Part of the great Australian lifestyle is swimming – after all, it’s our national sport!
Whilst you shouldn’t be afraid of the water, there are risks related to ear health and hearing loss associated with swimming which we will discuss in this article. The type of risk depends a lot on the type of swimmer that you are. Jumping in the backyard pool every so often? Then it’s mostly swimmer’s ear that you need to worry about. Are you a serious ocean swimmer? If you get problems regularly then it’s likely that you have ear canal exostoses. And if you are a scuba diver…. well, where do we start?
Swimmer’s ear – what is it?
Swimmer’s ear is another name for otitis externa. It is an infection of the external ear canal that normally transmits sound down to your eardrum.
What causes swimmer’s ear?
Whether you swim in the ocean, a pool, lake, or the river you can be susceptible to swimmer’s ear. However sometimes it’s the things that people do to try and clear water from their ear canals that cause most of the problems. Some of the risk factors for developing swimmer’s ear include:
- Dirty water containing bacteria which can then enter the ear canal. Avoid swimming in lakes, harbours and the ocean after heavy rain.
- Trying to clean water from the ear canals using cotton buds, fingernails or other objects can damage the delicate skin of the ear canal and cause an infection.
- Narrow ear canals (which can be a long term complication of swimming).
- Excess wax accumulation.
What are the symptoms of swimmer’s ear?
Symptoms of swimmer’s ear include:
- A blocked ear.
- Pain – which can be exacerbated by pulling at the ear.
- Itchiness of the ear canal.
- Green or yellow pus in the ear canal that often has a foul smell.
How is swimmer’s ear diagnosed?
Swimmer’s ear is usually straightforward to diagnose by a simple examination where A/Prof McGuinness will check the appearance and condition of the ear canal with an otoscope. The discharge from the canal can be swabbed and cultured to determine which bacteria or fungus is responsible.
How is swimmer’s ear treated?
The treatment for swimmer’s ear is dependent upon the degree of the infection, and the type of infectious agent and may include:
Prevention
- Avoid Swimming in lakes rivers or the ocean after heavy rain. Heavy rain can often wash sewage into the water which contains bacteria and viruses that can infect your ears.
- Make sure the water in your home pool is clean and that bacterial loads are checked and within safe limits.
- If you swim a lot it is a good idea to get your GP to check your ears and make sure the canals are clear of wax.
- Wear ear plugs or a swimming cap to stop water getting into your ears.
- After a swim dry the outer part of the ear with a clean towel.
- DO NOT USE COTTON BUDS OR OTHER IMPLEMENTS to dry your ear canals as you will only push any wax deeper into your ear canals and potentially damage the skin of the canal leading to infection.
- If you find that your ear feels blocked after a swim using eardrops such as Aquaeze or EarClear, which contain wetting agents or acetic acid which helps to reduce the surface tension of any water in your ear and lets it drain naturally, will help
Treatment
If your ear gets blocked, painful and itchy after you swim then you likely have swimmer’s ear. You need to see an ENT specialist and have your ear carefully cleaned using microsuction. Ear syringing in these cases is likely to make the problem worse and is not advised. If the ear canal is swollen shut then your ENT specialist will insert a special wick into your ear canal to hold it open. Generally, swimmers ear is treated by combination steroid/antibiotic drops and usually responds in around 48 hours.
What are the complications of swimmer’s ear?
Complications can include:
- The development of chronic otitis externa. This is persistent infection of the ear canal often with itching and bouts of acute infection and pain.
- An ear canal abscess or furuncle. This results in complete ear canal blockage and intense pain. It will usually need to be drained surgically and a wick inserted.
- Facial Cellulitis. This is spread of infection from the ear canal to the surrounding facial skin. This is a serious infection and will often need intravenous antibiotics to clear.
What are ear canal exostoses?
These are bony growths in the deep part of the ear canal that are often seen in ocean swimmers. They grow quite slowly but can eventually block the ear canal leading to a conductive hearing loss. You may have canal exostoses if you swim a lot and find that the water does not clear completely from your ear canals. This trapped water can also become infected and cause swimmer’s ear with pain, blockage, itching and discharge. If you get frequent ear infections after swimming, then this may be the cause. Ear canal exostoses can be treated with a surgical procedure called a canalplasty which drills out the bony growths and restores the diameter of the canal.
What to do if you or someone you love develops swimmer’s ear
If you or a loved one develops swimmer’s ear, your family doctor will likely advise they will need to refer you to an Ear, Nose and Throat specialist. Once you have your referral, please contact our rooms and speak to our team regarding arranging a consultation with A/Prof McGuinness at our rooms at either St George or Campbelltown.