Otitis externa 

Introduction 

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Earache

What you can do, when to call your GP and the most likely causes

Otitis externa is a condition that causes inflammation (redness and swelling) of the external ear canal, which is the tube between the outer ear and eardrum.

Otitis externa is often referred to as "swimmer's ear" because repeated exposure to water can make the ear canal more vulnerable to inflammation.

Symptoms of otitis externa include:

  • ear pain, which can be severe
  • itchiness in the ear canal
  • a discharge of liquid or pus from the ear
  • some degree of temporary hearing loss

Usually only one ear is affected.

With treatment, these symptoms should clear up within a few days. However, some cases can persist for several months or longer.

Read more about the symptoms of otitis externa.

When to see your GP

You should see your GP if you think you may have otitis externa.

Your GP will ask you about your symptoms and whether you regularly use any items that are inserted into your ears, such as hearing aids or ear plugs. They may also examine inside your ear using an instrument called an otoscope.

If you have recurring episodes of otitis externa that haven't responded to treatment, your GP may take a swab of the inside of your ear. This will be tested to help determine what type of infection you have, if any, so that appropriate medication can be prescribed.

What causes otitis externa?

Most cases of otitis externa are caused by a bacterial infection, although the condition can also be caused by irritation, fungal infections and allergies.

There are a number of things that can make you more likely to develop otitis externa, including damaging the skin inside your ear and regularly getting water in your ear.

Getting water in your ear is particularly significant because this can cause you to scratch inside your ear, and the moisture also provides an ideal environment for bacteria to grow.

Read more about the causes of otitis externa.

Who is affected?

Otitis externa is relatively common. It is estimated that around 1 in 10 people will be affected by it at some point in their lives.

The condition is slightly more common in women than men and is most often diagnosed in adults aged 45 to 75.

People with certain long-term (chronic) conditions, such as eczema, asthma or allergic rhinitis, are at greater risk of developing the condition. 

How otitis externa is treated

Otitis externa does sometimes get better without treatment, but it can take several weeks. Your GP can prescribe ear drop medication that will usually improve the symptoms within a few days.

There are a number of different types of ear drops that may be used to treat otitis externa, but they all tend to be used several times a day for about a week. 

Your GP may refer you to a specialist for further treatment and advice if symptoms are severe or they fail to respond to treatment.

Read more about treating otitis externa.

Preventing otitis externa

To help reduce your chances of developing otitis externa, you should avoid inserting cotton wool buds and other things into your ears (including your fingers), as this can damage the sensitive skin in your ear canal.

If you are a regular swimmer, consider using ear plugs when swimming or wearing a swimming cap to cover your ears and protect them from water.

You should also try to avoid getting water, soap or shampoo into your ears when you have a shower or bath.

Read more about preventing otitis externa.

Complications

Complications of otitis externa are uncommon, but some can be very serious.

One rare complication of otitis externa is malignant otitis externa, which is where an infection spreads from the ear canal into the surrounding bone. 

This requires prompt treatment with antibiotics and sometimes surgery, as it can be fatal if left untreated.

Read more about the complications of otitis externa.

Page last reviewed: 28/01/2014

Next review due: 28/01/2016

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Kitleo said on 21 August 2014

I have lived with this condition for approximately 22 years - it started when I use to take my young daughter swiming every week. I would go to the doctors almost monthly but was finally told that there was no treatment for it. It will flair up every few months but never actually goes away. It has now caused my ear to become swollen and I am partially deaf in that ear and the pain is unspeakable - also I find it hard to eat at times because the pain affects my jaw. I have just read this and have made another appointment to see my doctor at 8.30 tomorrow morning : I cannot believe I have never been given ear drops : all the symptoms above are the exact thing I have. I do wonder if I went privately it would have been treated more seriously and cured years ago?

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Amazonia said on 31 March 2013

Hi Emmalou1506, I also have otitis externa and have done so since 2010. It started out as a middle ear blockage in my left ear, which was pretty painful then that went away and about a month later I ended up with OE! Have tried various treatments but it just won't go. I was wondering if microsuction would help clear up all the crusted bits I get in my ears but when I mentioned this to my GP I was told that I can't get that done - not sure if it's just in this area or an NHS thing? It seems to be so difficult to get rid of, would be interested to hear how you get on if you go private.

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emmalou1506 said on 09 March 2013

I've had this condition for 3 years now and suffer everyday. I wash my hair over the sink with my head forward to prevent getting my ears wet, I don't go swimming etc and I still cannot get rid of it!
My GP has no interest and I have been told by her that it is chronic and I need to get used to it.
Considering going private to see if there are any other options available to treat it.
I've suffered long enough!

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