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Quick reference medical handouts used by Pediatric offices


Swimmer's Ear


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CAUSES OF SWIMMER'S EAR

Moisture from swimming, humidity, perspiration,
Water contaminated with bacteria
Mechanical removal of ear wax
Insertion of foreign objects such as cotton swabs, fingernails, ear plugs
Chronic skin conditions such as eczema, psoriasis, seborrheic dermatitis, acne
Water normally flows into and out of your child's ears without causing any problems. When we shower, bathe, swim, and walk in the rain we are  protected by the ear's shape, which tips fluid out, and by its lining, which has acidic properties that protect against bacteria and fungi.

However, when the ear is exposed to excess moisture water can remain trapped in the ear canal. The skin inside becomes soggy, diluting the acidity that normally prevents infection. A cut in the lining of the ear canal also can allow bacteria to penetrate your skin. When this happens, bacteria and fungi from contaminated water or from objects placed in the ear can grow and cause a condition called swimmer's ear (external otitis).

Children get swimmer's ear when bacteria grow in their ear canal. This happens when something irritates the delicate skin in the ear canal. Some of the causes are listed in the table above.

Swimmer's ear can be very painful. The pain can get worse when you touch your child's  earlobe. Other symptoms include

  • Pain or discomfort in or around the ear. Usually only one ear is involved.
  • Itching of the outer ear.
  • Swelling in the ear or lymph nodes in the  neck.
  • Your child complains of a fullness or stuffiness in the ear.
  • There is pus draining from the ear.
  • You notice your child's hearing is decreased

Your child's doctor can usually tell whether your youngster has swimmer's ear by looking into your child's ear canal. Swimmer's ear usually isn't serious, but complications can occur if it isn't treated. Complications are rare but may include:

  • Temporary hearing loss.
  • Recurrent outer ear infections which can lead to infection in the surrounding skin (cellulitis).
  • Bone and cartilage damage (necrotizing otitis externa).
  • More widespread infection. If swimmer's ear develops into necrotizing otitis externa, the infection may spread and affect other parts of your child's body,
The goal of treating swimmer's ear is to clear up the infection. Treatment may include:
  • Cleaning. Clearing your child's outer ear and ear canal of any drainage. In severe cases, your child's doctor may do this with a suction device. To prevent further irritation or injury, don't clean inside your child's ear.
  • Ear Drops Your child's doctor may prescribe eardrops containing antibiotics to fight infection and corticosteroids to reduce itching and inflammation. Use eardrops as directed. If your child's ear canal is exceptionally swollen, a special wick may be inserted into the ear to allow the drops to reach the entire ear canal.
  • To ease your child's ear pain, have them hold a warm, moist washcloth against the  ear. Give them an over-the-counter pain medicine like acetaminophen (such as Tylenol), or ibuprofen (such as Advil or Motrin).  Do not give aspirin to anyone younger than 20.  
  • Avoid getting water in the ear until after the problem clears up. Make an earplug out of cotton that is lightly coated with petroleum jelly (such as Vaseline). Don't swim, fly or scuba dive during treatment for swimmer's ear. For the most effective treatment results, water should be kept out of the ear. Have your child use a hair dryer to carefully dry the ear after you shower.

Parents may be able to prevent swimmer's ear in their child by doing the following.

  • Do not scratch or clean the inside of the ear with cotton swabs, bobby pins, or other objects.
  • Avoid prolonged use of earplugs. Earplugs, like cotton swabs, can cause irritation and itching and can plug the ear with wax.
  • Keep soap, bubble bath, and shampoo out of the ear canal. These products can cause itching and irritation.
  • Keep the ears dry.
    • After your child swims or showers, have them shake their head to remove water from the ear canal.
    • Gently dry their ears with the corner of a tissue or towel, or use a hair dryer on its lowest setting.
    • Put a few drops of rubbing alcohol or rubbing alcohol mixed with an equal amount of white vinegar in your child's ears after they  swim or shower. This mixture may help prevent the growth of bacteria and fungi that can cause swimmer's ear. Over-the-counter drops, such as Star-Otic or Swim-Ear, can also be used to help prevent swimmer's ear. As you put these drops in your child's ear, wiggle the outside of their ear to let the liquid enter the ear canal, and then tilt their  head to let it drain out.
  • Do not let your child swim in dirty or polluted water.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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