With summer full swing, we are seeing swimmer’s ear more commonly. It is not one of your major illnesses, but it is an important cause of ear pain in kids. They are in the pools because of the heat and enjoying the water while at camps and other activities. So, the setting is ripe for a rise in the incidence of swimmer’s ear, also known as a form of otitis externa or outer ear infection.
Understanding Swimmer’s Ear
Swimmer’s ear is an inflammation of the skin of the ear canal. It is not an infection behind the eardrum, as seen in otitis media, or the classically defined middle ear infection. Most often moisture in the ear canal makes it hospitable for bacteria to grow and inflame the skin of the ear canal. Frequent swimming or playing in pools and other bodies of water allows a steady supply of moisture to accumulate in the ear canals, creating the perfect environment for a particular form of otitis externa, or swimmer’s ear as it is more commonly known.
The typical symptom of the classic swimmer’s ear is ear pain. But, this differs from the typical ear infection as the ear pain is exacerbated by touching the outer ear, particularly at the tragus, or pulling on the ear. This manipulation deforms the ear canal transiently to cause stress on the skin surface of the ear canal. As the ear canal is inflamed, this movement causes pain. Just as you would have pain if you touched or pulled on your skin after sustaining a scrape or cut on your hand, movement of the ear canal causes a similar discomfort. With traditional ear infections of the middle ear, there is ear pain, but it is not exacerbated by touching the outer ear in any way.
Escalation of Inflammation: Potential Consequences
As with any illness or injury, the condition has a spectrum of severity. Most swimmer’s ear conditions are mild. There is discomfort, and the findings on the exam include ear pain with touching the tragus or pulling on the ear and a mildly pink or red color change to the ear canal, usually regular skin color. Occasionally, there is a little buildup of debris in the canal that is the result of skin inflammation and discolored or bloody discharge from the ear. However, as time goes on and it remains untreated, the ear canal's inflammation can worsen. The skin in the canal becomes more swollen and more inflammatory debris accumulates. As this happens, the canal itself becomes more and more narrow. Occasionally, the canal becomes obstructed entirely by swelling and debris.
Why is this narrowing a problem? Well, the mainstay of treatment of swimmer’s ear is inserting antibiotic or antibiotic/steroid combination liquid ear drops into the canal. When the medication comes in contact with the skin of the ear canal, the superficial infection and inflammation are treated and the condition resolves. However, if the canal is extremely narrowed or completely obstructed by swelling and inflammatory debris, then the medication drops cannot pass and spread the length of the ear canal to treat the condition.
In these severe cases of swimmer’s ear, a special fiber wick is placed through the narrowed or obstructed ear canal to contact the length of the canal. The purpose is to allow the medication to be absorbed through the entire length of the wick, once placed in the ear. As the antibiotic or antibiotic/steroid combination ear drops are placed into the ear, they are absorbed into the wick, and the medication is spread along the length of the canal via the wick. As the medication comes in contact with the infected and inflamed skin, it starts to reverse the process, the swelling recedes, and the inflammation/infection resolves. The pain improves and the child feels better. The wick can be removed after a couple of days or eventually falls out as the swelling reduces and the canal opens more.
Ensuring Continued Delight: Timely Treatment and Prevention
Swimmer’s ear is not one of the major, disabling illnesses of childhood. But, it is a source of pain and inconvenience for many kids. Just as they are enjoying their summer and staying cool in the pool, kids are suddenly struck by a condition that forces them to view all the fun from the sidelines. Preventing prolonged exposure of the ear canals to moisture by promptly removing water from the ear canals or preventing water from entering with earplugs can really save a child from contracting swimmer’s ear. However, if they do start suffering from swimmer’s ear, prompt treatment is the key to sparing them from the unintended side effect of interrupting their water play and ruining their vacation or camp experience.
With summer being a prime time for swimmer’s ear, what strategies have you found effective in keeping your kids’ ears dry while enjoying water activities?