OTITIS EXTERNA

Otitis externa is commonly referred to as “swimmer’s ear” because repeated exposure to bodies of water makes the ear canal more susceptible to inflammation. While water plays a role in the condition, it is not the sole cause. For otitis externa to develop, the following factors must be met:

1. A high presence of bacteria in the ear region
2. Reduced skin integrity of the ear canal

As long as any of these conditions are met, the individual may suffer from inflammation. Getting water in the ear region is a common way to get otitis externa because it satisfies the two conditions well. The presence of water in the ear canal tempts the individual to scratch the inside of the ear. If the water is polluted or dirty, it can also introduce bacteria into the ear. Trapped moisture then allows the bacteria to multiply.

Those with chronic skin conditions (e.g., atopic dermatitis, seborrheic dermatitis, psoriasis, skin allergy) can impair the skin barrier, thus increasing the susceptibility to otitis externa. Physical or mechanical abrasion also damages the skin inside the ear. For those without any pre-existing conditions, the usual cause is an abnormally high presence of pathogens in the ear canal. 

While most cases of otitis externa are bacterial, inflammation can also arise from a fungal infection. 

SYMPTOMS

Ear pain is the most common symptom associated with otitis externa. The pain experienced is usually directly related to the severity of the infection. 

Individuals affected by otitis externa may also experience ear discharge — either in pus form or liquid. Itchiness is another common symptom. 

In more severe cases, otitis externa can induce swelling of the ear canal. When this happens, the discharge becomes trapped within the canal. Compounded by these two symptoms, otitis externa can cause some degree of hearing loss. 

These symptoms typically affect only one ear.

DIAGNOSIS

Any form of ear pain should be diagnosed immediately. When the ear is inspected, an individual’s ear canal with otitis externa should appear red and swollen. It may also occur scaly because of infection. 

• Early Diagnosis. Doctors usually check for otitis externa in two phases. The first phase involves a physical examination of the ear region, particularly the ear canal. The doctor may move the outer ear around to check for pain. 
• Further Testing. After the initial assessment, further testing may be conducted to see if the eardrum is damaged. If it is damaged, the patient is sent to an ear, nose, and throat specialist (ENT). Doctors might also schedule later appointments if the patient does not respond to treatment.

TREATMENT

Treating otitis externa involves regular cleaning and medication. In some cases, the condition gets better without treatment.

• Cleaning: Removal of debris on the outer ear helps ear drops flow to the affected area. If the ear canal is partially or entirely blocked, specialized cleaning might be required. The physician may need to use a suction cup or an ear curette to clean away debris or discharge. 
• Medication: For most cases of otitis externa, the physician will prescribe a combination of ear drops. Each ear drop has unique functions, such as reducing inflammation or fighting bacteria. The patients may need to use ear drops several times a day. 

If the patient fails to respond to the prescribed medications, he/she might need to seek further treatment from a specialist.