Otitis externa is a painful inflammation of the skin in the ear canal. This skin is protected from bacteria by a layer of earwax. When the protective layer disappears or the skin in the ear canal is damaged, this may lead to otitis externa. Otitis externa, as well as otitis media, falls under the heading of ‘ear infection’.
Cause
The ear canal is lined with a thin layer of skin. In the ear canal, there are over a thousand glands that produce earwax. Earwax is acidic and fatty. Irritation of the skin may cause inflammation. The skin can get irritated by:
- Heat and moisture (such as in case of bathing and swimming).
- Picking the ear.
- Cleaning the ear, for example with swabs. Swabs often push the earwax deeper into the ear canal. It then forms a plug of earwax. In the sweltering space behind the plug, an inflammation can easily arise.
- Cosmetic products, such as shampoo, soap and hairspray.
- Wearing earphones or hearing device.
A narrow ear canal is more prone to inflammation. In case of diseases like eczema, psoriasis or (contact) allergy, inflammation of the ear canal is more common. A bacterial or fungal infection is sometimes the cause. Apart from that, the cause of otitis externa is not always clear.
Symptoms
An otitis externa can lead to the following signs and symptoms:
- The ear canal is painful, itchy or has a burning sensation.
- The skin of the ear canal flakes, discharges moisture or is red and swollen.
- Due to the swelling or discharge, hearing can temporarily be reduced.
- Gently pulling the ear can hurt.
Diagnosis
The ear, nose and throat (ENT) specialist makes the diagnosis of otitis externa based on the patient’s symptoms and examination of the ear. Sometimes, additional examination is necessary, for example making a culture, taking X-rays or performing tissue examination.
Treatment
In case of otitis externa, ear drops containing an acid and a corticosteroid (adrenocorticotropic hormones) help. Sometimes, the ear canal must first be syringed by the general practitioner.
If the ear canal is very swollen, the patient may get an ear tampon to reduce swelling first. This should remain there one day. With ear drops, the ear tampon must be well kept wet. Use paracetamol in case of severe earache. If paracetamol doesn’t help, try an anti-inflammatory painkiller.
Prognosis
Otitis externa usually heals within one to three weeks. If the symptoms return, the patient can still use ear drops each time after swimming (or other contact with water) or as soon as the symptoms occur.
Considerations
- Don’t clean the inside of the ears and don’t pick. The ear canal generally cleans itself.
- Bend the head forward when showering and washing hair. Then, no water and soap will get into the ear.
- Dry the ear and the entrance of the ear canal thoroughly after swimming or showering.
- Use earplugs or put cotton pads with vaseline in the ears, if the inflammation keeps occurring after swimming.
- Avoid (cosmetic) products that irritate the skin.
- If a person wears a hearing device and has symptoms often, the hearing care professional can check whether the device fits properly.
