Outer ear infection (otitis externa)

Outer ear infection (otitis externa)

Otitis externa is an infection that causes inflammation (redness and swelling) of the ear canal, which is the tube between the outer ear and the eardrum.

Otitis externa is often called ‘swimmer’s ear’ because regularly getting water in your ear can make inflammation more likely.

Symptoms of otitis externa

Symptoms of otitis externa include:

• ear pain
• itching and irritation in and around your ear canal
• redness and swelling of your outer ear and ear canal
• a feeling of pressure and fullness inside your ear
• scaly skin in and around your ear canal, which may peel off
• discharge from your ear, which can be either thin and watery or thick and pus-like
• tenderness when you move your ear or jaw
• swollen and sore glands in your throat
• some hearing loss

Usually, only one ear is affected.

With treatment, these symptoms should clear up within a few days. Some cases can persist for several months or longer.

When to get medical advice

Pharmacists can give advice and treatment about outer ear infections.

Find your local pharmacy

Your pharmacist may advise you to speak to your GP practice if needed.

Diagnosing otitis externa

Your pharmacist or GP will ask about your symptoms and whether you regularly put things into your ears, such as hearing aids or ear plugs. They may also examine inside your ear using an instrument called an otoscope.

If you have otitis externa often, and treatment doesn’t help, your GP may take a swab of the inside of your ear. This will be tested to help check what type of infection you have, if any, so the right medication can be prescribed.

What causes otitis externa?

Most cases of otitis externa are caused by a bacterial infection. It can also be caused by:

• irritation
• fungal infections
• allergies

There are a things that can make you more likely to develop otitis externa, including:

• damaging the skin inside your ear – for example by scratching or picking your ear
• regularly getting water in your ear – for example by swimming

Getting water in your ear can cause you to scratch inside your ear, and the moisture also provides an ideal environment for bacteria to grow.

Who is affected?

Otitis externa is quite common. It’s estimated that around 1 in 10 people will be affected by it at some point in their lives.

The condition is slightly more common in women than men and is most often diagnosed in adults 45 to 75 years of age.

People with certain long-term (chronic) conditions are at greater risk of developing the condition. These include:

• eczema
• dermatitis

Treatment for otitis externa

Otitis externa sometimes gets better without treatment, but it can take several weeks.

Things you can do to help your symptoms

To help your symptoms and help prevent complications, you should:

• avoid getting your affected ear wet – wearing a shower cap while showering and bathing if you aren’t washing your hair can help
• avoid swimming until the condition has fully cleared
• remove any discharge by gently swabbing your outer ear with cotton wool – do not stick cotton wool or a cotton bud inside your ear
• remove anything from your affected ear that may cause an allergic reaction, such as hearing aids, ear plugs and earrings
• use pain relief such as paracetamol or ibuprofen to relieve ear pain – these aren’t suitable for everyone, so make sure you check the information leaflet that comes with the medication first and if you’re still unsure, check with your GP, practice nurse or pharmacist
• if your condition is caused by a boil in your ear, placing a warm flannel or cloth over the affected ear can help it heal faster

Ear drops

Your pharmacist or GP can prescribe ear drops that usually improve symptoms within a few days.

There are different types of ear drops that may be used to treat otitis externa. You usually use them several times a day for about a week.

Your GP may refer you to a specialist for further treatment and advice if your symptoms are severe, or treatment does not help.

How to prevent otitis externa

There are things you can do to reduce your chances of developing otitis externa.

Do

• consider wearing a swimming cap or using ear plugs if you’re a regular swimmer – but make sure you insert ear plugs carefully and don’t use them if they irritate your ears
• if earwax build-up is a problem, have it removed by a healthcare professional
• keep your ears dry and clean
• turn your head from side to side after getting out of water – this helps water drain from your ears

Don’t

• do not insert cotton wool buds or other things into your ears (including your fingers) – this can damage the sensitive skin in your ear canal
• do not swim in polluted water

You should also try to avoid getting water, soap or shampoo into your ears when you have a shower or bath.