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Outer Ear Infection or “Swimmer’s Ear” (Otitis Externa)

What is otitis externa?

Your child has otitis externa, or infection of the skin lining the ear canal. This infection may also be called “swimmers ear.” Excess water that stays in the ear canal after bathing or swimming can help bacteria or fungus grow. Attempts to clean wax from the ear canal, especially with cotton swabs, bobby pins, or other objects, can irritate or damage the skin and lead to infection. Hairsprays, hair dyes, shampoos, and other chemicals also may irritate the skin of the ear canal. Occasionally even the medicines that your doctor prescribes can further irritate the ear canal.

What you may see in you child:

Generally, this infection begins with mild symptoms before it becomes a severe earache. Symptoms of otitis externa may include:
  • Earache
  • Itching or a sense of fullness in the ear
  • Redness, swelling, and pain to the outer ear
  • A yellow, yellow-green, pus-like or foul-smelling discharge from the ear canal
  • Hearing loss
  • Ear noise or buzzing
  • Increase in pain while moving the ear, speaking, chewing, or yawning
  • Swollen glands in your child’s neck

Evaluation and treatment:

Your child’s ear may need to be cleaned by the doctor or nurse. You will get a prescription for ear drops that should clear up the infection within a few days. In some cases the doctor may put a cotton sponge or wick in your child’s ear to hold the ear drops in the canal.

If an infection of the middle ear, nose, throat, or lymph nodes is found, you may get a prescription for an antibiotic to be taken by mouth.

Home care instructions:

First, be sure to follow all instructions for any medications prescribed by your child’s doctor. If the doctor placed a wick in your child’s ear, you may be asked to remove it after 1 to 5 days, but continue to use the medications as directed.
  • Your doctor will tell you when it’s ok for your child to swim. Usually this is 10-14 days after treatment has finished.
  • Your child’s ear pain may increase for the first 12 to 24 hours after treatment begins
  • Use acetaminophen (Tylenol®) or ibuprofen (Motrin®) every 4-6 hours as needed for pain and fever. If over-the-counter medicines do not help, your doctor may order a prescription pain medicine for short term use.
  • Use preventive antiseptics or water repellents as directed by your child’s doctor.
  • Do not use cotton swabs or other small objects in your child’s ears for cleaning.
  • Keep ears clean and dry. Do not let water enter the ears when showering, shampooing, or bathing. You can use cotton ear plugs coated with petroleum jelly (remove after shower or bath).

Call your child's doctor if:

  • Your child does not feel better within 48 hours
  • Your child has a fever over 102 0 F that does not get better with Tylenol or Motrin
  • Your child develops a severe headache or pain around the ear which lasts in spite of treatment
  • The pain becomes worse after 24 hours of treatment
  • There is increased swelling around the ear
  • Your child’s ear looks swollen and bulges out from the side of his/her head

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 12/2008