By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

PRACTICING GOOD EAR HYGIENE CAN HELP PREVENT SWIMMER’S EAR

Question: Summer is again here, and I dread it. Every summer one of my children gets swimmer’s ear. This invariably comes on during the night or on a holiday and we end up with a long ER visit and some ear drops that take care of things in a few days. Is there anything I can do to prevent this? Can you tell me more about swimmer’s ear?

Answer: Swimmer’s ear is an infection of the external ear canal. It is a very common summertime ailment -- as you well know. This time of year, you’re more likely to swim in water that is untreated -- such as lakes, rivers or streams. Such water can harbor the bacteria Pseudomonas aeruginosa, the most common cause of swimmer’s ear. Less common causes are fungi or viruses. The normally moist, warm environment of the ear canal is a great place for these germs from “dirty” water to grow.

You can also acquire this infection -- at any time of the year -- when you swim in a chlorinated pool or get unclean water in your ear while bathing. It is true that chemicals used in a treated pool kill germs, but they can also dry out the skin in the ear canal. This can cause breaks in the skin that can provide a breeding ground for any bacteria and fungi that may be introduced into the ear canal.

Water is not always the culprit. You can make small cracks in the delicate skin of the ear canal -- and introduce germs into them -- by other actions. For instance, you might scratch the canal opening with a sharp fingernail, or try to clean wax from the ear with an unclean cotton swab, a bobbie pin or another small object.

Generally swimmer’s ear occurs in just one ear, but it can be in both ears. Usually the first thing you notice is severe, acute pain in the affected ear. By this time, however, the infection has been smoldering for several days. Besides pain, there may be itching and drainage from the ear canal.

Once the infection starts, you usually need prescription medication to make the problem go away. If it is not late at night or a holiday, your family doctor can easily take care of this problem.

Here are a few good “ear hygiene” tips that might help you prevent an infection this summer. First, instruct your children not to stick objects into their ear canals. If they have chronically itchy ear canals, they should be taken to the doctor to get a diagnosis and treatment. This could significantly reduce the itchiness and, subsequently, the frequency with which they scratch their ears.

Also, after swimming or bathing, they can dry their ears with a hair dryer set on the lowest setting. Just a few seconds of the warm dry air can significantly reduce the likelihood of getting an infection. Be careful. Overdrying could cause cracks in the skin and help promote an infection.

Over-the-counter ear drops can be used after swimming or bathing to help prevent an infection. These are usually vinegar or alcohol-based. They are not to be used to treat an existing infection, however. Some people use ear plugs or a bathing cap to keep water out of their ears while swimming.

I hope these tips will help you and your family have a better summer!

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.