FAMILY MEDICINE® COLUMN

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

HOMEMADE VINEGAR AND WATER SOLUTION MAY PREVENT SWIMMER’S EAR

Question: My children swim every day during the summer. Before the season is over, each of them will probably 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. It is shaped somewhat like a funnel and is able to catch sound waves and direct them into the narrow passageway called the ear canal. The surface of this canal is covered by a thin layer of skin attached over bone. The end of the canal is closed off by the eardrum. This membrane vibrates when sound waves strike it.

The areas behind the eardrum are the middle ear and the inner ear. The middle ear -- which begins with the eardrum -- contains a series of bones that act as simple levers to amplify and transmit sound waves from the eardrum to the inner ear. This region contains special nerve endings that are stimulated by the sound waves and send messages to the brain that are interpreted as the sounds we hear.

While infections develop in all parts of the ear, swimmer's ear is no more complicated than a minor infection of the skin in the ear canal. It is different, however, from skin infections in other parts of the body. For instance, 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 swelling 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 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 smaller than a football in your ear!" 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. The scratches make it easier for the invading bacteria to form 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. You can also concoct a homemade solution by diluting a tablespoon full of white vinegar in 8 ounces of water. This makes the ear canal more acid, a condition which slows the growth of most bacteria. Your pharmacist can also recommend other store-bought products.

Some individuals may need something stronger than over-the-counter or homemade medications to prevent swimmer's ear. If your children continue to have swimmer's ear, talk to their doctor about prescription 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.

Past columns are available online at http://www.FamilyMedicineNews.org.