FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

VINEGAR SOLUTION CAN HELP PREVENT SWIMMER'S EAR

Question: My children swim every day during the summer. Before the season is over, each of them will have swimmer's ear at least once. Why do they always get this?

Answer: Let me explain a bit about the parts of the ear in hopes that it will make it easier to understand my answer. The ear is a complex structure. The outer part of the ear, the part you can wiggle if you're talented, is made of cartilage covered by skin. It is shaped somewhat like a funnel, and it works like one in that it catches the sound waves and directs them into the narrow passageway of the ear canal. The surface of this canal is covered by a thin layer of skin attached over bone. The inside end of the canal is closed off by the eardrum, the membrane that vibrates when sound waves strike it. The middle ear which begins with the eardrum contains a series of bones that act as simple levers to amplify and transmit the sound into the inner ear, where the vibrations are converted into nerve signals.

Swimmer's ear is a minor skin infection in the outer ear. A small scratch within the ear canal provides an opportunity for the infection to develop, and the outer ear becomes a little red and swollen. A similar injury to the skin of your arm doesn't cause much pain because the ample soft tissue under the skin allows for swelling without creating pressure. An infection in the ear canal, however, causes considerable pain because the skin there is attached to the cartilage and bone without the padding of subcutaneous tissue. Your children identify this condition by saying, "Ouch! Mom, I've got swimmer's ear again. Take me to the doctor." Fortunately, antibiotic drops in the ear canal and medication for pain typically give prompt relief.

Your children have this infection repeatedly during swimming season because they get water in their ear canals. The water tends to disrupt the normal condition of the ear canal skin and makes it easier for invading bacteria to start an infection. This is particularly true when the water is untreated (like water from lakes, rivers or streams).

Question: What can they do to keep from having swimmer's ear?

Answer: Since they shouldn't quit swimming, another approach is needed. Avoid sticking things, including fingers and cotton swabs, down the ear canal. I often tell patients, "Don't put anything in your ear smaller than a football!" One thing that's smaller than a football is your finger. There's a natural tendency after swimming to put a finger in your ear and wiggle it to remove the water. This is likely to make small scratches in the skin of the ear canal, which then become an inviting site for invading bacteria to make a home and multiply; that is, produce an infection.

Placing a few drops of Burrow's solution in the ear canal after swimming often prevents episodes of infection. Burrow's solution is available without a prescription. A common brand that is formulated specifically for swimmer's ear prevention is Star-Otic Ear Solution. A homemade solution of white vinegar created by diluting a tablespoon full in 8 ounces of water also works effectively. This makes the ear canal more acid, a condition which slows the growth of most bacteria. Some individuals may need to use medicine stronger than vinegar or Burrow's solution to prevent swimmer's ear. If your children continue to have swimmer's ear, talk to their family doctor about other medications to help prevent the problem.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.