This time of year pediatricians get a lot of calls about ear pain. Okay, we get a lot of calls about ear pain most times of year. But in the summer, especially, the ear pain may signal otitis externa, more commonly known as swimmer's ear. Acute otitis externa (AOE) is, as the name implies, an infection of the outer ear canal. It can be distinguished from otitis media, or middle ear infection, fairly easily. The pain in AOE is felt, or increased, when the pinna or auricle of the ear is moved or the tragus is depressed. The ear canal is red and swollen and at times itchy. Sometimes a yellowish discharge can be seen. Swimmer's ear is usually caused by bacteria. The two most common ones are a staph species that reside on the skin and a pseudomonas species that are often found in water.
Warm weather and high humidity predispose people to swimmer's ear. Prolonged water exposure, as in swimming, makes the skin of the ear canal susceptible to minor irritation and trauma: anything from cotton swabs to fingernails. This same water exposure also tends to eradicate the ear's naturally occurring defense mechanism, namely ear wax (cerumen).
If you think your child has swimmer's ear, he should be seen by a pediatrician or other health care provider. The condition is treated with antibiotic drops. These drops may also contain corticosteroids as an anti-inflammatory to help calm down the inflammation. If swelling of the ear canal is preventing the drops from entering the ear, the doctor may fashion a wick out of gauze or cotton to allow the medicine to reach its target. Underwater swimming should be avoided until the infection is cured, generally in 7-10 days.
To prevent swimmer's ear in the future, children should be taught to keep their ears as dry as possible. After swimming or showering, children should tilt their heads from side to side to allow water to drain out and towel their ears thoroughly. Kids should also be discouraged from using cotton swabs in their ears and should keep other foreign objects such as pencils and fingertips out of there as well.
Commercially made ear-drying drops are available but should be avoided with active infection, perforation of the eardrum or in children with tympanostomy tubes. Parents can make their own ear solution by mixing equal parts rubbing alcohol and white vinegar. Ear plugs can also help keep water from causing ear canal infections. Fancy-fitted ones are available from ear nose and throat specialists, though while these may be warranted for professional swimming athletes, a good old wad of cotton smeared with Vaseline will do the trick as well.
Swimming is a great aerobic activity and keeps kids moving and having fun. With a few precautions, swimmer's ear won't get in the way of a great summer diversion.
Carolyn Roy-Bornstein, MD
Carolyn Roy-Bornstein is a practicing pediatrician and author of the new memoir CRASH! due out in September 2012. You can read more of her work at www.carolyn-roybornstein.com.
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|Title Annotation:||Pediatric Points|
|Publication:||Pediatrics for Parents|
|Date:||May 1, 2011|
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