Ouch, My Ear!

Hey guys! I hope you are having a great summer! It’s hot, so your kids are swimming in the pool, the river, the Bay and/or the Gulf. So now it’s Sunday night and your child’s ear is killing them! They haven’t had an ear infection in years! So what’s going on? You guessed it, swimmer’s ear! Today we will talk about swimmer’s ear or otitis externa, what causes it, why it can be very serious, how to treat it and finally how to prevent it for the next few months and for every summer in the future!

Otitis Externa (OE) is an external ear canal infection that occurs when water gets in the ear and causes breakdown of the lining of the canal. Then, bacteria or yeast can penetrate the lining of the canal and cause the infection. The most common bugs we find include Pseudomonas (which is very common in the Bay and rivers), Staphylococcus, and Streptococcus species. When the ear canal is inflamed, the ear produces drainage, which is kind of like “ear snot,” and can cause pain or burning when it’s touched or pulled, or when the child chews food! In addition the swelling can make the outer ear stick out and even cause the lymph nodes around the ear to swell up. Usually the kids do not have fever, and it is not contagious.

So, my kids haven’t swam in weeks, so it can’t be swimmer’s ear, right? Well, actually you can get OE not just from swimming in pools or rivers or the Bay, but also from bathing! If left untreated, OE can cause some serious issues. Not only can it cause severe pain, but the infection can spread to other structures near the ear, especially to the temporal bone behind the ear and possibly cause the need for surgery by an ENT! This summer alone I have seen several really bad cases of OE, including one case where the child required IV antibiotics and IV pain medicines!

OK, so my kid is crying, what do we do? First let your medical provider take a look at the ear. While it most likely is OE, I have pulled all kinds of things from a kid’s ear including beads, Q-tips, roaches (that’s right, roaches!), pencil lead, and erasers. So if it’s OE, the appearance of the canal helps dictate treatment. Usually, it only needs some special ear drops, but sometimes we place an ear wick. This is a small strip of cotton that can absorb a special antibiotic/inflammatory medicine and deliver it into the canal and work to settle down the inflammation. Sometimes, kids also need antibiotics by mouth and special pain medicines to help the child get rest. And, of course, you have to stop swimming until you are done with the medicines, or they won’t work!

Now you guys are over the swimmer’s ear, but are afraid to get back in the water so it doesn’t come back! Well, you live in Baldwin County, so they are bound to get back in at some point! The move is to prevent OE by acidifying the ear canal so the bugs won’t grow! We recommend buying a clear ketchup bottle from your local large grocery store and mixing up equal parts of rubbing alcohol and white vinegar with a tablespoon of olive oil. So now, after swimming and bathing at the end of the night, dry the ear out well with a hair dryer, and then take the ketchup bottle, shake it well, and place 3 drops in each ear. The key with this is to use it as a preventative measure. Sometimes this medicine can help with treatment, but not always, so if you have an episode of swimmer’s ear, we recommend implementing this plan after it’s been treated.

OK, so today we reviewed the words ear snot, Pseudomonas, roaches, and ketchup bottles in reference to your kid’s ears! Who knew? If you have any questions, please talk to your medical provider and review the references at aap.org. Good Luck!

Guest Contributor