Treating Swimmer's Ear
As children seek refuge from the summer heat in pools and lakes, parents should be alert for the symptoms of painful swimmer's ear. To avoid unnecessary discomfort, Texas Children's Hospital specialists recommend the ailment be treated as soon as symptoms appear and that swimmers stay out of the water until it is healed.
"Swimmer's ear is characterized by an inflammation and irritation of the external auditory canal," says Dr. Jan Drutz, chief of the residents' primary care group clinic at Texas Children's Hospital and professor of pediatrics at Baylor College of Medicine in Houston, Texas. "Itching can occur; however, pain is the most common symptom. Gentle movement of the outer cartilaginous portion of the ear, particularly the skin-covered cartilage just in front of the opening to the ear canal, can cause extreme discomfort. The external auditory canal becomes red and swollen, and in severe cases, the canal can swell shut. The patient does not run a high fever or risk hearing loss; however, the pain usually is intense."
Swimmer's Ear Symptoms
- Although itching can occur, pain is the most common symptom of swimmer's ear.
- The external auditory canal is inflamed and irritated.
- In severe cases, the external auditory canal can swell shut.
- If fever is present, it is usually low grade.
During swimming, water entering the external auditory canal can cause a change in the normal acidity of the canal. The membranous canal normally is protected by a coating of ear wax. When the hydrogen ion concentration (pH, or normal acidity) of the canal is changed, it becomes susceptible to infection.
Once swimmer's ear is diagnosed, oral medications containing acetaminophen, ibuprofen or stronger pain relievers may be prescribed. The child's physician also may prescribe liquid drops containing a pain reliever to be applied into the external canal, according to Dr. Drutz. "It's important to address the infection," says Dr. Drutz. "If the infection is bacterial, ear drop antibiotics – some of which also may contain steroids – are prescribed to treat the infection and reduce inflammation of the canal. If the condition does not improve, it may be caused by a fungal infection that may require anti-fungal agents."
Swimmer's Ear Treatment
Following diagnosis, oral medications containing ibuprofen, acetaminophen or a stronger medicine may be prescribed for pain management. Liquid drops containing a topical analgesic also may be prescribed.
- Antibiotic eardrops – some of which may contain steroids – may be prescribed for bacterial infections. Anti-fungal agents are used to treat fungal infections.
- Swimmers should stay out of the water until the infection is cleared.
Most importantly, people being treated should stay out of the water for at least five to seven days or until the infection is under control. "Even if your child is the star of the swim team and can't miss the 'big meet,' there's no reason to further irritate the external auditory canal," says Dr. Drutz. "With treatment, the condition usually clears in three to four days. Severe cases may take up to a week."
There are preventive measures parents can take to lower the risk of swimmer's ear. "When a child gets out of the water, dry the ears with a clean towel," says Dr. Drutz. "It's a good idea to use one of the over-the-counter preparations, a few drops of hydrogen peroxide or a home remedy of rubbing alcohol and white vinegar to maintain the ear canal's normal acidity. "
Dr. Drutz advises swimming only in pools that are chemically treated to maintain a normal pH balance. There may be a greater chance of acquiring swimmer's ear by swimming in a lake or river.
Swimmer's Ear Preventive Measures
- Swim only in pools that have been properly treated to maintain pH balance. Rivers and lakes offer a greater chance of infection.
- Ears should be dried with a clean towel immediately after swimming.
- Used after swimming, over-the-counter preparations or a few drops of hydrogen peroxide can help maintain the ear's pH balance. A home remedy can be made with 2 milliliters each of rubbing alcohol and white vinegar. Several drops should be placed in the affected ear canal while the child stands with the head tilted toward the opposite shoulder. This position should be held for three to five minutes so the medication can run down the length of the canal. Then, cotton should be inserted in the outer opening of the canal and left in place for about an hour.