Ear infections are most commonly associated with children. However, according to the NHS, otitis externa is also regularly found in adults aged 45 to 75. Read on to find out what otitis externa is, what causes it, and how it is best treated.
What Is Otitis Externa?
Otitis externa is an outer ear infection that affects the ear canal. The outer canal becomes inflamed, leading to pain and discomfort. Otitis externa is considered an acute infection and will usually last no longer than 3 weeks. You may hear otitis externa referred to as ‘swimmers ear’. This is because it is common among regular swimmers as water in the ear can be a main cause of otitis externa.
Signs And Symptoms Of Otitis Externa
There are a number of symptoms of otitis externa to look out for.
- Pain in the ear
- Itching and irritation in the ear canal or around the outside of the ear.
- Visible redness around your ear
- A feeling of fullness or pressure in the ear
- Dry, flaky or scaly skin in and around the ear
- Discharge coming from the ear
- In some cases, those with otitis externa experience hearing loss
Otitis externa usually only occurs in one ear, although this does not mean it can’t happen in both. Some patients also have swollen glands accompanying the ear infection.
These are all symptoms to look out for if you suspect you have otitis externa.
What Causes Otitis Externa?
Otitis externa is mostly caused by germs getting into the ear. The ear canal is a small, warm space and so is a perfect area for germs to grow. Otitis externa can be caused by skin conditions like eczema or psoriasis, but this is less common. Factors that contribute to acute otitis externa are:
1. Swimming and water
If the ear canal gets wet and does not dry out adequately, excess moisture in the ear canal can cause bacteria to grow and thrive. This is where the term ‘swimmer’s ear’ comes from, as swimmers are frequently underwater and therefore more prone to infection. Otitis externa can also be worse in hot climates because the heat and perspiration encourage bacteria to grow.
2. Excess ear wax
A build-up of earwax can cause otitis externa because water can become more easily trapped in the ear canal when there’s too much wax.
This can explain why otitis externa is more common in adults aged 45 to 75. As we age, our ears become drier and wax is able to build up more easily causing blockages that can lead to otitis externa.
3. Cotton buds
Cotton buds are not effective at removing ear wax and can actually push it in further. By pushing the ear wax further down the ear canal, you encourage a build-up. This build-up is then a risk factor for otitis externa. Choosing other methods, like microsuction, is a more long-term and effective solution.
4. Foreign substances in the ear
Getting anything in the ear that shouldn’t be there can cause itching or irritation. Things like shampoo, hair spray or moisturiser might make their way into the ear canal. If you then try to itch or relieve the irritation in your ear, you potentially damage the skin in the ear canal, which could lead to an otitis externa infection.
Ear syringing is a traditional way of removing a build-up of ear wax. It involves flushing water into the ear canal to push the ear wax out. As well as the obvious implications of putting excess water directly into the ear, syringing can leave too little ear wax in the ear canal and the ear cannot then effectively clean itself. If the ear cannot clean itself, there is a higher risk of infection.
6. Otitis Media
A middle ear infection, or otitis media as it is also known, can lead to otitis externa when too much discharge gets stuck in the ear canal. You can therefore have otitis media and otitis externa simultaneously, which can be very uncomfortable and unpleasant.
Otitis Externa Treatment
Otitis externa can usually be diagnosed on sight without the need for any tests. You can get over-the-counter ear drops without a prescription to treat the infection. Look for ones containing acetic acid as this helps to kill the infection.
Over-the -counter treatments should be sufficient for acute otitis externa that is still manageable. If symptoms persist or you get recurrent bouts of otitis externa, known as chronic otitis externa, then you may need one or more of the following:
- Prescribed ear sprays or ear drops that contain an antibiotic
- Painkillers to ease the discomfort while the antibiotics get to work
- An ear wick inserted into the ear with treatment drops that stays in for 2-3 days while the infection clears
- Antibiotics taken orally and usually in tandem with ear drops
- Microsuction to remove a build up of wax that is continuing to cause otitis externa
Otitis externa rarely clears up on its own. It is best treated at the onset of symptoms and should resolve itself quickly once treatment starts.
Malignant Otitis Externa Or Necrotising Otitis Externa
Malignant otitis externa, also known as necrotising otitis externa, is an extremely rare advancement of the infection. The infection spreads to the bone beside the ear. This then causes swelling, significant discharge and pain. You will need a long course of antibiotics to clear up malignant otitis externa. It generally only happens to people with low immune systems and is not a common complication of otitis externa.
Preventing Otitis Externa with Ear Care Clinic
In certain circumstances, an excess of ear wax is a contributing factor for otitis externa. Therefore, for people prone to large wax impactions, making sure ear canals are clear is one of the best ways to prevent otitis externa from occurring. It is particularly advised if you have recurrent episodes of otitis externa. Microsuction is the safest and most effective way to remove ear wax build-up. It can also be performed when you already have otitis externa. By removing wax from the ear canal, ear drops are more effectively able to penetrate the affected area.
Ear Care Clinic is part of a growing network of microsuction clinics located in convenient spots across London and Kent. Please contact us if you need any more information or advice about microsuction and otitis externa. Microsuction can even be performed on the same day that you book your appointment.