Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2001;63(5):941-942

What is otitis externa?

Otitis externa (OE) is an infection of the ear canal. Because the canal is dark and warm, it can easily get infected with bacteria (germs) and fungus.

OE is different from the kind of infection you get in the middle part of your ear. The kind that you get in the middle of your ear is called otitis media.

What causes OE?

If you swim or shower a lot, too much water can get into your ears. Water removes the protective ear wax. Then it's easier for germs and fungus to grow. Cleaning your ears can remove the protective wax layer and lead to infection.

If you injure the skin in the ear canal by putting your finger or some object in your ear, an infection can develop in the canal.

Skin conditions that occur in other parts of the body, such as acne or psoriasis, can also occur in the ear canal and cause OE.

What happens if you have OE?

Your ear might itch. It might hurt very badly. The pain might get worse when your ear moves while you're chewing. The ear might feel plugged up. You might not be able to hear as well. Your ears might drain. See your doctor if any of these things happen. None of these things should last if you get treated.

How is OE treated?

The doctor will look in your ear canal and remove any drainage or pus. Your doctor will check your eardrum to make sure there's no other infection. Most OE infections can be treated with ear drops, but sometimes pills are needed.

How should I use ear drops?

Use your ear drops until all your symptoms have been gone for three days. Warm the bottle in your hands before putting the drops in your ear. Using warm ear drops may keep you from getting dizzy when the drops go in. Moving the earlobe back and forth after putting the drops in can help the medicine go deep into the ear canal.

How else can I help heal my infected ears?

Follow directions carefully and use all of the medicines that your doctor prescribes for you. OE can be hard to treat. Here are some general things that will help:

  • Keep your ear as dry as possible for seven to 10 days. Take baths instead of showers. Try to keep water out of your ears when you wash your hair. Don't swim or play other water sports. If you're on a swim team, ask your doctor before you return to swimming.

  • Don't put anything except the prescribed medicine in your ears. Scratching and rubbing will only make OE worse.

Symptoms are usually much better in three days. They should be completely gone in 10 days. If you're not better by then, call your doctor.

How can I prevent OE?

The best way to prevent OE is to keep the ear canal's natural defenses against infection working well. You can do this by:

  • Never putting anything in the ear canal (cotton swabs, paper clips, liquids or sprays, or even your finger). This can damage or irritate the skin. If your ears itch a lot, see your doctor.

  • Leaving ear wax in the canal. If you think your ear wax hurts or affects your hearing, see your doctor to be sure there's no other cause.

  • Keeping your ears as dry as possible. Use a towel to dry your ears well after swimming or showering. Help the water run out of your ears by turning your head to each side and pulling the earlobe in different directions. A hair dryer set on the lowest heat and speed can also help dry ears. Be sure to hold it several inches from your ear. If you swim or surf, use a bathing cap or wet suit hood to keep water out of your ears.

  • Not using earplugs. They can irritate the ear canal.

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