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Swimmers' ear

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Swimmers' ear is a form of otitis externa, an inflammation or infection of the canal between the eardrum and the external opening of the ear.

Symptoms

The symptoms of swimmer’s ear tend to develop quickly, usually over a day or two, and may include:

  • Earache, sometimes with itching or a sense of fullness inside the ear and tenderness of the tissues in the region.
  • Hearing may be muffled or diminished, or tinnitus (ringing in the ears) may occur
  • Effusions (discharges) sometimes drain from the affected ear, and may start out clear, becoming coloured and developing a foul odour as the infection progresses
  • Fever is present occasionally
  • The infection can sometimes become chronic, persisting for six weeks or longer
  • In severe cases, the infection may spread to the bones, nerves and other tissues in the adjacent area.

Causes

As it’s name suggests, swimmer’s ear often develops after swimming in contaminated water, but may also occur any time that water becomes trapped in the ear canal, creating an environment that’s hospitable for bacteria to multiply in.

This is more likely to occur if:

  • The ear canal is obstructed for some reason (e.g. an excess of earwax)
  • Too little earwax is present, which may be a consequence of spending a large amount of time in water
  • The tissues of the ear are damaged (e.g. from wearing a hearing aid or ear plugs, or from using cotton buds to clear the ear of wax)
  • The acidity of the ear canal is altered

The functions of earwax include inhibiting the proliferation of infectious organisms and maintaining the health of the surfaces of the inner ear, so its presence in appropriate quantities is a vital part of the body’s defences against ear infection.

People who have allergies (for example, asthma, dermatitis or hay fever) are more likely to develop swimmer’s ear than other people, as are those with diabetes and some other chronic illnesses.

The bacteria most commonly responsible for the infection are Staphylococcus aureus and Pseudomonas aeruginosa, but fungal organisms of the Aspergillus and Candida species may also be involved.

Diet and lifestyle

  • Don’t allow the ear to get wet when you have swimmer’s ear. You may need to wear a shower cap when bathing and avoid swimming until the infection is resolved. If you do go swimming, take care to keep your head above water.
  • Don't swim in polluted water.
  • Clear the water from your ears after swimming or bathing.
  • Don’t use cotton buds or other items to clear wax from your ears.
  • Don’t use soap to wash out the ears, as this can alter the pH of the canal, predisposing you to infection.
  • Prevent swimmers' ear by using eardrops immediately after swimming to dry and disinfect the ear canal.
  • Prevent damage to the ear by avoiding the use of earplugs. Ensure any hearing aid you wear fits well.

Important notes

  • Serious consequences can arise from untreated ear infections, so it’s important that you consult your health care professional if you or your child are displaying symptoms of infection or develop hearing problems.

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