Ear - Swimmer's

Symptoms

DEFINITION

• Painful or itchy ear
• Pain increases when ear moved up and down
• Swimming recently or use Q-tips frequently

General Information about Otitis Externa (Swimmer's Ear)

• Otitis externa is an infection of the skin that lines the ear canal. It is also referred to as Swimmer's Ear.
• Cause: When water repeatedly gets trapped in the ear canal (usually from swimming), the lining becomes wet and swollen. This makes the skin of the ear canal susceptible to superficial infection (swimmer's ear). Ear canals were meant to be dry.
• Ear Wax (cerumen): Cerumen is produced by the ear canal as a natural water-proofing agent. Thus, frequent use of cotton ear swabs depletes the wax barrier and increases the likelihood of developing otitis externa. On the other hand, excessive amounts of ear wax can inhibit water drainage from the ear, leading to chronic wetness, ear canal skin maceration, and then on to otitis externa.

Treatment of Otitis Externa

• Antibiotic ear drops: Otitis externa is usually treated with antibiotic ear drops. Examples include Cortisporin Otic, Floxin Otic, and Cipro HC Otic.
• Oral antibiotics: Occasionally more severe cases are treated with oral antibiotics.
• Acetic acid solution: Milder cases of otitis externa can be treated with an acetic acid solution. Household white vinegar contains acetic acid; instructions for use are to rinse the ear canals twice daily with 1/2-strength white vinegar (dilute it with equal parts water). Acetic acid is also available by prescription (e.g., Acetic Acid Otic, Vosol)
• Pain medications

See More Appropriate Topic (instead of this one) If

• EARACHE and your symptoms do not match the Main Symptoms described above

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE

Treatment of Swimmers Ear

1. White Vinegar Rinses. Vinegar (acetic acid) restores the normal acid pH of the ear canal. This helps Swimmer's Ear to get better. Rinse the ear canals twice daily with 1/2-strength white vinegar (dilute it with equal parts water). Here are some instructions on how to do this:
   • Lie down with the affected ear upward. Fill the ear canal.
   • After 5 minutes, remove the fluid by tilting the head to one side and gently pulling on the ear.
   • Continue doing this twice daily until the ear canal returns to normal.
   • CAUTION: Do not do use if you have ear tubes or hole in eardrum.
2. Pain Medicines:
   • For pain relief, take acetaminophen, ibuprofen or naproxen.
   • Acetaminophen (e.g., Tylenol):
     • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
     • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
     • The most you should take each day is 3,000 mg.

   • Ibuprofen (e.g., Motrin, Advil):

     • Take 400 mg by mouth every 6 hours

     • Another choice is to take or 600 mg by mouth every 8 hours.

     • Use the lowest amount that makes your pain feel better.

   • Naproxen (e.g., Aleve)

     • Take 250-500 mg by mouth every 12 hours.

     • Use the lowest amount that makes your pain feel better.

   • Extra Notes

     • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An overdose can hurt the liver.

     • Before taking any medicine, read all the instructions on the package.

3. Local Heat: If pain is moderate to severe, apply a heating pad (set on low) or hot water bottle (wrapped in a towel) to outer ear for 20 minutes (Caution: avoid burns). This will also increase drainage.
4. Avoid Earplugs: If pus or cloudy fluid is draining from the ear canal, wipe the pus away as it appears. Avoid plugging with cotton (Reason: retained pus causes irritation or infection of the ear canal).
5. Avoid Swimming: Try to avoid swimming until symptoms are gone.
6. Contagiousness: Swimmer's ear is not contagious.
7. Expected Course: With treatment, symptoms should improve in 3 days and resolve within 7 days.
8. Call Your Doctor If:
   • Ear symptoms last longer than 7 days with treatment
   • You become worse

Prevention of Swimmers Ear

1. Prevention - Keep Ear Canals Dry:
   • Try to keep your ear canals dry.
   • After showers, hair washing, and swimming, help the water run out by tilting the head to one side. You can also use a hair dryer set on the lowest setting to dry out your ears.
2. Prevention - Avoid Cotton Swabs:
   • Avoid cotton swabs (i.e., Q-Tips, cotton tip applicator).
   • These remove the protective earwax of the ear canal.
3. Prevention - Rinse Ear Canal with Vinegar After Swimming:
   • After swimming, place several drops of 1/2-strength white vinegar (dilute it with equal parts water) in your ear canals.
   • After 5 minutes, remove the fluid by tilting the head to one side and gently pulling on the ear.
   • REASON: Vinegar (acetic acid) restores the normal acid pH of the ear canal.
   • INDICATION: You may want to try this if you tend to get swimmer's ear frequently.
   • CAUTION: Do not use if you have ear tubes or hole in eardrum.

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.