Dr. Neumann’s 10 Tips: Children/Swimmer’s ear

August 23, 2010

Posted in Prevention, Safe & Healthy Travel Comments Off
Tags: backyard pools, bathing caps, canal opening, chlorinated swimming pools, ear discomfort, ear drainage, ear drops, ear infection, ear wax, earache, eardrum, earlobe, fungi, hot tubs, medical care, muffled hearing. bacteria, non-chlorinated, oral antibiotics, outer ear canal, recreational water, salt water, skin lining the outer ear canal, swimmers earplugs, swimmer’s ear, whirlpools

When children complain of ear discomfort in the summertime, chances are that they have swimmer’s ear, a condition important for you, the parent, to recognize. Early treatment can save you from a few days of having a very unhappy child on your hands and, perhaps, from having to seek medical care and all the hassle that entails. 

Here is what you should know:

1. Swimmer’s ear is an infection of the outer ear canal. The canal extends inward for about an inch or so and ends abruptly at the eardrum. If pulling down on the earlobe or pressing on the canal opening causes pain, it is nearly always a case of swimmer’s ear. Other early symptoms include increasing discomfort, drainage, and muffled hearing.

2. Where you swim determine the odds of becoming infected.  Swimmer’s ear is caused by bacteria and fungi that are plentiful in non-chlorinated recreational water such as lakes and streams, particularly polluted ones, and in poorly chlorinated swimming pools, hot tubs and whirlpools. Backyard pools are common culprits.  Chances of becoming infected are considerably smaller in optimally chlorinated pools and in the ocean. Salt water retards the growth of these organisms.  

3. Infection is due to organisms invading the skin lining the outer ear canal. Prolonged exposure to contaminated water, continuing moisture in the ear canal and high humidity allow these organisms to flourish. In temperate climates, cases of swimmer’s ear are far less common in non-summer months when kids swim less often, backyard pools stand empty, and the air tends to be dryer.

4. Damaged skin is more likely to become infected. Skin lining the outer ear canal is very thin, taut and tightly attached to the underlying bone, therefore easily damaged. Skin elsewhere moves more freely. The more damaged the skin, the fewer organisms necessary to cause infection.

5. Even a cotton tip applicator can abrade this skin. Moreover, cotton applicators push wax deeper into the canal and remove the thin layers of wax that helps protect the skin from moisture. Clumps of wax can solidify and develop sharp edges capable of damaging the skin. Instruct children not to try to remove wax or relieve discomfort with paper clips, hairpins, fingernails or similar objects. (An old tongue-in-cheek saying is: the only object to insert into an ear is an elbow.)

6. Wearing earplugs for swimming is controversial. If they fit well, they do keep moisture out of the ear canal. However, poorly fitting ones – which most are – allow moisture in and may abrade the skin. Competitive swimmers wear earplugs specifically molded for their ears.

7. Swimmer’s ear may occur in non-swimmers. Repeated water in the ear, perhaps from frequent and prolonged showers and baths, damaged skin in the canal, hard wax and a few stray organisms, suffice to cause infection in susceptible individuals.

8. Dry the ear canal as soon as symptoms occur. Use equal parts of rubbing alcohol and acetic acid (vinegar), prepared at home or available as eardrops in drug stores. This mixture is also a mild antibacterial/antifungal agent. Hair dryers aimed at the ears are also effective. Bathing caps and cotton in the ears interferes with drying.

9. Apply drops correctly. Have children lie on their side and pour the alcohol/acetic acid solution into the ear until the canal is full. Have them lie there for five minutes. Do the other side, if necessary. Do this several times a day. Continue until several days after the pain is gone. For children with previous swimmer’s ear, apply drops before and after each time they swim. Note: do not use eardrops if a child has a perforation of the eardrum or other serious, ongoing ear problems. 

10. Seek medical help if pain is severe or symptoms continue. Occasionally cases of swimmer’s ear require eardrops containing other substances: specific antibiotics, an anesthetic for pain, and steroids to promote healing and decrease swelling. Such eardrops need prescriptions. Sometimes debris (such as wax) must be cleaned to allow drops to reach the damaged skin. Rarely, oral antibiotics are necessary.

Posted in Prevention, Safe & Healthy Travel Comments Off
Tags: backyard pools, bathing caps, canal opening, chlorinated swimming pools, ear discomfort, ear drainage, ear drops, ear infection, ear wax, earache, eardrum, earlobe, fungi, hot tubs, medical care, muffled hearing. bacteria, non-chlorinated, oral antibiotics, outer ear canal, recreational water, salt water, skin lining the outer ear canal, swimmers earplugs, swimmer’s ear, whirlpools