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  Otitis Externa

Otitis Externa is severe soreness of the outer ear and the ear canal, which is also known as swimmer’s ear. The skin of the ear canal becomes inflamed resulting in severe pain. The inflammation can progress to infection causing swelling tissue, blockage and drainage.

Otitis Externa Ear infections
Otitis Externa

A serious, but rare for of external otitis is called necrotizing external otitis. In this condition the bone surrounding the ear canal becomes infected. This condition is also known as malignant otitis and is life threatening. Individuals with severe diabetes and a debilitated immune system are typically the only sufferers of this condition.

People who are in the water often can have a higher risk of recurrent otitis externa because the healthy wax and oil production that protects the ear canal is impeded.


Pain is the main symptoms of external otitis. The pain increases when the ear is touched. Ear discharge and an itchy feeling can occur. Discharge can aggregate in the ear canal causing conductive hearing loss that is temporary.

Symptoms of external otitis often make individuals attempt to clean the ear canal which only aggravates the condition.


A physician will use an otoscope to view the inside of the ear. The ear canal will present with red and swollen tissues and possible eczema-like scales. Touching the ear or pushing on the ear increases pain and the response is often used for a clinical diagnosis.

The drainage from the ear may be cultured to determine if a fungus or bacteria is present, but it is not a typical procedure.


The most common way to contract swimmers ear is swimming in polluted or dirty water. Swimmers ear can also occur from water from a shower or bath that gets trapped in the ear canal. Cotton swabs used to clear the ear canal can cause irritation of the ear canal skin. Two factors cause external otitis, bacteria and injured ear canal skin (whether from excessive cleaning or scratching).

Swimmer’s ear affects more that 1% of the population at one time in their lives.


The goal of treatment is to clear the infection and allow the ear canal skin to return to a healthy state. Sometimes external otitis can clear on its own. It is important to let the ear canal heal completely, so that the healthy wax and oils can rebuild and protect it. Patients need to be responsible and protect their ears during the healing process.

Topical solutions and ear drops are the primary treatment for swimmer’s ear. The drops serve two purposes, washing out debris and drainage and killing germs. Depending on the cause, antibiotic drops or anti-fungal drops are used to treat external otitis. Steroids may be used if the swelling and inflammation is severe, but steroids can aggravate the condition if the cause is a fungus.

The irritation and infection can clear in a few days to a week, but the skin of the ear canal needs a few weeks to heal complete. Cerumen is the waxy oil protection produced for the ear canal. Until the cerumen has been produced to protect the ear, patients should avoid even the slightest irritation to the ear canal.

It is possible that both bacteria and fungus are causing the external otitis and a combination of anti-biotic and anti-fungal medication needs to be used. Pain can be treated with over the counter medications.

If external otitis is recurring, the prevention should be used. Preventing acute external otitis include:

 avoiding swimming in dirty water
 increase vitamin C consumption, which will fight pathogens causing the ear infection
 dry the ears thoroughly after any exposure to moisture and use a ear drops such as diluted alcohol and vinegar or Burow’s solution.
 avoid washing hair or swimming if the symptoms begin to appear
 use ear plugs that are soft and fit well, so that the ear canal will not be scratched, when swimming.

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