Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0
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Swimmer's Ear (Otitis Externa)

DESCRIPTION

  • Your child has itchy and painful ear canals.
  • Your child has been swimming recently.
  • Your child feels pain when the ear is moved up and down.
  • Your child feels pain when the tab of the outer ear overlying the ear canal is pushed in.
  • The ear feels plugged up.
  • There is a slight amount of clear discharge at first. Without treatment, the discharge becomes yellowish.

CAUSE

Swimmer's ear is an infection of the skin lining the ear canal. The cause is prolonged contact with any type of water. Ear canals need to be dry. When water gets trapped in the ear canal the lining becomes damp, swollen, and prone to infection.

Children are more likely to get swimmer's ear from swimming in lake water, compared to swimming pools or the sea. During the hottest weeks of the summer, some lakes have high levels of bacteria. Narrow ear canals also increase the risk of swimmer's ear.

EXPECTED COURSE

With treatment, symptoms should be better in 3 days.

HOME TREATMENT

  1. Antibiotic-steroid eardrops for severe swimmer's ear. (These require a prescription.)

    Your child needs the eardrops prescribed by your physician.

    Run the eardrops down the side of the ear canal's opening so that air isn't trapped under the drops. Move the earlobe back and forth to help the eardrops pass down. Continue using the eardrops until all the symptoms are cleared up for 48 hours.

    Generally, your child should not swim until the symptoms are gone. If he is on a swim team, he may continue but should use the eardrops as a rinse after each swimming session. Continued swimming may cause a slower recovery but won't cause any serious problems.

  2. White vinegar eardrops.

    For mild swimmer's ear, use half-strength white vinegar eardrops. Fill the ear canal with white vinegar diluted with an equal amount of water. After 5 minutes, remove it by turning the head to the side. Do this twice a day.

  3. Pain relief.

    Use acetaminophen or ibuprofen for pain relief.

  4. Prevention.

    First, limit how many hours a day your child spends in the water. The key to prevention is keeping the ear canals dry when your child is not swimming. After swimming, get all water out of the ear canals by turning the head to the side and pulling the earlobe in different directions to help the water run out. Dry the opening to the ear canal carefully. If recurrences are a big problem, rinse your child's ear canals with rubbing alcohol each time he finishes swimming or bathing to help it dry and kill germs. Another helpful home remedy is a solution of half rubbing alcohol and half white vinegar. The vinegar restores the normal acid balance to the ear canal.

  5. Common mistakes.

    Don't use earplugs of any kind for prevention or treatment. They tend to jam earwax back into the ear canal. Also, they don't keep all water out of the ear canals.

    Cotton swabs also shouldn't be inserted in ear canals. They increase earwax buildup. The earwax then traps water behind it and increases the risk of swimmer's ear.

    Rubbing alcohol is helpful for preventing swimmer's ear but not for treating it because it stings an infected ear too much.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

  • The ear pain becomes severe.
  • Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

  • The ear symptoms are not cleared up in 3 days.
  • You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems