Otitis externa is an infection, inflammation, or irritation of the ear canal, the tube leading from the outer ear to the eardrum. Because it is often found in swimmers, particularly in warm, humid climates, it is often referred to as swimmer’s ear. This condition can easily be treated but can become serious, even life-threatening in some people, if left untreated. This can be very serious particularly in diabetics, where the infection can spread to the middle and inner ears, and cause an infection in the bone ( osteomyelitis), described as malignant otitis externa. Contact your doctor if you think you may have otitis externa.
Otitis externa can develop under the following circumstances:
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing otitis externa:
People with weak immune systems or who have a chronic illness, such as diabetes or AIDS, may suffer an aggressive form called malignant otitis externa. This life-threatening condition requires immediate treatment, hospitalization, intravenous antibiotics, and surgery (if needed). Malignant otitis externa results in infection of the cartilage and bone around the ear, as well as between the ear and the brain (the skull base). The condition can be severe and difficult to treat, causing nerve paralysis.
If you experience any of these symptoms do not assume it is due to otitis externa. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.
Your doctor will ask about your symptoms and medical history, and perform a visual exam of the ear, including the ear canal and inner ear, using a lighted device called an otoscope. If malignant otitis externa is suspected a CT scan may be necessary.
Treatment options include the following:
Your doctor will remove any drainage or pus from the ear canal using a suction.
Prescription ear drops containing infection-fighting medications and inflammation reducers, like antibiotics and corticosteroids, are the usual treatment for otitis externa. Sometimes, antibiotic or antifungal pills are prescribed. With treatment, symptoms of otitis externa usually decrease in severity within 24 hours to three days. If the ear canal is very swollen, it may not allow the ear drops to get in. A small sponge, called a wick, may be inserted in the ear canal to absorb the drops. It is usually removed after 24-48 hours.
Your doctor may also recommend:
If you are diagnosed with otitis externa, follow your doctor's instructions.
To help reduce your chances of getting otitis externa, or from having the condition recur, take the following steps:
American Academy of Family Practitioners
American Academy of Otolaryngology, Head and Neck Surgery
Canadian Society of Otolaryngology
American Academy of Otolaryngology. Swimmer’s ear. American Academy of Otolaryngology website. Available at: http://www.entnet.org/healthinfo/ears/swimmers.cfm . Accessed September 29, 2005.
Block SL. Otitis externa: providing relief while avoiding complications. J Family Practice . 2005;54(8):669-676.
DynaMed Editorial Team. Otitis externa. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 20, 2010. Accessed November 10, 2010.
National Center for Emergency Medicine Informatics. Otitis externa (swimmer's ear). National Center for Emergency Medicine Informatics website. Available at: http://www.ncemi.org/cse/cse0302.htm . Accessed November 10, 2010.
Rutka J. Acute otitis externa: treatment perspectives. Ear Nose Throat J . 2004;83(9 Suppl 4):20-21;discussion 21-22.
US Centers for Disease Control and Prevention. Swimmer’s ear. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyswimming/swimmers_ear.htm . Accessed September 29, 2005.
Last reviewed September 2012 by Kari Kassir, MD
Last Updated: 09/10/2012