CAUTION: If you already have an ear infection, or if you have ever had a perforated, punctured, ruptured, or otherwise injured eardrum, or if you have had ear surgery, you should consult an ear doctor before you go swimming and before you use any type of ear drops. If you do not know if you have or ever had a perforated, punctured, ruptured, or otherwise injured eardrum, you should consult your ear doctor.
Otitis Externa/ Swimmer’s ear
Another common type of ear infection is otitis externa, or “swimmer’s ear”, an infection of the skin of the ear canal (outside of the eardrum). The ear canal is a warm, moist place which is not easily cleaned, and a superficial skin infection can linger in this region (just like a diaper rash!). These patients have ears which hurt when moved and which itch severely. Otitis externa is usually treated with ear drops containing an antibiotic and possibly asteroid, but it is usually important to thoroughly clean the ear, using a microscope and suction. Cleaning is NOT something that should be done by anyone but a doctor with experience in this procedure. Do not try to clean the ear yourself, this may make things worse. In severe cases of otitis externa, antibiotics are also used.
What is “Swimmer’s Ear”?
“Swimmer’s ear” is one of a number of names for infection of the outer ear canal. It is also called “fungus” of the ear or “jungle ear”
Sometimes it really is caused by a fungus, but more often, especially in painful cases, it is caused by one of nature’s common bacteria. Although otitis media and otitis externa can both be present at the same time, they generally have nothing to do with each other. In some cases, though, if there is a hole (or ear tube) in the eardrum, fluid can drain from a middle ear infection into the ear canal, causing swimmer’s ear.
If there is no hole, the eardrum is watertight. Therefore, getting water in the ear canal from swimming or bathing cannot cause otitis media or any other type of middle ear fluid. While occasionally excessive water exposure can cause a swimmer’s ear, this should not be confused with a middle ear infection. They are different problems and are treated differently.
What causes swimmer’s ear?
A common source of the infection is increased moisture trapped in the ear canal, from baths, showers, swimming or moist environments. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection of the ear canal. Swimmer’s ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing, as well as to prevent the spread of infection.
Factors that may contribute to swimmer’s ear include:
- Contact with excessive bacteria that may be present in hot tubs / hot water springs or polluted water
- Excessive cleaning of the ear canal with a cotton bud
- Contract with certain chemicals such as hairspray or hair dye
- A cut in the skin of the ear canal
- Other skin condition affecting the ear canal, such as Eczema or Seborrhea
How do you avoid it?
When water gets into your ear, it may bring with it bacteria or fungus particles. Usually, the water runs back out, the ear dries out, and the bacteria and fungi don’t cause problems. But sometimes the water remains trapped in the ear canal, and the skin gets soggy. Then the bacteria and fungi grow, flourish, and can infect the ear.
First, the ear feels blocked and may itch. Soon the ear canal becomes swollen, sometimes swells shut, starts draining a runny milky liquid, and becomes very painful. It is also very tender to touch, especially on the tragus (the triangular piece of cartilage in front of the ear canal). When the infection gets to this stage, a doctor’s treatment is needed. This is also true if glands in the neck become swollen.
However, the entire sequence of events can be easily prevented if you use antiseptic eardrops whenever you feel that water is trapped in your ears. Such eardrops are inexpensive and are sold without prescription under various trade names such as Aqua Ear®, Ear Magic®, Swim Ear®, etc.
If your ear doctor says you have normal eardrums, and it he says it is safe, you could make up your own eardrops to use after swimming. Many doctors recommend rubbing alcohol as an important ingredient. It absorbs the water, helps dry out the ear, and may even kill the bacteria and fungi that cause swimmer’s ear. Another effective ingredient is white vinegar, which you could mix half and half with the alcohol. (Vinegar contains acetic acid, which kills the bacteria and fungus.) Your druggist can supply you with a dropper bottle for your alcohol or alcohol-vinegar mix eardrops so you can keep them in your beach bag.
If your ear feels moist or blocked after swimming, hair washing, showering etc. put your head over with that ear up, pull the ear upwards and backwards and instill the eardrops into it. Wiggle your ear to get the drops to go all the way down in, and then turn your head to let them drain out.
*If yours is a frequently recurring problem, your doctor may instead recommend placing oily (or lanolin) ear drops in your ears before swimming to protect them from effects of the water.
Why do ears itch?
An itchy ear is a maddening symptom. Sometimes it comes from a fungus (especially in acute cases), but more often it is a chronic dermatitis (skin inflammation) of the ear canal. One type is seborrheic dermatitis, a condition similar to dandruff in the scalp; the wax is dry, flaky, and abundant. Some patients with this problem will do well to decrease their intake of foods that aggravate it, such as greasy foods, carbohydrates (sugar and starches), and chocolate. Doctors often prescribe an oily or cortisone containing eardrop to use at bedtime whenever the ears itch. There is no long-term cure, but it can be kept under control. Itchy ears in a few patients are caused by allergies that require specific medical treatment.
Patients with itchy, flaky ears or ears that accumulate wax are very likely to develop “swimmer’s ear.” They should be especially conscientious about using the alcohol ear drops as described above whenever water gets trapped into the ears. They also do well to get their ears cleaned out each year before the swimming season starts.
What about Gnats, Insects, and Foreign Objects?
Of the many types of insects that can get into the ears, gnats, moths, and roaches are the most common. Gnats get tangled in the wax and cannot fly out. Bigger insects cannot turn around; neither can they crawl backwards. They keep on struggling, though, and their motion can be painful and frightening.
Gnats are easily washed out with warm water from a rubber bulb syringe. (Remember to dry the ear out afterwards with alcohol drops.) For a big insect, the first step is to fill the ear with mineral oil, which plugs off the breathing pores of the insect and kills it. It takes 5 to 10 minutes or so. Then see the doctor to get the insect removed.
Beads, pencil lead, erasers, bits of plastic toys and dried beans are common objects that children put into their ears. Removal is a delicate task – one for the doctor to perform