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Otitis Externa

What is otitis externa?

Otitis externa, or swimmer's ear, is an infection in the outer ear canal. This canal goes from the outside of the ear to the eardrum.


What causes otitis externa?

Otitis externa is most commonly caused by bacteria. It can also be caused by damage to the skin lining of your outer ear canal. For example, you can scratch or damage the skin lining when you put cotton swabs or other objects in your ears.

What increases my risk for otitis externa?

  • Swimming

  • Hot, humid weather

  • Hearing aid use

  • A lot of ear wax

  • Allergic skin disorders, such as eczema

  • Medical conditions that weaken your immune system, such as diabetes

What are the signs and symptoms of otitis externa?

  • You have ear pain.

  • Your outer ear canal is red and swollen.

  • You have clear fluid or pus leaking out of your ear.

  • Your outer ear canal is itchy and you see a rash.

  • You have trouble hearing because your ear is plugged.

  • You feel a bump in your ear canal, called a polyp.

  • Flakes of skin fall from your ear.

How is otitis externa diagnosed?

Your caregiver will ask about your signs and symptoms. He will look inside your ears. He may blow a puff of air inside your ears. These tests tell caregivers if your eardrums look healthy. You may also need a hearing test.

How is otitis externa treated?

  • Ibuprofen or acetaminophen: These help decrease your pain and fever. They are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and how often to take it. These medicines can cause stomach bleeding if not taken correctly. Ibuprofen can cause kidney damage. Do not take ibuprofen if you have kidney disease, an ulcer, or allergies to aspirin. Acetaminophen can cause liver damage. Do not drink alcohol if you take acetaminophen.

  • Ear drops: These are a combination of a steroid medicine and an antibiotic. The steroid helps decrease redness, swelling, and pain. The antibiotic helps kill the germs that caused your ear infection.

  • Ear wicking: Your caregiver will remove fluid or wax from your outer ear canal. Caregivers may insert a small tube, called a wick, into your ear to help drain fluid. A wick also may be used to put medicine into your ear canal if the canal is blocked.

How can I prevent otitis externa?

  • Do not put cotton swabs or foreign objects in your ears.

  • Wrap a clean moist washcloth around your finger, and use it to clean your outer ear and remove extra ear wax.

  • Use ear plugs when you swim. Dry your outer ears completely after you swim or bathe.

How do I use eardrops?

  • Lie down on your side with your infected ear facing up.

  • Carefully drip the correct number of eardrops into your ear. Have another person help you if possible.

  • Gently move the outside part of your ear back and forth to help the medicine reach your ear canal.

  • Stay lying down in the same position (with your ear facing up) for 3 to 5 minutes.

What are the risks of otitis externa?

  • You may have temporary hearing loss until the infection goes away. Your outer ear canal may feel blocked. Even with treatment, you may get otitis externa more than once. Otitis externa may become a long-term problem.

  • Without treatment, the infection can spread and cause cellulitis. This is an infection of your skin and tissue under the skin. The infection can spread to other parts of your head, including your brain. You may get a disease called necrotizing otitis externa, which can damage the skin and bones of lower part of your skull. This disease also may cause nerve damage in your face.

When should I contact my caregiver?

Contact your caregiver if:

  • Your signs and symptoms do not get better after 2 days of treatment.

  • Your signs and symptoms go away for a time, but then come back.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a fever.

  • You have severe ear pain.

  • You suddenly are unable to hear at all.

  • You have new swelling in your face, behind your ears, or in your neck.

  • You suddenly cannot move part of your face.

  • Your face suddenly feels numb.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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