severe damage to the bones, tissues, nerves and even brain. Individuals with immune disorders or diabetes are at increased risk. If you experience ongoing ear infections with unusual symptoms, such as muscle weakness in the face or dizziness, it is important to seek medical assistance immediately.
As always, prevention is preferred so it’s best to avoid swimming in dirty water and keep ears clean and dry by wearing earplugs and drying ears thoroughly (a few drops of drying solution can be used to help). Avoid spraying hair styling products into the ear or allowing other chemicals to enter the ear canal – cotton wool can be used to temporarily block the entrance – and avoid poking the ear with fingernails or cotton tips. As has often been said, put nothing smaller than your elbow into your ears!
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