(otitis externa) is a painful inflammation and infection of the
ear canal . It occurs when the protective film that covers the ear canal
(lipid layer) is removed. This causes the ear canal to look red and swollen.
The ear canal may be narrower than normal and is tender when the outside of the
ear is gently pulled up and back.
Swimmer's ear may develop when
water, sand, dirt, or other debris gets into the ear canal. Since it often
occurs when excess water enters the ear canal, a common name for this
inflammation is "swimmer's ear." If you have had swimmer's ear in the past, you
are more likely to get it again.
A rare but serious infection
called malignant external otitis can develop if bacteria invade the bones
inside the ear canal and spread to the base of the skull. Not many people get
this infection—it is mainly seen in older adults who also have
diabetes, people who have
HIV, and children who have
impaired immune systems—but it can be fatal. Symptoms
include ear pain with sudden facial paralysis, hoarseness, and throat pain.
Antibiotics are used to treat this infection.
Other causes of
inflammation or infection of the ear canal include:
- Bony overgrowths in the
ear canal called exostoses.
- Bubble baths, soaps, and
- Cleaning the ear canal harshly or with a sharp
- Headphones inserted into the ear.
the ear canal with a cotton swab, bobby pin, fingernail, or other sharp
- Skin problems, such as
You are more likely to get swimmer's ear if:
- You have a very narrow or hairy ear canal.
- You have earwax stuck in the ear canal (impacted) because you commonly use cotton swabs that may push the ear wax deeper into the ear canal.
Symptoms can include
itching, pain, and a feeling of fullness in the ear. Your ear canal may be
swollen. You may have moderate to severe pain, drainage, or hearing loss.
Unlike a middle ear infection (acute otitis media), the pain is worse
when you chew, press on the "tag" in front of the ear, or wiggle your
You may be able to prevent swimmer's ear. Symptoms often
get better or go away with home treatment.
symptoms to decide if and when you should see a doctor.
If you have a
ruptured eardrum, you will likely need to see your doctor to treat the infection or injury that caused the rupture. A ruptured eardrum usually drains suddenly and leaks fluid that can look like pus, smell bad, or even be bloody.
If you do not have a ruptured eardrum, you may be able to relieve your ear
- Gently rinse the ear using a bulb syringe and
warm saline solution or a half-and-half solution of white vinegar and warm
water. Make sure the flushing solution is body temperature. Inserting cool or
hot fluids in the ear may cause dizziness.
- If your ear is itchy, try nonprescription swimmer's
eardrops, such as Star-Otic or Swim-Ear. Use them before and after swimming or
getting your ears wet.
- To ease ear
pain, apply a warm washcloth or a heating pad set on low. There may be some
drainage when the heat melts earwax. For more information about earwax removal,
see the topic
- Do not use a heating pad when you are in bed.
You may fall asleep and burn yourself.
- Do not use a heating pad on
- Do not use ear candles. They
have no proven benefit in the removal of earwax or other objects in the ear and
can cause serious injury.
To insert eardrops
- First, warm the drops to body temperature by
rolling the container in your hands or placing it in a cup of warm water for a
few minutes. Inserting cold eardrops can cause pain and dizziness. See a
picture showing how to insert eardrops safely .
- Have the
person lie down, ear facing up.
- Place 2 or 3 drops on the wall of
the ear canal so air can escape and drops can get into the ear. Gently wiggling
the outer ear will help.
- You may find it easier to insert eardrops
in a small child's ear by holding the child on your lap with his or her legs
around your waist and head down on your knees. If possible, remain in this
position for 2 to 3 minutes.
Medicine you can buy without a prescription
| Try a nonprescription
medicine to help treat your fever or pain:|
- Acetaminophen, such as
- Nonsteroidal anti-inflammatory drugs (NSAIDs):
- Ibuprofen, such as Advil or
- Naproxen, such as Aleve or Naprosyn
- Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
| Be sure to follow these
safety tips when you use a nonprescription medicine:|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
- Do not take a medicine if you have had an
allergic reaction to it in the past.
you have been told to avoid a medicine, call your doctor before you take
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home
- The ear canal, the opening to the ear
canal, the external ear, or the skin around the external ear becomes swollen,
red, or very painful.
- Dizziness or unsteadiness
- Bleeding or discharge from the ear develops.
- Ear symptoms last longer than 1 week.
- Symptoms become more severe or frequent.
In most cases, it is best to leave your
ears alone and let them maintain their own healthy, natural balance.
- Do not scratch or clean
the inside of the ear with cotton swabs, bobby pins, your fingernail, or other
- Removable earplugs may be used to keep moisture out of the
ear canal. But prolonged use of earplugs can make your ears hurt and itch, and
the earplugs can push earwax deeper into the canal. If this happens, your ears
are more likely to get infected.
- Keep soap, bubble bath, and
shampoo out of the ear canal. Do not let a child lie down in the bathtub with
his or her ears underwater. These products can cause itching and irritation.
- Keep your ears dry.
- After swimming or showering, shake your head
to remove water from the ear canal.
- Gently dry your ears with the
corner of a tissue or towel, or use a blow-dryer on its lowest setting. Hold
the dryer several inches (centimeters) from the ear.
- Put a few
drops of rubbing alcohol or rubbing alcohol mixed with an equal amount of white
vinegar into the ear after swimming or showering.
- Wiggle the
outside of the ear to let the liquid enter the ear canal, then tilt your head
and let it drain out.
- You can also use nonprescription drops, such
as Star-Otic or Swim-Ear, to prevent swimmer's ear.
- If you use public swimming pools or hot tubs, ask
about the chlorine and pH testing of the pool. You are less likely to get
swimmer's ear from facilities that maintain good control of their pool testing
- Do not swim in dirty water or locations that have
been closed because of pollution.
- Follow any instructions your
doctor has given you to treat skin problems—such as
seborrhea—that may cause ear canal irritation.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
- Have you done anything recently that may have
caused your ear canal to become infected, such as cleaning your ears or
- Have you had a history of ear itching, pain, or other
symptoms? Describe your symptom:
- When did it start?
- Do you have
problems with the inside or the outside of your ear?
- Are your
symptoms constant, or do they come and go?
- Does anything make your
ear feel better or worse?
- Did you put anything into your ear before the
- Do you have drainage from the ear? What does the
drainage look and smell like?
- Have you had a fever?
you dizzy or do you feel unsteady?
- Have you had problems like this
before? If so, how was it treated?
- What home treatment measures
have you used? Did they help?
- What prescription and nonprescription
medicine have you tried? Did they help?
- Do you have any
- Objects in the Ear
|By: ||Healthwise Staff ||Current as of: January 14, 2014|
|Medical Review: ||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
H. Michael O'Connor, MD - Emergency Medicine