"Swimmer's Ear" refers to an infection of the canal that connects the outside of the ear with the inside of the ear. Normally this passageway is dry and slightly acidic so germs do not grow there. Swimmer's Ear happens when bacteria (Pseudomonas aeruginosa) or fungi have a chance to grow in the canal. This causes pain and swelling of the ear. Cleaning the ear and applying ear drops is usually needed to treat Swimmer’s Ear.
Swimmer's Ear can occur at any age, but is most common in school-aged children. In fact children get Swimmer's Ear most frequently between 7-12 years of age. This infection is nicknamed Swimmer’s Ear because swimmers get this ear infection much more often than non-swimmers.
What causes Swimmer's Ear?
When contaminated water stays inside the ear canal after swimming, several things can happen that can lead to an infection. The water can wash away the earwax that is usually in the canal to help keep out objects. The water changes the normally dry, acidic skin in the area. The ear canal is also warm and dark. All of these things allow for bacteria to grow in the ear canal.
What increases the risk of Swimmer's Ear?
Conditions that may break down the natural defenses in the ear include:
- When the ear stays moist or wet or keeps getting wet repeatedly - The presence of moisture or water can change the acidity that would help keep bacteria from growing. This happens in swimmers when the inside of the ear stays wet for long periods of time. The surface of the skin becomes irritated, allowing bacteria to grow rapidly in the ear canal.
- When cleaning or scratching the inside of the ear causes breaks or cuts in the skin - This lets bacteria get into the skin and cause an infection.
- Overuse of devices for the ear – Using earphones or hearing aids that do not fit properly and rub the skin can cause irritation.
- Certain skin conditions, like eczema, psoriasis, or even acne - These conditions can cause cuts in the skin.
How can I tell if my child has Swimmer's Ear?
Initial symptoms may be mild to severe. These usually include:
- Itching in and around the ear
- Pain or discomfort in and around the ear
- Small amounts of clear liquid is in or draining from the ear
As the infection gets worse, the symptoms may include:
- Pain when touching or pulling on the ear
- Large amounts of fluid (white or yellow) draining from the ear
- Temporary hearing loss as the ear canal swells up
- A feeling of pressure in the ear
If the infection is severe, other possible symptoms include:
- Severe pain
- Redness around the ear, face, or neck
- Dizziness
- Fever
How is Swimmer's Ear treated?
Treatment starts with cleansing of the ear canal by the doctor. Debris is usually removed with a small device. The ear canal is then rinsed with a cleaning solution like hydrogen peroxide diluted with water. One or more kinds of topical ear drops may be placed in the ear canal as part of the treatment. Try to have your child stay away from water sports for at least 7 to 10 days. If your child is a competitive swimmer, she may be allowed to return after two-three days of antibiotic treatment. Check with the doctor first. Well-fitted earplugs may also be needed.
If Swimmer’s Ear is caused by bacteria, the doctor will prescribe an antibiotic ear drop to kill the bacteria causing the infection. Examples are tobramycin or ofloxacin. Sometimes other drops may also be included in your child’s treatment, such as a steroid to help with the pain and swelling. Dexamethasone, hydrocortisone, and prednisolone are examples of steroid ear drops. The doctor may also prescribe an ear drop with acetic acid to restore the acidity of the canal. Products that combine one or more of these ingredients are available to make treatment less of a hassle.
If there is a lot of swelling in the ear canal, the doctor may use something known as a "wick". A wick is a small cotton sponge filled with medicine that is put inside the ear canal so that the antibiotic can reach the skin.
An antibiotic to take by mouth may be required if your child has a serious infection or is at risk for more severe infections. Sometimes the infection takes longer than usual to heal. This is another reason to start an antibiotic by mouth. Make sure your child finishes the course of antibiotics.
Acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®) can help with the initial pain. The condition(s) that led to the infection should be avoided to allow for healing and preventing the infection from coming back.
When should I take my child to the doctor?
If a Swimmer's Ear infection is suspected, consult a doctor for treatment. Some people are at a higher risk of having a more severe form of Swimmer's Ear infection. People who have diabetes or any other condition that causes them to have a lower immune response are at risk for getting Swimmer’s Ear. These conditions delay the speed and process of healing. These children may need additional treatment. Also, some infections may spread into deeper tissues, even to the bone. Serious infections like these will also require more treatment than the topical ear drops.
If you suspect that any of these conditions exist, contact your child’s doctor immediately. Sometimes a concentrated infected area, also called an abscess, may form. The abscess may need to be opened and drained, Doing this will help to relieve the pain and allow for faster healing. For complicated infections, a long course of antibiotics either taken by mouth or through an I.V. (intravenous) may be necessary.
A child under 2 years old with a respiratory infection and a fever should also be brought to the doctor to make sure it is not a middle ear infection (otitis media).
How can I prevent Swimmer's Ear in my child?
Some great tips to avoid getting Swimmer’s Ear again or for the first time can be found at the CDC’s website and other resources. Here are KidsMeds’ favorites:
· Avoid getting water in the ears when bathing or swimming.
· Use cotton with petroleum jelly, earplugs, or tight-fitting bathing caps when swimming.
· Dry the ear canal after bathing or swimming by wiping the outside of the ear thoroughly.
· Tipping the head can help drain water from the ear.
· Using a hair dryer on the lowest heat setting can also work.
· Alcohol-based ear drops or other drops, such as aluminum acetate drops (Burow's Solution), may also be used to dry the ears after bathing or swimming. Check with your child’s doctor first, since these may be irritating to the infected ear. Ask the pharmacist to help you find these products.
· Acetic acid drops may be used to try to return the ear canal to the normal acidic environment there.
· Avoid using hairpins, fingernails, or cotton swabs. These may scratch the inside of the ear.
- Beware of polluted locations; do not swim in those areas.
References:
Otitis Externa, Swimmer's Ear. URL: http://www.fpnotebook.com/ENT/Ear/ActOtsExtrn.htm (Accessed July 29, 2010)
http://www.uptodate.com/online/content/topic.do?topicKey=pc_id/2947 (Accessed April 2009)
Waltzman AA. Otitis Externa. URL: http://www.medscape.com/article/994550-overview (Accessed July 29, 2010)
Mayo Clinic Staff. Swimmer's ear. URL: http://www.mayoclinic.com/health/swimmers-ear/DS00473/METHOD=print (Accessed July 29, 2010)
•
del.icio.us
digg
facebook
