From the Guidelines
To treat an external ear canal abrasion, keep the area clean and dry while allowing it to heal naturally, and apply a thin layer of antibiotic ointment like Polysporin or Bacitracin to the accessible abrasion once or twice daily for 3-5 days to prevent infection. Gently clean the outer ear with a soft cloth and warm water, avoiding insertion of anything into the ear canal, as this can push debris further into the ear and potentially cause more harm 1. It is essential to avoid getting water in the ear while showering or bathing by using a cotton ball lightly coated with petroleum jelly as a temporary barrier. For pain management, take acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed, as recommended by clinical practice guidelines for acute otitis externa 1. If the abrasion was caused by objects inserted into the ear, avoid this practice as the ear is self-cleaning. Seek medical attention if you develop increasing pain, discharge, fever, hearing loss, or if symptoms don't improve within 3-5 days. The skin lining the ear canal is delicate and thin with minimal protective layers, making it prone to injury, but it also has good blood supply which typically allows for quick healing when kept clean and protected from further trauma. Proper administration of topical medication is crucial, and patients should be informed on how to administer ear drops effectively, which may include having someone else apply the drops or using a wick to permit drug delivery through the length of the ear canal 1.
From the Research
Treatment for External Auditory Canal (EAC) Abrasion
The treatment for an external auditory canal (EAC) abrasion typically involves:
- Cleaning the ear canal mechanically, by rinsing with saline, and finally drying by suction 2
- Applying topical antimicrobials or antibiotics, such as acetic acid, aminoglycosides, polymyxin B, and quinolones 3
- Using ear drops with or without topical corticosteroids, which may help resolve symptoms more quickly 3
- In some cases, using a combinatorial broad-spectrum antibiotic/corticosteroid ear drop, which is the most effective remedy for bacterial inflammation 2
Factors to Consider in Treatment
The choice of treatment depends on several factors, including:
- Tympanic membrane status 3
- Adverse effect profiles 3
- Adherence issues 3
- Cost 3
- The presence of underlying conditions, such as allergies or inflammatory dermatologic conditions 3, 4
Additional Treatment Options
Other treatment options that have been studied include:
- N-chlorotaurine, a novel endogenous antiseptic agent, which has been shown to be well tolerated and effective in treating acute otitis externa 5
- Boric acid, which has been compared to a combination of polymyxin, neomycin, and hydrocortisone in the treatment of acute otitis externa, with similar pain relief results 6