Swimmer

itchy, painful ear canals
pain when earlobe is moved up and down
pain when tab of earlobe overlying ear canal is pushed in
currently in swimming or water sports

These symptoms occur when water gets trapped in the ear canal. The lining of the ear canal becomes swollen and prone to infection. Water exposure also can wash away protective cerumen (wax),which serves as a water-repellent coating for the skin of thecanal and provides antimicrobial properties.

Treatment includes antibiotic ear drops until symptoms are gone. Children should stay out of the water until symptoms are gone.

Prevention includes keeping ear canals dry.

After swimming dry ears and pull on earlobes while tipping head to side to help water run out. Use a towel to dry the ear, tiltthe head to each side in turn to allow water to drain from thedown-turned ear, and consider using a blow dryer set on the lowest heat and fan speed held several inches away from theear.

Alcohol-based ear drops after swimming (or each morning andevening) to reduce moisture content in the ear canal, correctthe ear pH and reduce bacterial growth has been recommended.Commercially prepared alcohol-based ear-drying solutions areavailable, or patients can make their own 1:1 mixture of rubbingalcohol and white vinegar. These drops should not be used inthe presence of ear tubes, tympanic membrane perforation oracute external ear infection.

Instruct patients and parents to avoid putting objects intothe ear canal, including fingers or cotton-tip swabs.

^{~AAP 2011}