Otitis externa 

Introduction 

Never stick anything in your ears

Almost all people do it, often without realising it, but where possible you should avoid sticking anything inside your ears. This includes:

  • cotton wool buds – these should only be used to sweep around your outer ear
  • pencils and pens
  • one of your fingers

The skin of the external ear canal is extremely sensitive and can be easily damaged making it vulnerable to infection.

There is a saying that goes: "You should never stick anything inside your ear smaller than your elbow."

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

Otitis externa is often referred to as "swimmer's ear", as repeated exposure to water can make the ear canal more vulnerable to inflammation (otitis externa is one of the most common conditions to affect competitive swimmers).

Symptoms of otitis externa include:

  • ear pain, which can range from moderate to severe
  • 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 two-to-three days.

In some cases the symptoms can persist for several months, which is known as chronic otitis externa. The symptoms of chronic otitis externa tend to be much milder.

Read more about the symptoms of otitis externa.

What causes otitis externa?

Repeated exposure to water increases your risk of otitis externa. This is because water can clear earwax out of the external ear canal, making it very itchy. If you try to scratch inside your ear, the sensitive skin of the canal can break down, allowing an infection to take place.

Water in the ear also creates a moist environment, which encourages bacteria to grow.

Other causes include:

  • a spot (pimple) developing inside the ear
  • a fungal infection
  • something directly irritating the ear canal, such as a hearing aid or an ear plug

Read more about the causes of otitis externa.

Treating otitis externa

If you think you may have otitis externa, see your GP as it tends to last for several weeks if it is not treated.

Painkillers are used alongside eardrops to treat the underlying swelling and any infection.

In very severe cases of infection, antibiotics (that you take as a capsule, tablet or suspension that you drink), such as flucloxacillin, may be prescribed.

Read more about treating otitis externa.

Who is affected

Otitis externa is relatively common. It is estimated that around 10% of the population will be affected at some point in their lives.

The condition is slightly more common in women than men (possibly because more women go swimming regularly).

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

Prevention

If you are a regular swimmer, consider getting a swimmer’s hat to cover your ears and protect them from water. Ear plugs are not recommended as they can cause damage to your ear canals.

Make sure that you ear canals are clear of water after swimming, bathing or showering.

Read more about preventing otitis externa.

Complications

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

A rare and potentially fatal complication of otitis externa is the infection spreading into the underlying bone – this is known as malignant otitis externa and may require surgery.

(There is an average 350 cases of malignant otitis externa each year in England).

Read more about the complications of otitis externa.




Last reviewed: 31/03/2012

Next review due: 31/03/2014

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Comments are personal views. Any information they give has not been checked and may not be accurate.

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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