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

[VINERGAR AND WATER HOME REMEDY CAN 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 little bit about the parts of the ear; then I'll answer your question. The ear is a complex structure. The outer part of the ear, the part you can wiggle if you are talented, is made of cartilage covered by skin. This outer ear is shaped somewhat like a funnel, which helps it catch sound waves and direct them into the narrow passageway called the ear canal. A thin layer of skin attached over bone covers the surface of this canal. The eardrum closes off the end of the canal. This membrane vibrates when sound waves strike it.

The middle ear - which begins on the inner side of the eardrum - contains a series of bones that act as simple levers to amplify and transmit the sound impulses. It is another common site of ear infection - but not swimmer's ear.

Now to your question - swimmer's ear is no more than a minor skin infection inside the ear canal. This is different from a middle ear infection that is produced by an infection behind the eardrum in the enclosed middle ear space.

A minor scratch on your arm can get a little red and swollen without causing much pain because there is enough soft tissue under the skin to allow the skin to swell without creating pressure. When a similar infection happens in the ear canal, it causes considerable pain because the skin there is attached to the cartilage and bone without the padding of subcutaneous tissue. In the real world, this translates to, "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 down in their ear canals. The water tends to disrupt the normal condition of the skin there and make 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. 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. The scratches make it easier for bacteria to invade then form an infection. Therefore, avoid sticking things, including fingers and cotton swabs, down the ear canal.

Placing a few drops of Burrow's solution, which is available without a prescription, in the ear canal after swimming often prevents episodes of infection. A common brand that is formulated specifically for swimmer's ear prevention is Star-Otic Ear Solution. Diluting a tablespoon full of white vinegar in 8 ounces of water can create a homemade solution that is nearly as effective. A few drops of this after swimming makes the ear canal more acid, a condition that slows the growth of most bacteria. Talk to your childrens' doctor if they continue to have swimmers ear after taking these simple precautions because stronger prescription medicines are also available.

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.