Swimmers Ear

Otitis Externa, also known as swimmer's ear or tropical ear, is an inflammation of the external ear canal.

CAUSE
The inflammation may be caused by infection, allergy, or other causes. Otitis Externa can be caused by water getting inside the ear canal, and it is often more common in humid conditions. However, in many cases, the cause remains unknown.

Some of the known causes and risk factors for Otitis Externa include:
• Water - contaminated water can deliver bacteria to the ear canal. A wet ear canal is also prone to dermatitis. Tiny cracks or splits in the skin can allow bacteria to enter.
• Mechanical damage - attempts to clean the ears using fingernails, cotton buds or other objects may cut the delicate tissues of the ear canal and lead to infection.
• Chemical irritation - hairsprays, shampoos and hair dyes may get into the ear canal and irritate the tissues.
• Middle ear infection (otitis media) - an infection within the middle ear can trigger an infection or inflammation in the external ear canal.
• Diabetes - this condition can create an alkaline environment in the ear canal, which increases the risk of infection.
• Folliculitis - an infected hair follicle within the ear canal can trigger a generalised infection.
• Narrow ear canals - some people have narrow ear canals and this means that water cannot drain as effectively.

SIGNS AND SYMPTOMS
Some of the symptoms of Otitis Externa include:
• Pain
• The pain may be exacerbated by moving the head or pulling at the ear
• Itchiness
• Foul-smelling yellow or green pus in the ear canal
• Reduced hearing
• Noises inside the ear, such as buzzing or humming.

TREATMENT OPTIONS
As with all medical conditions it is advisable to consult your Doctor for an accurate diagnosis and treatment. Antibiotic eardrops or spray may be prescribed to clear any infection and a steroid to reduce the inflammation and itch. Oral antibiotics may be prescribed if the infection is severe. Paracetamol or ibuprofen will help to ease any pain. Holding a hot flannel against the ear may also ease pain.

PREVENTION
If you are prone to Otitis Externa, it is important to keep your ears dry and touch them as little as possible. This means:
• Try not to let soap or shampoo get into your ear canal. You can do this when you have a shower by placing a piece of cotton wool coated in soft white paraffin into the outer ear.
• Avoid using corners of towels or cotton buds to dry any water that does get in the ear canal. This will push things further in. Let the ear dry naturally.
• Try not to scratch or poke the ear canal with fingers, cotton wool buds, towels, etc.
• Do not use cotton buds to clean the ear canal. These can scratch and irritate the outer ear and push wax or dirt further into the ear.
• Keep your ears dry when swimming. You can do this by wearing a tightly fitting cap that covers the ears. Some swimmers use silicone rubber earplugs, which are only suitable if they do not irritate the skin in your ear canal.

VITAMINS/MINERALS/HERBS
Nutritional supplements may be of use if dietary intake is inadequate.
• Vitamins A, C, E and the mineral, zinc, are antioxidant nutrients. These help to keep the body's immune system healthy and able to combat infection. See the Antioxidants topic.
• Tea tree essential oil is made from the herb Melaleuca alternifolia. This oil has antimicrobial properties, which make it effective against many common bacteria and fungi. It may also help to relieve itching. A few drops may be added to 10mls of clean water and applied to the ear with a sterile cotton bud to help prevent and treat Otitis Externa. See the tea tree oil topic.
• Propolis is a natural bee product, which has anti-bacterial properties. A few drops of propolis liquid may be added to 10mls of clean water and applied to the ear with a sterile cotton bud to help prevent and treat Otitis Externa. It may also be taken internally to boost the immune system.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints. It is believed that a balanced diet helps the body to recover from infections.
2.If you have any queries about prescribed medication be sure to ask your Pharmacist.
3.If a painkiller is required ask your Pharmacist for the most suitable brand and how it should be taken. Products containing paracetamol and ibuprofen may be used.
4.In any treatment it is important to keep the infected ears as dry as possible and no swimming should be undertaken until the infection has cleared up. Before using ear drops it is important to ensure that the ear is thoroughly cleaned. If the ear is not cleaned properly between applications of eardrops a build up of debris may cause the drops to run out of the ear. Tilting the head to the side whilst instilling the drops will help to keep the drops in the ear canal.
5.Try to avoid scratching or rubbing the ear as this may aggravate the condition and/or expose the ear canal to further infection by possibly moving the debris around or introducing further bacteria into the canal.
6.If you are prone to swimmer's ear, ask your Pharmacist about suitable earplugs that can be inserted before swimming and showering to keep the ear canal clean and dry to prevent further infections.
7. To help keep the ear clean and dry your Pharmacist may recommend special eardrops made up of a solution of acetic acid/isopropyl alcohol. These drops promote an acid pH in the ear canal and at the same time help kill unwanted bacteria. Sometimes it is a good idea to use the drops both before and after swimming. Never use these drops if the ear is inflamed.
8. If an infection is present consider using a hot pack over the ear to gain relief. Use a higher pillow to help raise the head.
9. Never push cotton buds into the ears to clean them as it may disrupt the natural cleaning mechanisms and push debris further into the ear.