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Patient Education: Otitis Externa

What is an outer ear infection?

An outer ear infection is a condition that can cause pain in the ear canal. The ear canal is the part of the ear that goes from the side of the head to the eardrum (figure 1).

An outer ear infection is sometimes called “swimmer’s ear.” But an outer ear infection does not happen only in people who swim. People who do not swim can also get it.

What causes an outer ear infection?

An outer ear infection happens when the skin in the ear canal gets irritated or scratched, and then gets infected. This can happen when a person:

  • Puts cotton swabs, fingers, or other things inside the ear
  • Cleans the ear canal to remove ear wax
  • Swims on a regular basis – Water can soften the ear canal, which allows germs to infect the skin more easily.
  • Wears hearing aids, headphones, or ear plugs that can hurt the skin inside the ear

What are the symptoms of an outer ear infection?

The most common symptoms are:

  • Pain inside the ear, especially when the ear is pulled or moved
  • Itching inside the ear
  • Fluid or pus leaking from the ear
  • Trouble hearing

Is there a test for an outer ear infection?

No. There is no test. But your doctor or nurse should be able to tell if you have it by learning about your symptoms and looking in your ear. During the visit, your doctor might clean out your ear so that it can heal more quickly.

How is an outer ear infection treated?

Treatments can include:

  • Ear drops – Be sure to finish all the medicine, even if you feel better after a few days. When you use ear drops, you should:
    • Lie on your side or tilt your head
    • Make sure the ear drops go into the ear canal
    • Stay in the same position for 20 minutes (after the ear drops are in)
  • Medicines to relieve pain

What else should I do during treatment?

It is important to keep the inside of your ear dry while the infection heals. You should not swim for 7 to 10 days after starting treatment. But you can take a shower. To keep the ear dry during a shower, put some petroleum jelly (sample brand name: Vaseline) on a cotton ball, and then put the cotton ball in your outer ear, covering the opening of your ear canal. Do not push the cotton ball into the ear canal.

You should also avoid wearing hearing aids or headphones in the infected ear until your symptoms improve.

Should I see a doctor or nurse?

Call your doctor or nurse if:

  • Your symptoms get worse
  • Your symptoms are not better 2 days after starting treatment

Can an outer ear infection be prevented?

You can reduce your chances of getting an outer ear infection by:

  • Not sticking things in your ears or cleaning inside your ears – The inside of the ears do not usually need to be cleaned. It is normal to have some ear wax in your ears. Ear wax protects the ear canal. But if you are worried that you have too much ear wax, talk to your doctor or nurse. He or she can look in your ears and tell you how to clean them safely.
  • Following these tips if you swim a lot:
    • Blow dry or shake your ears dry after you swim
    • Use ear drops that can prevent infections after you swim
    • Wear ear plugs to prevent water from getting in your ears. Keep the ear plugs clean and get new ones if your ear plugs are too dirty or start to fall apart.