Swimmer’s ear – a playground for bacteria & fungi

It's the summer season and across all of South Africa beaches are filling up, pool covers are removed and the collective zeitgeist, especially amongst children, is all about cooling off and swimming.

By Dr Gary Kroukamp, Ear Nose & Throat (ENT) Specialist, MBChB (UCT), FCORL (SA)

When ears get wet and with the summer heat, we ENTs always see an uptick in ear canal skin infections, also known as otitis externa or ‘swimmer’s ear’. The features of swimmer’s ear are pain, blockage, a moist discharge and swelling of the external ear canal. Bacteria and fungi love a warm moist environment and flourish in these conditions, sometimes even together in the same ear canal in a kind of infectious mush.

The first symptom is usually a bit of an itch, which encourages fiddling in the ear and trying to scratch the canal with that instrument of all evil (in the ear anyway) – the ear bud.

As the bacteria and fungi flourish, so the pain and swelling increase, the infection then becomes full blown. The ear may block completely, and the pain can be excruciating.

Dr Gary Kroukamp is an Ear, Nose & Throat Specialist, practising from rooms at Life Kingsbury Hospital in Claremont, Cape Town. Dr Kroukamp’s interests include ENT conditions in children, cochlear implants, snoring, sinusitis and sinus surgery, ear disease, vertigo (balance) disorders, surfer’s ear, ear diseases or hearing loss – to name a few. His philosophy is underpinned by a patientcentred and family focused approach. 401 Kingsbury Medical Suites Wilderness Rd, Claremont, Cape Town T +27 (0)21 6740885 E garykroukamp@iafrica.com W www.entconsultant.co.za

How to treat swimmer’s ear

To treat the infection, one usually needs a combination antibiotic and steroid drop to kill off the bacteria, reduce the swelling and dry up the discharge.

It is important to diagnose a fungal infection as antibiotic drops won’t work (the fungi just laugh and laugh!) and one will need an antifungal treatment. In both cases cleaning the ear out thoroughly speeds up recovery but is best done by an ENT with a micro suction technique.

How to prevent swimmer’s ear

To prevent these infections in the first place, obviously keeping the ears dry would do so, but try telling that to a hot child, with a cool swimming pool beckoning...

Drying the ears out will help, either using a hairdryer or using an alcohol based swimmer’s ear drop to help evaporate the water. Regular swimmers can wear waterproof ear plugs to keep water out.

Bad habits can also cause swimmer’s ear

Certainly, there are some bad habits which make one prone to getting a swimmer’s ear. Those that probe their own ears with the evil ear buds, or other homemade devices, like bent hair clips or matches tend to cause self-inflicted infections. Other habits, like the regular use of noise protective ear plugs or in-the-ear style head phones increase the humidity and bacterial count. It might be better to use the external type headphones instead.

Those who are prone to wax should get their ears cleaned out before summer as the wax can trap water.

‘Surfer’s ear’ can also lead to swimmer’s ear

Cold water swimmers and surfers can develop ‘surfer’s ear’ – a condition where the bone of the ear canal grows inwards due to regular cold water immersion. The canal can narrow so much that the canal traps water every time their head goes under water.

Then the dreaded swimmer’s ear infection happens as the skin is soggy and bacteria and fungi start growing. If you’re prone to this, wear water-sport earplugs to keep the water out.

With these measures in place, we can reduce the incidence of the dreaded swimmer’s ear and enjoy carefree time in the water on the hot summer days coming up. Get out there! Have fun! 