From the Guidelines
Otitis externa, commonly known as swimmer's ear, presents with several characteristic symptoms, including ear pain, itching, redness, swelling, discharge, and occasionally fever, which can be effectively managed with antibiotic or antifungal ear drops and careful cleaning of the ear canal by a healthcare provider, as recommended by the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1.
Symptoms of Otitis Externa
The symptoms of otitis externa include:
- Ear pain that worsens when touching or pulling the outer ear
- Itching inside the ear canal
- Redness and swelling of the ear canal
- Discharge that ranges from clear to yellow-green or even bloody
- Feeling of fullness in the ear
- Tenderness in the area around the ear
- Occasionally fever These symptoms develop when moisture, trauma, or removal of protective ear wax allows bacteria or fungi to infect the ear canal skin, which can be prevented by keeping the ear dry, avoiding inserting objects into the ear canal, and seeking medical attention if symptoms persist 1.
Risk Factors for Otitis Externa
People who are at higher risk for developing otitis externa include:
- Those who swim frequently
- Those who live in humid climates
- Those who clean their ears aggressively
- Those with certain skin conditions like eczema or psoriasis
- Those with diabetes or immunocompromised states, who may require special consideration and different management, including systemic antibiotics and careful cleaning of the ear canal 1.
Management of Otitis Externa
The management of otitis externa typically involves:
- Antibiotic or antifungal ear drops
- Careful cleaning of the ear canal by a healthcare provider
- Avoiding inserting objects into the ear canal
- Keeping the ear dry
- Avoiding trauma to the ear canal
- Managing underlying skin conditions or immunocompromised states 1.
Importance of Early Treatment
Early treatment of otitis externa is important to prevent complications, such as necrotizing otitis externa, which can be life-threatening, especially in people with diabetes or immunocompromised states 1.
From the Research
Otitis Externa Symptoms
- The most characteristic symptom of otitis externa is discomfort limited to the external auditory canal 2
- Other symptoms include erythema and swelling of the canal with variable discharge 2
- Signs and symptoms of otitis externa can also include ear inflammation, tenderness, edema, and discharge 3
Common Precipitants
- Excessive moisture and trauma are the two most common precipitants of otitis externa, which impair the canal's natural defenses 2
- Avoidance of these precipitants is the cornerstone of prevention 2
Diagnosis and Treatment
- Thorough cleansing of the canal is essential for diagnosis and treatment, but flushing should be avoided 2
- Acidification with a topical solution of 2 percent acetic acid combined with hydrocortisone for inflammation is effective treatment in most cases 2
- Topical antibiotic and steroid preparations can be used to treat otitis externa, but systemic antibiotics are rarely needed 4
- Some studies suggest that topical antibiotics may not be necessary in the management of otitis externa 5