Otitis externa, commonly known as "swimmer's ear," is inflammation of the external ear canal—the tube that runs from your outer ear to your eardrum. This condition often involves an infection but can also result from irritation or allergic reactions.

How it develops:

The ear canal is normally protected by earwax, which has antibacterial properties and creates a protective barrier. When this natural defense is compromised—through moisture, injury, or removal of too much wax—the skin in the canal becomes vulnerable to infection and inflammation.

While otitis externa can make your ear feel sore, itchy, or blocked, with the right care it's usually straightforward to treat. Most cases respond well to prescribed ear drops and proper ear care within a few days.

Types of otitis externa:

• Acute otitis externa: Sudden onset, typically lasting less than 6 weeks
• Chronic otitis externa: Persisting for more than 3 months, often recurring
• Malignant (necrotizing) otitis externa: A rare but serious form requiring urgent medical attention, primarily affecting people with weakened immune systems

You might have otitis externa if you experience any of the following symptoms:

• Ear pain or tenderness: Often worse when you touch your ear or move your jaw (chewing, talking)
• Itchiness in the ear canal: A persistent, irritating sensation inside the ear
• Fluid or discharge: Clear, yellow, or pus-like drainage from the ear
• Temporary muffled hearing: Sounds may seem quieter or unclear
• Redness and swelling: Visible inflammation around the ear opening
• Feeling of fullness: A sensation that your ear is blocked or plugged
• Tenderness when touched: Pain when pressing on the tragus (small flap in front of the ear canal)

Early recognition and treatment of these symptoms can prevent the infection from worsening and reduce the duration of discomfort significantly.

Several factors can trigger an outer ear infection. Understanding these causes can help you take preventive measures:

Primary causes:

• Bacterial infections: The most common culprit, particularly Pseudomonas aeruginosa and Staphylococcus aureus
• Fungal infections: Less common but can occur, especially in humid climates or after prolonged antibiotic use
• Viral infections: Occasionally cause otitis externa, though less frequently than bacteria

Contributing factors that increase risk:

• Excess moisture: Swimming (especially in unclean water), heavy sweating, or humid environments create ideal conditions for bacterial growth. This is why the condition is often called "swimmer's ear"
• Ear canal damage: Scratching your ear, aggressive cleaning with cotton buds, or inserting objects can break the skin's protective barrier and introduce bacteria
• Skin conditions: Eczema, psoriasis, or dermatitis can compromise the ear canal's natural defenses and cause chronic inflammation
• Allergies or irritants: Reactions to hair products (shampoo, hair spray, dye), antibiotic ear drops, or jewelry can trigger inflammation
• Narrow ear canals: Some people naturally have narrower canals that trap moisture and debris more easily
• Excessive ear cleaning: Removing too much earwax eliminates the canal's natural protective coating
• Hearing aid use: Can trap moisture and irritate the ear canal if not properly cleaned

Seeking medical care:

If you suspect an outer ear infection, visit your GP as soon as possible. Left untreated, otitis externa can cause discomfort for weeks and may lead to complications. Early treatment typically results in faster recovery.

What your GP may prescribe:

• Medicated ear drops: The primary treatment, usually containing antibiotics to fight infection and corticosteroids to reduce inflammation. Your GP will select drops appropriate for your specific infection
• Ear cleaning: Your GP may need to gently clean your ear canal to remove debris and allow the drops to work effectively
• Pain relief: Over-the-counter painkillers like paracetamol or ibuprofen for mild cases. For more severe pain, stronger prescription painkillers may be needed
• Oral antibiotics: Prescribed for severe infections or if the infection has spread beyond the ear canal
• Ear wick: For severe swelling, a small sponge may be inserted to help deliver medication into a swollen ear canal

Home care during treatment:

• Keep ears dry: Avoid getting water in the affected ear while it heals. Use cotton wool coated with petroleum jelly when showering
• Use earplugs: Consider swim-specific earplugs for bathing to protect your ears from water
• Avoid swimming: Stay out of pools, lakes, and the sea until your infection has completely cleared
• Gentle cleaning: If there's discharge, carefully clean the outer ear with cotton wool or a soft cloth. Never insert anything into the ear canal
• Complete the treatment: Use prescribed drops for the full course, even if symptoms improve earlier
• Avoid irritants: Keep hair products, soaps, and other potential irritants away from the ear

For care home residents:

Residents with mobility challenges or cognitive impairment may have difficulty reporting ear symptoms or managing treatment. Care staff should watch for signs like increased agitation, touching the ears frequently, or appearing not to hear. Clear Ear Cheer provides mobile ear health assessments to help identify and manage ear conditions in care settings.

Prevention is always better than cure. Here are practical steps to keep your ears healthy and reduce the risk of developing otitis externa:

For frequent swimmers:

• Consider using preventive ear drops before and after swimming (consult your GP or pharmacist)
• Invest in well-fitted, waterproof earplugs or custom swim molds
• Shake your head gently from side to side after swimming to help water drain
• Consider a swimming cap that covers your ears for additional protection

For people prone to recurrent infections:

Talk to your GP about:

• Preventive strategies specific to your situation
• Using acidifying ear drops after water exposure
• Identifying and avoiding specific triggers
• Underlying conditions that may make you more susceptible

If you're prone to recurrent infections despite preventive measures, regular ear health checks can help identify problems early before they become more serious.

At Clear Ear Cheer, we're passionate about helping everyone maintain happy, healthy ears. We believe that understanding your ear health is the first step toward prevention and effective care.

Our commitment includes:

• Providing clear, accessible information about common ear conditions
• Raising awareness about proper ear care and prevention strategies
• Ensuring everyone has access to reliable, evidence-based advice
• Offering professional mobile ear care services across Essex and Suffolk
• Supporting care homes and medical practices with specialist ear health services
• Advocating for better access to ear health services throughout the UK

While otitis externa requires medical diagnosis and treatment from your GP, we're here to support you with education, prevention advice, and ongoing ear health maintenance once your infection has cleared.

We work alongside healthcare professionals to ensure residents in care homes, individuals with mobility challenges, and anyone in our community receives the ear care they need.