Clinical Reference Systems: Pediatric Advisor 10.0
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Illustration
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
- 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.
- 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.
- Pain relief.
Use acetaminophen or ibuprofen for pain relief.
- 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.
- 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.
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