MedlinePlus Medical Encyclopedia: Swimmer's ear

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Swimmer's ear - chronic

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Ear anatomy

Medical findings based on ear anatomy

Alternative names Return to top

Ear infection - outer ear - chronic; Otitis externa - chronic

Definition Return to top

Swimmer's ear is an inflammation, irritation, or infection of the outer ear and ear canal. Swimmer's ear usually responds to treatment, but a small number of cases become chronic. This means the infection does not go away, or it comes back multiple times.

See also swimmer's ear - acute.

Causes, incidence, and risk factors Return to top

Swimmer's ear (otitis externa) is fairly common. It consists of inflammation, irritation, or infection of the outer ear and ear canal. Swimming in polluted water is one way to contract swimmer's ear. Moisture predisposes the ear to infection from fungus or water-loving bacteria such as pseudomonas. Swimming is not the only cause, however -- the condition can be caused by scratching the ear or an object stuck in it.

Chronic swimmer's ear may result from inadequate treatment, or may suggest the presence of a disease in underlying bone, a complication called malignant otitis externa.

Symptoms Return to top

Ear pain -- may worsen with pulling on the external ear
Itching of the ear or ear canal
Persistent drainage from the ear -- yellow, yellow-green, pus, or foul smelling
Hearing loss

Signs and tests Return to top

When the physician looks in the ear, it appears red and swollen, including the ear canal. The ear canal may appear eczema-like, with scaly shedding of skin. Touching or moving the outer ear increases the pain. It may be difficult for the physician to see the eardrum with an otoscope, or the eardrum may appear red.

The outermost part of the ear, the tragus, may ultimately become infected, and appear red and swollen.

Treatment Return to top

The goal is to cure the infection, usually with ear drops containing antibiotics. Corticosteroids can reduce itching and inflammation. Sometimes other remedies such as acetic acid (vinegar) drops may be used.

If the ear canal is very swollen, a wick may be placed in the ear to allow the drops to travel to the end of the canal. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help relieve pain.

In elderly individuals or diabetics with persistent ear pain or drainage, malignant otitis externa is a possibility. The ears should be evaluated with CT scanning to look for bone erosion. Malignant otitis externa is treated with high-dose intravenous antibiotics effective against Pseudomonas aeruginosa.

Expectations (prognosis) Return to top

Chronic swimmer's ear usually responds to treatment. Treatment may be prolonged or repeated. If untreated, complications may develop.

Complications Return to top

Infection of the surrounding skin
Malignant otitis externa, which can cause bone infection, hoarseness, and difficulty swallowing

Calling your health care provider Return to top

Call for an appointment with your health care provider if you have symptoms of chronic swimmer's ear, or if acute swimmer's ear does not respond to treatment.

Prevention Return to top

Dry the ear thoroughly after swimming. Individuals who swim frequently should consider earplugs. Swimmer's ear from any cause should be treated completely, and treatment should not be stopped sooner than recommended by the doctor.

Update Date: 8/27/2003

Updated by: A.D.A.M. editorial. Previously reviewed by David N. Fisman, M.D., M.P.H., FRCP(C). Hamilton Department of Social and Public Health Services, and McMaster University Division of Infectious Diseases, Hamilton, Ontario, Canada. Review provided by VeriMed Healthcare Network (9/8/2001).

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