Outer ear infection (otitis externa)

Otitis externa is an infection that causes inflammation, which means redness and swelling, of the ear canal. That's the tube between the outer ear and the eardrum.

Most people know it as "swimmer's ear", because getting water in your ear regularly can make inflammation more likely.

Otitis externa, an infection of the outer ear, can cause these symptoms:

• ear pain
• itching and irritation in and around your ear canal
• redness and swelling of your outer ear and ear canal
• a feeling of pressure and fullness inside your ear
• scaly skin in and around your ear canal, which may peel off
• discharge from your ear, which can be either thin and watery or thick and pus-like
• tenderness when you move your ear or jaw
• swollen and sore glands in your throat
• some hearing loss

Usually, only one ear is affected.

With treatment, these symptoms should clear up within a few days. Some cases can persist for several months or longer.

Your pharmacist or doctor will ask about your symptoms. They'll also want to know whether you regularly put things into your ears, such as hearing aids or ear plugs. They may look inside your ear with an instrument called an otoscope.

If you get otitis externa often and treatment doesn't help, your doctor may take a swab from inside your ear. The swab is tested to check what type of infection you have, if any, so the right medicine can be prescribed.

Most cases of otitis externa are caused by a bacterial infection. But it can also be caused by:

• irritation
• fungal infections
• allergies

Some things make you more likely to develop otitis externa, including:

• damaging the skin inside your ear (for example, by scratching or picking your ear)
• regularly getting water in your ear (for example, by swimming)

Water in the ear can make you scratch inside it, and the moisture also gives bacteria an ideal place to grow.

Otitis externa is quite common. It's estimated that around 1 in 10 people will have it at some point in their lives.

It's slightly more common in women than in men, and doctors most often diagnose it in adults 45 to 75 years of age.

People with certain long-term (chronic) conditions are at greater risk of developing otitis externa. These include:

• eczema
• dermatitis

Otitis externa sometimes gets better on its own without any treatment, but that can take several weeks.

To help your symptoms and avoid complications from outer ear infection (otitis externa), there are a few things you can do:

• Try not to get the affected ear wet. If you aren't washing your hair, a shower cap while showering and bathing can help.
• Don't swim until the infection has fully cleared.
• Remove any discharge by gently swabbing your outer ear with cotton wool. Do not push cotton wool or a cotton bud inside your ear.
• Take out anything from the affected ear that may cause an allergic reaction, such as hearing aids, ear plugs and earrings.
• Use pain relief such as paracetamol or ibuprofen for the ear pain. These aren't suitable for everyone, so read the information leaflet that comes with the medicine first. If you're still unsure, check with your doctor, practice nurse or pharmacist.
• If a boil in your ear has caused the infection, placing a warm flannel or cloth over the affected ear can help it heal faster.

A doctor can prescribe ear drops for otitis externa, and they usually improve symptoms within a few days. A pharmacist can prescribe them too. There are different types of ear drops that may be used to treat the infection, and you usually use them several times a day for about a week.

If your symptoms are severe, or the treatment doesn't help, your doctor may refer you to a specialist for further treatment and advice.

You can do a few things to lower your chances of getting otitis externa.

• Think about wearing a swimming cap or using ear plugs if you swim regularly, but put the ear plugs in carefully, and don't use them if they irritate your ears.
• If earwax build-up is a problem, have a doctor or other health professional remove it.
• Keep your ears dry and clean.
• After you come out of the water, turn your head from side to side. This helps water drain out of your ears.

• do not insert cotton wool buds or other things into your ears (including your fingers), because this can damage the sensitive skin in your ear canal
• do not swim in polluted water

If you have outer ear infection (otitis externa), you should also try to avoid getting water, soap or shampoo into your ears when you have a shower or bath.