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Otitis Externa

Otitis Externa is a condition that causes inflammation of the external ear canal, the tube between the outer ear and eardrum. It is often referred to as 'swimmers ear', because a common cause is water remaining in the ear canal after swimming. With treatment, symptoms should clear up within a few days, but some severe cases can persist for several months or longer, despite normally only affecting one ear at any given time. 

Symptoms

Symptoms of otitis externa can include a range of the following:

  • Ear pain, varying in severity according to the intensity of the infection
  • An itchy feeling in the ear canal
  • Temporary hearing loss, or difficulty deciphering quiet sounds
  • Some discharge from the ear, normally of a clear, white or yellowy colour
  • Redness and swelling of your outer ear and ear canal
  • Tenderness when moving your ear or jaw
  • Swollen and/or sore throat glands

Causes and triggers

Otitis externa can be attributed to a wide range of causes, as well as some triggers that might make you more susceptible to the condition.

Possible triggers can include:

  • Overexposure to moisture - swimming (especially in dirty water), sweating or humid environments can all introduce bacteria-laden liquid to the delicate ear canal, or wash away protective layers of earwax.
  • Ear damage - most often caused by the insertion of cotton buds, or incorrect insertion of ear plugs or earphones.
  • Chemicals - such as hair spray, hair dye or some earwax softeners.
  • Underlying skin conditions - such as psoriasis, eczema and acne.
  • Weak immune system or allergic conditions - such as asthma, diabetes or as a result of using certain cancer treatments such as chemotherapy.

Common causes can include:

  • A bacterial infection, usually by strains of pseudomonas aeruginosa or staphylococcus aureus.
  • Allergic reaction to ear medication, ear plugs, certain shampoos or cosmetics.
  • A fungal infection, more likely for people who use antibacterial or steroid ear drops for an extended period.
  • Discharge from a middle ear infection (otitis media).
  • Seborrhoeic dermatitis - a common skin condition where naturally greasy areas of the skin become inflamed.

Otitis externa can also occur when a hair follicle in the ear becomes infected by bacteria, developing into a boil. Even if you can reach this boil with your fingers, it is very important not to squeeze or pop it without the advice of a medical professional, as it may spread the infection elsewhere.

Treatments

Otitis externa can usually be remedied with a simple course of eardrops, as prescribed by your GP. If symptoms linger or your case has been particularly severe, you may be referred to a specialist who may undertake, micro-suction or dry swabbing to remove earwax and other debris to make your drops more effective. Severe cases might require an earwick, a plug made from soft cotton gauze that helps insert medication into your ear.

While you take your medication, it is important to take certain steps at home to help aid recovery. Avoid getting your ear wet by wearing a shower cap when you bathe, and gently remove any discharge by gently swabbing around your ear rather than in it. Removing hearing aids, ear plugs and earrings will also help prevent the spread of bacteria.

If you are exhibiting symptoms of otitis externa, it is important to make an appointment with your doctor. To learn more about other ear infections, visit our otitis media, labyrinthitis or ear infection overview pages.