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Swimmer’s Ear Treatment

What is Swimmer’s Ear

Swimmer’s ear is infection or inflammation of the ear canal. Your child does not have to be a swimmer to get swimmer’s ear. It is most common in active children who spend a lot of time in the water or in humidity. For this reason it is most common in summer. Most cases of swimmer’s ear get better with simple treatment. Sometimes, though, children develop chronic infections that require special treatment. The most common causes of swimmer’s ear are bacteria. Less common causes are viruses and fungi. Sometimes children with eczema or blocked wax glands in the ear canal can develop a draining ear with or without infection. Very rarely, children develop “malignant” otitis externa, which is not a cancer despite the name. It usually has bacterial causes, and may require long-term antibiotic treatment or even surgery.

What is the biggest concern?

Pain, itching, and ear drainage are usually the child’s biggest concerns. Children with swimmer’s ear always have pain with movement of the ear. The doctor will want to know the cause and to be sure there is not a middle ear infection (otitis media) as well. Swimmer’s ear does not pose a threat to hearing.

Swimmer’s Ear treatment

Most of the time we can treat swimmer’s ear just by gently cleaning the ear canal and applying antibiotic or antifungal drops. Sometimes we use drops that contain a combination of antibiotics, antifungals, and a small amount of steroid to reduce inflammation. Making the ear canal slightly acidic can also help, but this is often very painful to the child. Very often doctors start treatment for swimmer’s ear with these simple medicines, and only look for more unusual causes if the child does not improve rapidly. Please do not put any medication into your child’s ear until the doctor has had a chance to examine it. Sometimes pus draining from a broken eardrum can make you think a child has swimmer’s ear. Some medications can cause damage to the middle ear if they go through a broken eardrum.

Herpes simplex viruses can cause very painful infections. If your child has this kind of infection, the doctor will give you ear drops and sometimes oral anti-viral medication. It is important to use all of the medicine.

In addition to any medications your doctor has prescribed, you may want to give your child acetaminophen (Tylenol® and others) or ibuprofen (Advil® or Motrin® and others) as directed for the next 24 hours to help relieve pain. This is fine, but please check with your doctor first, to make sure you do not accidentally double up on an ingredient such as acetaminophen.

When should I be worried?

Most children with routine swimmer’s ear get better in 5-7 days. The following are signs that your child might have an unusual form of the condition, or might have something else going on:

  • Pain and drainage that continue for more than 5-7 days after starting treatment
  • Greenish pus coming from the ear, or a strong musty smell
  • Bleeding from the ear for more than 24 hours
  • Fever above 101 ° F or 38.3 ° C
  • Pain that gets worse instead of better after the first 24 hours of treatment
  • Redness, swelling, or pain spreading across the skin around or behind the ear

If any of these things occur, or if the condition seems to be getting worse instead of better over time, please call your doctor.

Other points of concern

Children with swimmer’s ear usually are anxious to know when they can return to their normal activities, including, of course, swimming! Treatment of the infection usually takes about a week, so tell your child that s/he can return to the pool after about 10 days. Meanwhile, avoid getting water into the ear from bath or shower, and take care to clean the ear gently several times a day to keep it dry. Remember that returning to the water too soon may make the infection last longer. After the infection gets better, teach your child how to dry his or her ears gently each time s/he leaves the water. Some doctors recommend putting a few drops of rubbing alcohol into each ear after swimming. This helps to dry the ear canal quickly, and it does not sting when the ear is not inflamed. Rubbing alcohol is poisonous – please keep it out of the reach of young children. Ear plugs made from a wad of cotton covered with Vaseline® are a simple, inexpensive, and effective way of keeping water out of the ear. You may want to consider using these if your child has frequent episodes of swimmer’s ear. Commercial ear plugs are less effective.

Other Conditions that Might Be Present with Swimmer’s Ear

Children with pus draining from the ear and pain with movement of the ear may occasionally have a condition other than swimmer’s ear. One of the most common causes is injury to the ear canal. This often happens when the child (or someone else) puts an object into the ear. Children often poke around in their ears with pens, pencils, and fingernails, all of which can damage the delicate skin in the ear canal. Younger children often put small objects like beads, toy parts, or even food items in their ears. These things can cause infections or damage to the ear canal. A middle ear infection with pus behind the eardrum can cause the eardrum to burst. The pus draining from the ear can appear similar to swimmer’s ear. If the pus drains for long enough, it will irritate the ear canal and a real case of swimmer’s ear will develop. Because of the possibility that there is a broken eardrum, please do not put any medication into a draining ear until your doctor has had a chance to examine it.