If you have a baby, chances are you already know the signs of an ear infection – fussiness for no apparent reason, frequent waking during normal sleeping times, tugging on ears. Most parents know to watch for these signs. But what about older children or adults? Do they tug their ears, too?
If an annoying itch or stuffiness has been bothering you on and off for a while, it could well be what doctors call otitis externa (OE) and we call “swimmer’s ear.” This infection can manifest as a persistent irritation and inflammation of the outer ear canal. Unlike its cousin, otitis media (OM), infection of the middle to inner ear, OE is less common in infants and easy for older kids and adult to get.
The most common cause of swimmer’s ear is simply too much water entering and staying in the ear, hence the term “swimmer’s ear.” When water is trapped in the ear canal, it creates a moist environment for bacteria and fungi to grow.
Signs of swimmer’s ear
Ear tugging is most likely not the sign to look for in grown-ups, but OE ears may itch. The affected ear also can feel pressure or become plugged up, as if in an airplane, temporarily interfering with hearing. Pain, sometimes terribly severe, along with swelling is common. The infection can become worse and may include swollen glands as well as oozing of a yellowish, bad-smelling pus. Although bothersome, the infection easily can be cleared with treatment.
“Only rarely will OE clear up by itself,” says Rajesh S. Kakani, M.D., assistant professor of otolaryngology at Albert Einstein College in New York. “Seek early treatment to prevent it from getting worse.”
Mom always said, “Keep your ears dry”
Mom was right. Think of the skin in your ear canal as warm, moist and tender. Bacteria and fungi love these kinds of places. You can’t do anything about the temperature in there or the tenderness of the skin, but you can help with the moisture content by avoiding water buildup.
If your ears stay stuffy after swimming, then take the following steps to clear them before problems develop:
- Use a towel or even a handheld blow dryer to dry your ears after showering or swimming. Be careful not to burn your ears. Tilt your head to let gravity do its thing, draining your ears.
- Consider a bathing cap if you swim often, but earplugs are not recommended. Earplugs, like other things that enter the ear, actually can do more harm than good by irritating the delicate skin in the canal, setting the stage for infection.
- If you have recurring ear infections, your otolaryngologist (ear, nose and throat doctor) may recommend using lanolin or other preventive drops before activities that might invite water into the ear.
- Your doctor may tell you how to prepare your own eardrops with items at home to help dry up swimmer’s ear. A solution of half rubbing alcohol and half white vinegar often is recommended. As the alcohol evaporates, it absorbs water to help dry out the ear, and it even may kill the bacteria and fungi that can cause swimmer’s ear. However, make sure to ask your doctor first before self-treating.
If chronic dermatitis (skin inflammation) of the ear canal is bothersome, try cutting back on foods that aggravate symptoms such as greasy foods, carbohydrates and chocolate, says the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS).
‘Ear’ this – stay out!
Speaking of putting things in your ears, remember the old adage about “anything smaller than your elbow”? It’s still good advice. The best way to prevent irritation is by keeping sharp items away from the delicate skin inside your ear. Never subject those tender canals to sharp items such as paper clips, which can cause, at the least, irritation and, at the most, serious tears inside the ear.
“It is a common misunderstanding that our ear canals require regular cleaning,” Kakani says. Avoid avid cleaning of the wax in your ears or repeated use of cotton swabs such as Q-tips, he advises. “More often than not they make it worse since they push cerumen (earwax) deeper, where the body’s natural cleaning system does not work.”
“Not only will frequent digging around in your ear canal irritate the skin, possibly leading to inflammation, but removing earwax can work against you in the fight to combat infection,” Kakani says. “Wax in your ears is how your body resists harmful invaders like the water we talked about and without any protective wax, the delicate skin is left vulnerable to infection.”
Beware of over-the-counter cleaning kits if you have earwax, Kakani cautions. “For most people, these kits make the wax softer and wet but do not get it out. This makes the ears a perfect setting for bacteria and fungus to grow.”
Plenty of people have found out the hard way that hair spray and hair dye can build up in the ear over time and also lead to an infection. So, when doing your hair, it’s best to cover your ears or place balls of lamb’s wool in your ears to guard against these chemicals.
Occasionally, a fungus or an infected hair follicle causes a problem. If you have a tendency toward recurring skin irritations, such as psoriasis or acne, you also may experience outbreaks in the skin of your ear leading to infection. Even hearing aids can be an irritant; using hypoallergenic silicone types may helpful.
What if you’re already “ear”-itated
If you’ve acquired swimmer’s ear, there are some simple treatments to clear it up and prevent it from progressing to an infection of the middle and inner ear, which are more uncomfortable and dangerous. Remember, you’ll need to see a health care provider for an accurate diagnosis before starting any treatment.
It may hurt a bit to have your infected ear inspected by a health care provider, but it’s the only way to see the extent of the problem. Your health care provider may need to suction out any fluid that is present and take a close look at your eardrum to make sure it’s not damaged.
Although oral antibiotics, decongestants or antihistamines sometimes are used to treat OE, in most cases, pills are unnecessary. Unless you have a temperature higher than 101 degrees F or other indications of advanced infection, you most likely will not need oral antibiotics to get better. Your doctor may prescribe antibiotic eardrops, which often work quite well and cause fewer side effects than oral medications.
However, if your ears do not feel better after three or four days using antibiotic eardrops, let your doctor know because oral antibiotics may be needed to clear your infection.
Eardrops containing corticosteroids work quickly to ease the dismal aching ear pain and itchiness that usually accompany swimmer’s ear. The American Academy of Family Physicians recommends you continue using prescribed drops until you’re symptom-free for at least three days. They also recommend making the drops less uncomfortable by warming them just to body temperature by holding the bottle in your hand. To help the drops swish around throughout the infected areas, tug on your earlobe while inserting them.
If your ears are painful, you may find aspirin or another analgesic brings relief. Aspirin is not generally recommended in children because of its association with Reye syndrome, which is a rare brain and liver inflammation affecting children 6 and younger. Also helpful is placing a warm (not hot) heating pad or hot water bottle over your ear.
So remember, the next time your ears feel stuffy or pressured after bathing or playing in water, think prevention and dry those ears.