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Swimmer’s Ear- Causes, Symptoms, Risk Factors, and Prevention

What is Swimmer’s Ears?

Swimmer’s Ear, also known as otitis externa, is an infection that develops in the outer part of the ear canal which runs towards the eardrum to the outside of the head. It is caused due to the water that accumulates in the outer portion of the ear after swimming. This water becomes the breeding ground for various bacteria resulting in Swimmer’s Ears.

Causes of Swimmer’s Ear:

  • Putting fingers, cotton swabs, or other objects in your ears can cause swimmer’s ear. This is because it damages the thin layer of skin lining the canal of your ear.
  • It is also caused due to bacteria that invades the skin inside the ear canal.

Symptoms of Swimmer’s Ears:

The symptoms of swimmer’s ears are mild in the initial stages. If left untreated, they begin to worsen. For convenience, the symptoms are classified as per mild, moderate and advanced stage of progression.

Mild Symptoms:

  • Itching in the ear canal
  • Slight redness inside the ear
  • Mild discomfort. You may feel more of this discomfort when pulling the outer area of your ear or pushing on the little bump, also known as tragus, in front of your ear.
  • Oozing out of clear and odorless fluid from the ear.

Moderate Progression:

  • More intense itching
  • Increasing pain
  • Increase in the redness inside the ear
  • Excessive fluid drainage
  • Discharge of puss
  • Feeling of fullness inside your ear and partial blockage of ear canal by swelling, fluid and debris
  • Decreased or muffled hearing

Advanced Progression:

  • Severe pain that may extend to face, neck or side of your head
  • Complete blockage of your ear canal
  • Redness of swelling of your outer ear
  • Swelling in the lymph nodes in the neck
  • Fever

Natural Defense of your Ear:

The outer ear canals have natural defenses that help keep them clean and prevent infection. Protective Features include:

Glands that secrete a waxy substance (cerumen):

These secretions form a thin, water-repellent film inside your ear. Cerumen is also slightly acidic. This prevents the bacteria from growing in your ear. The coating also collects dirt, dust and debris and helps you to remove the same out of the ear. The waxy clump that results is the familiar earwax you find at the opening of your ear canal.

The shape of your ear canal:

The shape of your ear canal is downward sloping from your middle ear to your outer ear. Due to this, water cannot accumulate in the region and is swept off your ear.

The immediate question that may strike you would be how does one have this infection if there are natural defenses available in our ear itself against the disease? The answer to your question is right here.

How do you get Swimmer’s Ears?

Your natural defenses are overwhelmed which causes you to Swimmer’s Ears. Your ears natural defenses can be weakened in the following way:

Excessive Moisture in your Ear:

Due to prolonged perspiration, humidity in weather and water that remains in your ear after swimming can create a favorable environment for bacterial growth.

Scratches or Abrasions in your ear canal:

Cleaning your ear with a cotton swab or hairpin, scratching inside your ear with a finger, or wearing headphones or hearing aids can cause small breaks in the skin that allow bacteria to grow.

Sensitivity reactions:

Hair products or jewelry can cause allergies and skin conditions that promote infection.

Risk Factors leading to Swimmer’s ears:

  1. Swimming can lead to swimmer’s ears. It causes the ear to constantly be damp and moist. That leads to swimmer’s ears
  2. Swimming in water that may have elevated levels of bacteria like a lake or a pond rather than a well maintained pool.
  3. A narrow ear canal like that of a child. A narrow ear canal can trap more water
  4. Aggressive cleaning of ear canal with cotton swabs or other objects
  5. Using of headphones or hearing aids
  6. Skin allergies from hair dye, hair spray or from jewelry.

Complications due to Swimmer’s Ear:

If treated on time, swimmer’s ear is not a serious problem. However, when overlooked, the problem may become severe to cause complications. The complications that may occur are as under:

Temporary Loss of Hearing:

You will not become deaf but you may begin to listen muffled sounds. You may have to listen to voices at a higher pitch than usual because of infection. However, you need not worry because this will be a temporary condition. This will clear once your infection is cleared.

Long Term infection also known as Chronic Otitis Externa:

An outer ear infection is considered chronic if the signs and symptoms persist for more than three months. It may be difficult to treat the infection if conditions like rare strain of bacteria, skin allergy, allergic reaction to antibiotics prescribed for ear infection and a combination of fungal and bacterial infection exist. In such conditions, treatment may become difficult.

Deep Tissue Infection (cellulitis):

In rare conditions, the infection of swimmer’s ear may spread to further layers affecting the deep layers within the skin and the connective tissues of the skin.

Bone and Cartilage Damage (necrotizing otitis externa):

This is a condition in which the outer ear infection spreads and damages the skin and the cartilage of the outer ear and the bone of the lower part of the skull. This condition causes severe pain and agony. Older adults, people with diabetes or people with weakened immune systems are at increased risk of this complication. Necrotizing otitis externa is also known as malignant otitis externa, but it’s not a cancer.

More Widespread Infection:

If the infection reaches the point of necrotizing otitis externa, it may also spread further causing damage to the brain and the surrounding nerves as well as other parts of the body. Though rare, such a condition may be extremely life threatening.

Prevention of Swimmer’s Ears:

These tips may prevent you from having swimmer’s ears:

1. Keep your ears dry:

The main cause of infection is humidity and wetness on the outer part of the ear. One must thus try to keep the ears as dry as possible. Use towels to wipe your ears dry in the outer part of you ear. Also you may use a blow drier to remove the water from your ears.

2. Avoid inserting foreign objects:

Do not insert foreign objects inside your ear. Avoid using ear plugs and ear phones especially if they belong to someone else. Use doctor’s prescribed ear drops to clean your ears instead of ear buds.

3. Swim wisely:

Avoid swimming in lakes and ponds or at places which you have no information of the cleanliness maintained therein. Swim in familiar pools which are cleaned periodically.

4. Protect your ears from irritants:

Insert cotton swabs to protect your ears from hair spray and hair dyes while using them. This will ensure dodging of the infection too.

5. Be cautious after a ear infection or surgery:

If you recently had a ear infection or underwent a surgery, you must be extra careful as you are vulnerable to bacterial infections and may fall prey to one very quickly.

We have been blessed with sensory organs to realize our surrounding better and also to use them to our advantage. It thus becomes our responsibility to ensure that we guard our ears well. Take timely steps to ensure that you prevent the aggravation of Swimmer’s ears if you have one. Also you must take precautionary steps and beware from contracting the infection in the first place.

Shabnam Vandeliwala

Venturing into writing is my second most admired hobby after litigating in courts. An advocate by profession, writing gives me immense sense of satisfaction especially in the time that I'm free from other work.

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