Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

• You have itchy and painful ear canals.
• You have been swimming recently.
• You feel pain when the ear is moved up and down.
• You feel 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 swollen and prone to infection.

People 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.)

   You need 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, you should not swim until the symptoms are gone. If you are on a swim team, you may continue, but use the eardrops as a rinse after each swimming session.

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 your head to the side. Do this twice a day.

3. Pain relief.

   Use acetaminophen or ibuprofen for pain relief.

4. Prevention.

   The key to prevention is keeping the ear canals dry when you are not swimming. After swimming, get all water out of your ear canals by turning your 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 ear canals with rubbing alcohol each time you finish 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 ear wax 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 PHYSICIAN IMMEDIATELY IF:

• The ear pain becomes severe.
• You start feeling very sick.

CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:

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