If you have otitis externa, there are several simple medications that, in most cases, can be used to successfully treat the condition. However, if you have localised otitis externa you may not need treatment as the condition may clear up on its own.
Whatever kind of otitis externa you have, there is some general advice that you should follow in order to aid your treatment. This is detailed below, along with information about treatment for the different types of otitis externa, plus advice about using ear drops.
General advice for all types of otitis externa
- Try to avoid getting your affected ear wet - for example, by wearing a shower cap while showering and bathing. Remove any discharge or debris by gently swabbing your ear with cotton wool, being careful not to damage it.
- Remove anything from your affected ear that may be causing an allergic reaction, such as hearing aids, ear plugs and earrings.
- Treat any underlying skin condition that may aggravate your otitis externa, such as seborrhoeic dermatitis, psoriasis or eczema.
- Relieve ear pain with analgesics (painkillers) such as paracetamol or ibuprofen. However, you should not take ibuprofen if you are asthmatic or if you have stomach problems such as stomach ulcers (past or present). If you are unsure check with your GP, practice nurse, or pharmacist. Children under the age of 16 should not take aspirin.
- If you have an allergic disposition (you tend to have many allergies), inform your GP or practice nurse. Ear drops that contain certain substances, such as neomycin or propylene glycol, are more likely to cause an allergic reaction than others. Your GP, practice nurse or pharmacist will be able to advise you about which ear drops are most suitable for you.
Treating localised otitis externa
If you have localised otitis externa it is likely that it will heal on its own within a few days. You can relieve any pain using analgesics (painkillers) such as paracetamol or ibuprofen. However, you should not take ibuprofen if you are asthmatic or you have stomach problems, such as ulcers. Children under 16 years of age should not take aspirin. It may also help to put a warm towel or flannel on your affected ear.
Without treatment, it is likely that the pimple or boil in your ear canal will eventually burst, drain and heal itself, although you may not want to wait for this to happen as it may cause you considerable pain and discomfort.
If you have localised otitis externa that has not healed by itself within a week or so, see your GP. If your infection is severe oral antibiotics may be prescribed. If the pimple or boil is very painful and swollen, your GP may suggest draining it to remove the pus. This may be done by your GP using a surgical needle or you may be referred for specialist treatment.
Treating acute diffuse otitis externa
If you have acute diffuse otitis externa you can relieve any pain at home using analgesics (painkillers) such as paracetamol or ibuprofen. However, you should not take ibuprofen if you are asthmatic or have stomach problems such as ulcers. Children under the age of 16 should not take aspirin.
It is likely that you will need treatment if you have acute diffuse otitis externa. Your GP may prescribe a topical ear preparation in the form of ear drops, which may be an astringent or acidic preparation, a corticosteroid preparation, an antibiotic preparation or an antifungal preparation. It may also be a preparation that combines these ingredients - for example, an antibiotic and a corticosteroid.
If you have severe acute diffuse otitis externa, your GP may refer you for specialist treatment. This may involve microsuction to clean your ear. This is where a small suction device is used to remove any ear wax, discharge and debris from your outer ear (pinna) and ear canal. This allows ear drops to work more effectively.
You may also need an ear wick, which is a soft cotton gauze plug that is covered with medication and inserted into your ear canal. An ear wick allows the medication to reach the end of your ear canal, and should be changed every 2-3 days.
Treating chronic otitis externa
In most cases of chronic otitis externa, the exact cause of the condition cannot be found. If this is the case, your GP will probably prescribe a topical preparation in the form of ear drops to be used for seven days. The ear drops will probably contain a corticosteroid (medication that relieves swelling) without an antibiotic.
Your GP may also prescribe an acetic acid spray for you to use at the same time as your ear drops. As chronic otitis externa is a long-term condition, your treatment may have to continue for between 2-3 months. If your condition has not improved after this time your GP may prescribe antifungal ear drops instead.
If your chronic otitis externa appears to be caused by an underlying skin condition, such as seborrhoeic dermatitis, psoriasis or eczema, your GP may prescribe a treatment for that before treating your otitis externa. If the condition appears to be caused by a fungal infection a topical antifungal preparation in the form of ear drops may be prescribed.
You will only need specialist treatment for chronic otitis externa if your condition does not improve following treatment prescribed by your GP, if your ear canal is in danger of closing up or if you have had an allergic reaction and you need a skin patch test to determine what you are allergic to.
