Swimmer's ear is not the same as a middle ear infection, which occurs behind the eardrum and is most often caused by a viral infection. Symptoms of swimmer's ear and a middle ear infection may appear the same to those unfamiliar with the differences. Here are four guidelines to help you understand the symptoms and determine why type of infection your child may have. With swimmer's ear the pain is located in the outer ear canal, or the area near the ear opening, and increases when you pull on the earlobe.
In a middle ear infection, pain is located in the inner ear, near the ear drum and will often increase with lying down, which can also cause trouble sleeping.
If your child is experiencing ear pain, these signals are especially helpful: With swimmer's ear, the outer ear may appear red and swollen and have a rash-like appearance. You may see your child frequently scratch at his ear or complain of an itchy ear. Also watch for a foul-smelling drainage coming from the ear s bothering them. Symptoms to watch for with a middle ear infection include fever, pulling or tugging on the ear, decreased appetite, diarrhea or vomiting.
Temporary hearing loss is a telltale sign for both a middle ear infection and swimmer's ear, but it may be one of the first signs you notice. Did the ear pain start after a recent swim in a lake, pool or hot tub? Despite its name, you don't have to swim to pick up swimmer's ear.
Simply cleaning your ears with a cotton swab or taking a shower or bath can also cause this condition. With a middle ear infection, your child may exhibit signs of an upper respiratory infection, such as congestion, runny nose and watery eyes, in the days before the inner ear pain began. Here is the infographic comparing swimmer's ear vs ear infection in an alternative format. It generally lasts up to seven to 10 days but this can vary, especially in chronic cases that can continue for weeks and months.
Treatment usually decreases the duration of symptoms. But because of the discomfort, most patients will seek care as the treatments are very effective at decreasing the symptoms.
Long-term damage is unusual in most cases. However, the infection can become chronic due to resistant bacteria, skin conditions dermatitis, psoriasis and other reasons. Other long-term issues can occur if the infection spreads into the deep layers of skin, cartilage and bone.
This can cause increasingly severe pain, damage to cranial nerves and more widespread infection. Thankfully, these cases are unusual and most of these patients have underlying medical conditions that helped the infection become more severe.
Having a physician clean the ear of drainage and debris can be very helpful in treating the infection. There are multiple types of these ear drops that are effective. Pain medications such as acetaminophen and ibuprofen are very helpful with the discomfort. Using ear plugs can help prevent moisture in the outer ear canal. The ear also creates natural barriers to infection, such as ear wax, and patients should avoid removing this with cotton swabs. This includes both pools and lakes, especially depending on how well the pool is maintained.
A middle ear infection is very common, especially in children. Those with middle ear infections may also have a history of these infections and may have ear tubes or other prior surgeries, and usually have more hearing loss. Ideally, we recommend you avoid swimming or getting any other moisture in the ear until the symptoms have subsided. In routine cases, this is likely not an issue but it can possibly lead to reinfection or more difficulty with the treatment.
Instead, swimmer's ear is usually treated with antibiotic ear drops, either with or without added steroids which some experts think can reduce inflammation and make symptoms go away faster. Common otic ear drops that are used to treat swimmer's ear include:. Although expensive, Floxin, Ciprodex, and Cipro HC are most commonly prescribed, as they have fewer side effects, can be used just twice a day, and may provide better coverage against the bacteria that cause swimmer's ear.
Oral antibiotics are rarely needed to treat uncomplicated cases of swimmer's ear. Pain relievers , including Tylenol acetaminophen or ibuprofen Motrin or Advil , can also be used to reduce your child's pain until his ear drops start working. If there is enough swelling, so that ear drops can't get into your child's ear, your pediatrician may place an ear wick inside his ear.
In this procedure, your pediatrician places a small strip of sterile gauze-like material into the ear canal which is saturated with an antibiotic solution. This cloth usually falls out on its own when the swelling goes down.
There isn't really a magic number of days for which swimmer's ear should be treated, although a week is usually needed to clear the infection. Most pediatricians recommend continuing the drops for at least two to three days after the infection has cleared. Your pediatrician may also recommend that your child stays out of the water during this time. In general, you can prevent swimmer's ear by keeping water out of your kids' ears. Fortunately, that doesn't mean that your kids can't swim and enjoy the water.
Instead, use an over-the-counter ear drying agent that contains isopropyl alcohol rubbing alcohol , such as Auro-Dri or Swim Ear or one with acetic acid and aluminum acetate Star-Otic. If you like, you might also create your own homemade swimmer's ear prevention solution by mixing equal parts of rubbing alcohol and white vinegar, and putting it in your child's ears after he swims.
Although some experts think that earplugs are irritating and can lead to swimmer's ear, you can also keep water out of your kids' ears by using a barrier, like earplugs, including Mack's AquaBlock Earplugs or their Pillow Soft silicone Earplugs. If your kids have a hard time keeping their earplugs in, consider also using the Aqua-Earband or Ear Band-It neoprene swimmer's headband. If you watch commercials on TV, you're probably thinking that to be a good parent you must remove the ear wax from your children's ears, but this can actually increase the risk of infections in two ways.
Ear wax seems to play a protective role against the development of swimmer's ear, so you don't want to aggressively remove wax from your child's ear. Cleaning your child's ears with a cotton-tip applicator may also put them more at risk for swimmer's ear, as small scratches and abrasion of the ear canal increase the risk of the infection.
If your child routinely develops a lot of ear wax, have his pediatrician remove this periodically in the office. Fungal infections and noninfectious disorders, including eczema , psoriasis, seborrheic dermatitis , and allergic contact dermatitis , can also cause otitis externa and should be suspected in chronic cases of swimmer's ear. Malignant otitis externa is a rare complication of swimmer's ear in which the infection spreads into the skin around the ear as well as into the bones of the skull temporal osteomyelitis.
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Facts About "Swimmer's Ear". The incidence and health burden of earaches attributable to recreational swimming in natural waters: a prospective cohort study. Environ Health. Merck Manual.
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