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Outer Ear Infections (Otitis Externa)

An infection of the outer ear canal be very painful. They typically occur in people who clean their ears with cotton buds or in swimmers.

What is an outer ear infection?

An outer infection occurs when the skin of your outer ear canal becomes inflamed, swollen and infected. The outer ear canal joins your external ear to your eardrum. The medical term for this is otitis externa. Outer ear infections nearly always begin as bacterial infections but can later become fungal infections. They usually occur because of some trauma to the ear canal skin (cotton buds) which interferes with the normal barrier to infection combined with water exposure (swimming or showering). Eczema, other skin problems and narrowing of the ear canal from surfing (exostoses) can also be predisposing factors.

Most infections respond promptly to treatment but occasionally can turn into a chronic form which is more challenging to treat.

What are the symptoms?

Outer ear infections can be extremely painful. The ear canal is a narrow tube and a significant amount of pressure can build up on the skin as well as the ear drum. The ear can also feel blocked and itchy.

A chronic infection may have occur if the ear continues to feel blocked or itchy for weeks or months following the acute infection.

What is the treatment?

The combination of the correct ear drops and total water avoidance will clear many infections. Unfortunately sometimes there is so much debris (wax, bacteria, hair or fungus) in the ear canal that this needs to be removed before resolution can occur as the infection tends to stick to this.

Dr Roth uses a microscope and a very gentle suction device to remove all the infected debris from the ear canal and eardrum. On some occasions, he may take a swab and send this to the laboratory in order to help determine which particular organism is causing the infection. The treatment for bacterial versus fungal infections is different. Occasionally the ear canal may need to be packed overnight with an “Otowick” in order to allow ear drops to actually stay in the ear canal. If the infection has spread onto the outer ear or face, oral antibiotics or even a hospital admission may be necessary.

Ways to prevent future infection

  • Never use cotton buds to clean your ears. These typically cause trauma to the ear canals and tend to push wax and debris down onto the ear drum.
  • Wear a swimming cap over your ears or use ear plugs when you swim
  • Tip your head to get rid of any water that gets in your ear.
  • Avoid shampoo in your ears
  • Use Aqua Ear after swimming to help dry the ear canal
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