Summer can be a great time for children to enjoy themselves. But it can also be a trying time for parents. A few illnesses become more prevalent during the warm months. Otitis externa, better know as swimmer’s ear, often tops the list.

A painful condition of the outer or visible part of the ear and ear canal, swimmer’s ear is one of the most common causes of an “earache.” Males and females are affected equally, with younger children and teenagers being afflicted most commonly. Two basic factors that are usually necessary for an external otitis to develop are the presence of bacteria or other microorganisms that can affect the skin and an impairment or break in the integrity of the skin of the ear canal that allows the infection to take hold.

The exposure of the ear to water gives the condition its common name. However, a person does not need to be swimming in a pool, beach or lake to get swimmer’s ear. Water from a bath or shower can get the ball rolling. Either way, people with diabetes or a weakened immune system can develop a more serious form of swimmer’s ear and should seek immediate medical attention. Their infections may even require hospitalizations if left untreated.

Causes of Swimmer’s Ear

The external canal, or opening into the ear, has several unique features that may lead to recurrent otitis externa. The outer portion of this canal is flexible and made up of cartilage just like the outside part of the ear. However, the next segment is comprised of bone, and the skin attached to the bone is immobile and almost paper thin. It is this reason that the delicate skin lining of the canal can be easily abraded or torn. In a large number of cases, the injury is caused by the person themselves or a parent by trying to ensure the ear is clean. Placing a finger or even a cotton swab in the ear can cause injury. Remember, this area of skin is extremely sensitive and easily damaged by slight pressure.

Symptoms of Swimmer’s Ear

Pain is the most common symptom of swimmer’s ear. It can progress over a few days, and the pain may increase significantly when the ear is touched or pulled. The outside of the ear may be red and swollen. If the condition continues, the external opening may swell until it is closed. A person may then have trouble hearing.

Drainage can often be seen from the ear. This can be clear or discolored and might look bloody. An odor may also start to come from the ear. And the outside of the ear may get crusty. Children with swimmer’s ear might complain of ringing sounds (tinnitus) or dizziness.

Prevention and Treatment

As with many illnesses, prevention is the best medicine. Using earplugs or bathing caps designed for swimming helps keep out water. If your child had a myringotomy or ventilation tubes placed in the ear drums for recurrent otitis media or middle ear infections, this measure of precaution is crucial. Your otolaryngologist or ear doctor should be consulted before your child goes swimming.

Certain homeopathic remedies prevent swimmer’s ear. This includes making a 50:50 mixture of white vinegar and rubbing alcohol and placing three or four drops in each ear canal after the child goes swimming. This helps dry out any water left in the ear and keeps a slightly acidic environment in the ear that prevents the growth of any bacteria or fungus. Remember the ear canal is normally slightly acidic as part of its own protective mechanism.

If you or your child does not like the vinegar smell or mess of drops, special earplugs such as by ClearEars can be placed in the ear after swimming to absorb any leftover water or moisture and keep the canal dry. These are different than earplugs used to prevent the entry of water. This is a simple and clean way to avert swimmer’s ear.

As far as treatment, teach your child to avoid placing objects in the ear canal that can irritate or scratch the skin. This includes earplugs from music players if there seems to be an initial problem. Avoid any further trauma to the ear and apply heat to help control pain. If the child is not allergic, then over-the-counter analgesics such as ibuprofen (Advil) or acetaminophen (Tylenol) can be used.

The first line of medical treatment for swimmer’s ear is antibiotic drops or a form of acidic drops. These are stronger than the home remedy, which will not work once the infection takes hold. Oral antibiotics are usually not used for swimmer’s ear. There are many different types of medicated drops. The one selected will be up to your child’s doctor. Some of the drops may contain anti-inflammatory agents, including a steroid that can help in shortening the recovery time. Confirm that your child refrains from any more swimming and keep the ear dry until the infection has completely been resolved.

Special Cases

Any child with a weakened immune system might have a more severe and prolonged course of treatment. Parents of diabetic children should especially be on the lookout for swimmer’s ear. Although less common, this type of infection can also be caused by a fungus. Children who have had repeated infections and multiple courses of antibiotic drops can then develop a mycotic or fungal infection. The repeated use of antibiotics can eliminate the normal bacteria found in the ear and allow the fungus to grow. Antibiotic drops have no effect on fungus. And if the drops contain a steroid to help bring down the inflammation, they can make the infection worse. If the infection does not seem to go away after a longer period of time than usual, bring your child to a specialist. If the ear canal has already swollen shut, the specialist may place a wick in the ear to aid in opening the canal and allow the medicine to go where it is needed. This may only be for a few days.

Summer should be a fun time for everyone. Being mindful of the causes and symptoms of swimmer’s ear can help your family enjoy a season of smiles in and out of the water.

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