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*Sucharu Chris Prakash, MD*
Q: My eight year old recently started taking swim lessons and has already had swimmer’s ear twice. How can I tell if his ear pain is not a sign of ear infection or something more serious?
A: As the name suggests, swimmer’s ear usually happens in swimmers, and is an infection of the ear canal. It is different from the “ear infection” that kids usually get, which involves the ear space behind the ear drum (middle ear or otitis media).
The most common cause is water getting lodged in the ear canal (after swimming or bathing) which causes inflammation of the skin, and gets infected with bacteria. This process can occur fairly rapidly even over a few hours.
Lake water is the most likely culprit to cause an infection, followed by ocean water, bath water, then pool water.
So, how do you know if your child has swimmer’s ear or an ear infection? There are several clues that can help you with this, such as: 1) Recent exposure to water in the ear such as swimming or bathing. 2) Onset of ear pain soon after this exposure 3) There is usually no fever associated with swimmer’s ear. If the child has fever or cold symptoms along with the ear pain, it is likely not swimmer’s ear. 4) You can try the ear movement test – if there is pain when you pull on the outer ear or push on the anterior ear flap, or put pressure on the part of the face just in front of the ear, you are most likely dealing with swimmer’s ear.
The best treatment for swimmers ear is antibiotic ear drops. These are placed into the affected ear canal, let them stay for 10 minutes or so, and then you can let the fluid flow out onto a napkin. This may need to be done for a few days. There is no effective over-the-counter treatment, but tylenol or ibuprofen can help the pain.
It is also important to follow dry ear precautions for at least several days after the treatment is finished. You should avoid getting any water into the ear (ear plugs are not effective enough).
If your child gets several swimmer’s ear infections and seems prone to them, you can try some preventative measures such as: 1) Mix white vinegar and rubbing alcohol together, and place a few drops in each ear after swimming or other water exposure. 2) You can also use swimmers ear drops from the drug store. These help evaporate the water out of the ear, and may prevent getting swimmer’s ear infection.
If your child has a swimmer’s ear, and gets water in it, then use just white vinegar (and not the alcohol).
Based on the above information, if you are pretty sure that your child has swimmer’s ear, you can follow the above described measures. However, if in doubt it is always better to be examined by a doctor. If you start treatment for a swimmer’s ear, but do not see any improvement within two days, then you should go to the doctor. Also note that if the area behind the ear is swollen, red, and tender to touch, this may be a sign that an infection has spread into the bone behind the ear, in which case it may be an emergency. Most of the times, Swimmer’s ear is just an annoyance (and a painful infection!) but the good news is that it is easily treated and can be easily avoided.
This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.firstname.lastname@example.org