Most children this summer will enjoy swimming with no problems, while some might develop otitis externa, or swimmer’s ear.
Swimmer’s ear is an infection involving the sensitive, skin-lined ear canal. This part of the ear produces wax that can help clean the canal, waterproof it and also provide an acidic pH giving it an antibiotic effect to help fend off infections.
Disruption to the healthy environment of the ear canal is the cause of swimmer’s ear. This usually occurs when the canal becomes wet and is subjected to mild trauma like cleaning with cotton swab, replacing a hearing aid or scratching. Moisture breaks down the protective layer of ear wax and leads to swelling of the canal skin, allowing bacteria to enter into the skin and cause inflammation and infection. The warmer summertime temperatures and swimming offer the perfect setting to develop swimmer’s ear. An infection can develop even after exposure to clean, chlorinated water of swimming pools.
A child complaining of ear pain, regardless of cause, should see a pediatrician. A history of recent swimming and/or manipulation of the ear canal will raise the suspicion of swimmer’s ear. It can sometimes be difficult to distinguish between swimmer’s ear and a middle ear infection, which is more common in cold weather months after an upper respiratory infection. If moving your child’s ear up and down causes pain, it is most likely swimmer’s ear.
Treatment of swimmer’s ear is usually handled by your child’s pediatrician; only complicated cases require a referral to an ear, nose and throat specialist (ENT), also known as an otolaryngologist. The most common treatment is the application of antibiotic eardrops. During treatment, swimming should be avoided and when bathing the canal can be protected with a petroleum jelly-covered cotton ball. Pain is the dominant symptom and can be treated with acetaminophen or ibuprofen.
If a child suffers with recurrent swimmer’s ear, preventive measures can be taken such as getting all water out of the ear after swimming and using over-the-counter swimmer’s ear drops to evaporate any residual water in the ear canal. The use of ear plugs is generally not recommended for the management of swimmer’s ear because this may cause mild trauma to the ear canal and can lead to impaction of ear wax.
If the proper precautions are taken your child can enjoy a fun and pain-free summer of swimming.
Dr. James Forsen, Jr. is a pediatric otolaryngologist at Mercy Children’s Hospital.