Otitis Externa

More commonly known as “swimmer’s ear,” external otitis is common among school-age children, especially during the summer when swimming and water sports are in full swing. Bacteria invade the skin and soft tissue lining the ear canal, causing inflammation.
In mild cases a little irritation and itching may be noticed. But more commonly the child with external otitis will complain of nonstop pain—which can be severe—in and around the ear. Discomfort may be experienced when the child chews. Even the gentlest tug on the lobe will provoke pain. In some cases swelling in the ear canal can be severe enough to cause a temporary decrease in hearing as the infection progresses.
Water remaining in the ear canal after swimming can serve as a reservoir for bacterial growth as the skin surface is more vulnerable to bacterial invasion. Wax build up contributes to this process by block-the natural drainage of water from the canal. Another major cause is trauma to the canal from overzealous attempts to clean the ear using cotton swabs or other instruments. Occasionally, chronic drainage from a perforated eardrum will result in external otitis.

Otitis Externa Treatment

Even if your child’s history and complaints strongly suggest external otitis, a physician should conduct the diagnosis. The infection is usually treated with eardrops that contain antibiotics to kill bacteria and cortisone to reduce swelling. Doctors may carefully place a soft “wick” in the ear to prolong the contact of the drops within the surface. In severe cases oral antibiotics may be prescribed as well. Swimming should be avoided until the infection has cleared up.
Adequate pain control is important. Acetaminophen and ibuprofen and a warm compress placed over the ear provide temporary relief, but your child may also require stronger prescription pain medication.
If excessive wax build up is a recurrent problem (this often runs in families and is not a reflection of inadequate hygiene), your child’s physician may need to remove this material periodically. The doctor might also suggest wax-clearing measures—other than the use of cotton swabs—to try at home. In some instances, the use of soft molded earplugs when swimming is beneficial. Another approach is to instill a bacteria eating preparation into the ear canal after swimming.