Otitis externa is an inflammation of the ear canal. The inflammation may be caused by infection, allergy or other causes. Treatment with ear drops is usually effective. Recurrences can often be prevented by the tips given below.
Otitis means inflammation of the ear. The inflammation is usually due to an infection. Otitis externa means that the inflammation is confined to the ear canal and does not go further than the eardrum. (There is a separate leaflet called 'Ear Infection (Otitis Media)', which is an infection of the middle ear.)
Otitis externa is an infection of the skin of the ear canal and is very common. It often occurs 'out of the blue' for no apparent reason.
In general, the infections are caused by a bacterial infection. Occasionally, they can be due to a fungal or yeast infection.
Some people are more prone to otitis externa. If you get water, shampoo, soap, hairspray, etc, in an ear then it may cause it to itch. You may then scratch or poke the ear. This can damage the skin in the ear canal and cause inflammation. Inflamed skin can quickly become infected. A vicious circle may then develop. The inflammation and infection cause more itch, you then scratch more, which then can makes things worse.
Other possible causes of otitis externa include:
The symptoms of otitis externa can vary between cases. Common symptoms include itch, ear discharge, temporary dulled hearing and pain. Your ear may feel blocked or full. One or both ears can be affected.
Sometimes the glands in your neck or around your ear can become enlarged and sore.
Although it is more common for only one ear to be affected, in some cases both ears become infected.
Most people with otitis externa are given treatment without having any tests as the diagnosis is usually clear from examination of your ear.
However, your doctor or nurse may decide to take a swab (specimen of the discharge) to find out which germ is causing the infection. This helps to guide the choice of antibiotic ear drops to use. (Some germs are resistant to some types of antibiotic.)
A doctor or nurse will usually prescribe a short course of ear drops or an ear spray. These usually contain an antibiotic to clear any infection and a steroid to reduce the inflammation and itch. It may take a week or so of treatment for symptoms to go completely. There are several brands of drops or sprays used to treat otitis externa. If one does not work well then a doctor or nurse may advise changing to another brand with different ingredients.
When you use ear drops:
As a rule, do not leave balls of cotton wool in the ear canal. This stops the discharge (debris) which needs to come out. However, if the discharge is heavy, you may need to place some cotton wool lightly in the outer part of the canal to mop up the discharge. If you use cotton wool, replace it frequently with a fresh piece.
You should not try to clean your ear canal with cotton buds. If you stick buds or other objects into your ear they may damage and irritate the inflamed skin, and make things worse. Just clean the outside of the ear with a cloth when any discharge appears.
Paracetamol or ibuprofen will usually ease any pain. Stronger painkillers are occasionally needed. If you hold a hot flannel against the ear it may also ease pain.
Other treatment may be needed if the inflammation is more severe or if the above measures do not work within a week or so. These may include:
If you are prone to otitis externa, to help prevent recurrences you should keep your ears dry and leave them alone! This means: