Swimmer’s Ear

What is Swimmer’s Ear (Otitis externa)

Otitis externa, otherwise known as swimmer’s ear, is an inflammation of the outer ear and the ear canal. It usually affects the ear canal, which encompasses the external part of the ear reaching up to the eardrum. It is usually characterized by infection, irritation and eventually inflammation.

Otitis externa got its layman’s term, swimmer’s ear, because people who are most affected by it tend to be swimmers who are usually exposed to infected water. Children and teenagers as well as people suffering from eczema are also easily infected with the condition.

Causes of Swimmer’s Ear

Otitis externa can be caused by a multitude of factors.

• The most common of which is through swimming in a contaminated water. Majority of the microbial organism that causes swimmer’s ears are Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcuspyogenes. Herpes simplex and herpes zoster viruses are usually the most common culprit among viruses while Candida albicans and those belonging to the Aspergillus specie are the most common causes for fungal infections.
• Allergy, trauma, bacteria, fungi and viruses could also predispose a person to the condition. Nickel and chromium allergy in earrings would usually result to otitis externa. Meanwhile, chemicals like hair sprays, medications like sulfonamides and neomycins as well as the use of cosmetics and hearing aids could also precipitate the condition.

Signs and Symptoms of Otitis externa

• A feeling of fullness and itchiness may be the first sign that an infection is settling in.
• Redness and swelling may be noted in well-developed cases.
• Ear drainage will eventually follow and the patient may experience pain upon tactile sensation.
• Lymph nodes behind the ear could also swell for severe cases of otitis externa. When this happens, the neck may enlarge and may cause difficulty for a patient to open the jaw. Hearing loss could also be experienced for some cases.

Picture : Infection caused by Swimmer’s Ear

Treatments for Swimmer’s Ear

• When otitis externa is in its initial stages, resolution of the condition could occur without any treatment undertaken. Avoidance of water entering the ear canal is, however, necessary to prevent further deterioration of the condition. Therefore, the ear must be kept dry at all times.
• If otitis externa becomes severe, appropriate treatment would be necessary to ensure that the condition would not worsen. Acidifying and drying agents, whether used individually or in combination can be effective in the treatment of otitis externa. The use of acid, however, can be extremely painful in conjunction with the pain already caused by the infection.
• There are various ear drops instillation that could address the problem of otitis externa. Topical solutions would usually contain antibiotics, whether antibacterial or antifungal. Meanwhile, other topical drops would also contain anti-inflammatory steroids that would help relieve swelling and itchiness.
• Oral antibiotics may or may not be necessary depending on the severity of the infection. However, these should be taken only under the advice and direction of a physician. Antibiotics may be necessary when a patient develops fever or when pain becomes extremely severe.
• Antihistamines for itching and acetaminophen for pain may also be prescribed by a physician if these signs are quite severe.
• Moreover, systemic antibiotics may be required for those who are already starting to develop necrosis in the affected ear. Immunocompromised patients as well as those having chronic illnesses like diabetes may also have a need to use antibiotics as a form of prophylaxis at the same time.

Home Remedies for Swimmer’s Ear

• Avoidance of getting the affected ear from being wet is the first step that could be taken. Shower caps and ear or cotton plugs may also be used.
• In addition, the compacted debris and discharge also needs to be removed. This can be done through the use of gentle swabbing with a cotton wool or cotton buds. Removal of the debris is necessary prior to the application of a topical solution to ensure that the medication would be in direct contact with the infected skin.
• Also, it would be best if external ear accessories would not be temporarily used. These could include hearing aids and earrings as these items could be infected as well and thereby delay the healing process.
• Pain medications like ibuprofen and paracetamol can also be taken to help relieve the pain. Application of a warm flannel over the affected ear could also help in addressing the pain.

Complications and Infections

If left untreated, otitis externa could develop into some complications. These could include chronic otitis externa, the further spread of infection to other parts of the body and malignant otitis externa or also known as necrotizing otitis externa. The elderly and diabetics are usually those who have the highest risk for developing these complications.

Otitis externa should therefore be addressed and treated properly. Although it may be left untreated in the initial stages, it would still be best to be referred to a physician once worsening of the signs and symptoms are noted.

References:

http://en.wikipedia.org/wiki/Necrotizing_fasciitis
http://www.medicinenet.com/necrotizing_fasciitis/article.htm
http://www.webmd.com/a-to-z-guides/necrotizing-fasciitis-flesh-eating-bacteria-topic-overview
http://emedicine.medscape.com/article/2051157-overview