From the Guidelines
Vinegar can be safely used for ear hygiene to help prevent otitis externa, but with important precautions, as recommended by the clinical practice guideline for acute otitis externa 1. To use vinegar for ear hygiene, a diluted solution of white vinegar and water in equal parts (1:1 ratio) can be used as an ear rinse after swimming or bathing.
- Place a few drops in the ear canal,
- let it sit for about a minute,
- then tilt your head to drain it out. The acetic acid in vinegar creates an acidic environment that discourages bacterial and fungal growth that can cause otitis externa 1. However, vinegar should never be used if you have a perforated eardrum, ear tubes, or any active ear infection, as it can cause severe pain and complications. For prevention, it's best to keep ears dry by tilting your head after swimming and using a hair dryer on low setting, as well as using acidifying ear drops shortly before swimming, after swimming, at bedtime, or all three, and avoiding trauma to the external auditory canal 1. If you experience ear pain, discharge, or hearing loss, stop using vinegar and consult a healthcare provider, as these symptoms may indicate an infection requiring medical treatment. Additionally, removing obstructing cerumen and using ear plugs while swimming can also help prevent AOE 1.
From the Research
Hygiene and Prevention of Otitis Externa
- Strength vinegar, which is typically a 5-8% acetic acid solution, can be used for hygiene and prevention of otitis externa, but its effectiveness and safety depend on the concentration and method of use.
- A study published in 2001 2 suggests that a topical solution of 2 percent acetic acid combined with hydrocortisone is effective in treating and preventing otitis externa.
- Another study from 1999 3 recommends the use of topical acidifying agents, such as acetic acid, to help prevent recurrent external otitis.
- However, it is essential to note that using full-strength vinegar may not be suitable for the ear canal, and diluting it to a lower concentration, such as 2%, may be necessary to avoid irritation or damage.
Prevention of Otitis Externa
- Preventing otitis externa involves avoiding excessive moisture and trauma to the ear canal, as well as keeping the canal clean and dry 2, 4.
- Using topical acidifying agents, such as acetic acid, after exposure to moisture can help prevent otitis externa 2.
- Avoiding manipulation of the external auditory canal and drying the ears with a hair dryer can also help prevent recurrence 2.
- There is no evidence to suggest that strength vinegar is a recommended or safe concentration for use in the ear canal, and further research is needed to determine its effectiveness and safety in this context.