Definition:
- Itchy and painful ear canals
- Currently engaged in swimming
- Pain when the outer ear is moved up and down
- Pain when the tab of the outer ear overlying the ear canal is pushed in
- A feeling that the ear is plugged up
- Slight, clear discharge initially; without treatment, it becomes yellowish
Cause:
Swimmer's ear is an infection of the skin lining the ear canal. The cause is prolonged contact with water (any type of water). When water gets trapped in the ear canal the lining becomes damp, swollen, and prone to infection. Ear canals were meant to be dry. Children are more likely to get swimmer's ear from swimming in lake water, compared with swimming pools or the sea. During the hottest weeks of summer, some lakes have high levels of bacteria. Narrow ear canals also increase the risk of swimmer's ear.
Expected Course:
With treatment, symptoms should be better in 3 days.
Home Treatment:
Antibiotic-Steroid Ear Drops - these ear drops are prescribed and your physician will discuss the instructions.
Run the ear drops down the side of the ear canal's opening so that air isn't trapped under them. Move the earlobe back and forth to help the car drops pass downward. Continue the ear drops for 48 hours until all the symptoms are cleared up.
Generally, your child should not swim until the symptoms are gone. If she is on a swim team, continue the sport, but make sure she uses the ear drops as a rinse after each session. Continued swimming may cause a slower recovery but won't cause any serious complications.
White Vinegar Ear Drops - For mild swimmer's ear, use 1/2 strength white vinegar ear drops instead of antibiotic-steroid ear drops. Fill the car canal with white vinegar diluted with equal parts of water. After 5 minutes, remove the solution by turning the head to the side. Do this twice a day.
Pain Relief - Use acetaminophen or ibuprofen as needed for pain relief.
Prevention - First, limit how many hours a day your child spends in the water. The key to prevention is keeping the ear canals dry when your child is not swimming. After swimming, get all water out of the ear canals by turning the head to the side and pulling the earlobe in different directions to help the water run out. Dry the opening to the ear canal carefully. If recurrences are a big problem, rinse your child's ear canals with rubbing alcohol for 1 minute each time she finishes swimming or bathing to help it dry the ear canals and to kill germs. Another helpful home remedy is a solution of 50% rubbing alcohol and 50% white vinegar. The vinegar restores the normal acid balance to the ear canal.
Common Mistakes - Don't use earplugs of any kind for prevention or treatment. They tend to jam ear-wax back into the ear canal. Also, they don't keep all water out of the ear canals. Cotton swabs also shouldn't be inserted in ear canals. Wax buildup traps water behind it and increases the risk of swimmer's ear. A rubbing alcohol mixture is helpful for preventing swimmer's ear but not for treating it because it would sting too much.
CALL OUR OFFICE
IMMEDIATELY if:
- Your child starts acting very sick.
- The ear pain becomes severe.
DURING REGULAR HOURS if:
- The symptoms are not cleared up in 3 days.
- A fever (over 100°F [37.8°C]) occurs.
- You have other concerns or questions.
Adapted from Instructions for Pediatric Patients by Barton Schmitt (2nd edition, 1999) with permission from the author.
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