Otitis externa treatment

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Otitis externa is an infection of the ear canal and is associated with inflammation, irritation, and pain in the ear. This infection is usually caused by bacteria (90% of cases) but can also be caused by fungal infections (10% of cases). It is a fairly common condition and affects 4 in 1,000 people annually in the U.S.(1). It is important, however, to seek medical care for otitis externa treatment because improper care can result in a more serious condition called malignant otitis externa, where the surrounding bones and tissues can also become infected and cause major damage to the area.


Often occurring after exposure to water, especially after swimming, this condition is often called swimmer’s ear. Although the nickname implies swimming is the precipitous factor, there are many causes for otitis externa. As mentioned, frequent exposure to water can allow bacterial or fungal colonization of the ear canal. In addition, excessive cleaning, injury, or other trauma can also instigate this condition. Skin conditions such as psoriasis, eczema, and even lupus can also allow an infection to ensue.


Otitis externa treatment varies from doctor to doctor and can depend on whether the patient is a child or an adult (1). Before any treatment can be attempted, any debris must be removed from the ear canal, but this should only be done by a medical professional! Normally, only topical treatment is necessary and drops consisting of diluted acetic acid, antibiotics or antifungals, or corticosteroids are given. A combination of either acetic acid and corticosteroids or antibiotics and corticosteroids are usually more effective than either treatment alone (2). The acetic acid, antibiotics, or anitfungals inhibits growth of the infective agent while the corticosteroids reduce the inflammation in the ear canal. If the inflammation is too severe to allow passage of the topical drops, a small wick can be placed in the ear to allow the medications to penetrate the canal. For more severe cases, like in the case of malignant otitis externa, an oral antibiotic may be necessary.

Normally, treatment for 5-7 days should be effective, but for more severe disease 10-14 day courses of drops may be necessary. The treatment should continue for 3 days beyond the end of symptoms to be completely effective. In addition, over the counter pain medications, like acetaminophen or ibuprofen, can be used to treat pain casued by inflammation.


The otitis externa treatment outlines above is usually very effective in managing swimmer’s ear but it is important to seek medical help when trying to treat this condition, as complications can occur if not treated properly. To prevent a reoccurance of otitis externa, there are multiple things you can easily do at home. Most important is to keep ears clean and dry and, when swimming, either use earplugs to keep water out of the ear or use diluted alcohol or vinegar drops after swimming to help prevent bacterial growth. It is also very important to refrain from putting objects into your ears (this includes cotton swabs and your fingers!) as this can cause trauma to the skin in your ear canal and allow the perfect place for bacteria to live.

The information in this article should not be considered medical advice. Always check with your physician before taking any products or following any advice you have read on Brighthub.com.


(1) Journal of the American Academy of Physician Assistants

(2) Balen et al. Clinical Efficacy of three common treatments in acute otitis externa in primary care: a randomised controlled trial. BMJ. 2003 November 22; 327(7425): 1201–1205

Medline Plus, NIH and National Library of Medicine