What are the causes of outer ear pain and swelling. How is outer ear infection diagnosed. What are the treatment options for ear pain outside. Why do some people experience recurrent outer ear infections. How can you prevent outer ear infections.

Understanding Outer Ear Infections (Otitis Externa)

Outer ear infections, also known as otitis externa or swimmer’s ear, affect the outer opening of the ear and the ear canal. This condition can cause significant discomfort, including pain, itchiness, and swelling. While it’s often referred to as “swimmer’s ear,” it can affect anyone, regardless of their swimming habits.

Otitis externa is distinct from otitis media, which affects the middle ear. People of all ages can develop outer ear infections, but they are most common in adults aged 45-75 years. Understanding the causes, symptoms, and treatment options for this condition is crucial for proper management and prevention.

Key Facts About Outer Ear Infections

• Can affect people of all ages, but most common in adults 45-75 years old
• Often caused by bacteria, but can also be due to fungal infections
• Symptoms include pain, itchiness, swelling, and sometimes discharge
• Treatment typically involves keeping the ear dry and using ear drops
• Preventive measures can help reduce the risk of recurrence

Common Causes of Outer Ear Pain and Swelling

Outer ear infections can be triggered by various factors. Understanding these causes can help in prevention and early intervention. Here are some of the most common reasons for outer ear pain and swelling:

Moisture and Water Exposure

Excessive moisture in the ear canal creates an ideal environment for bacterial and fungal growth. This is why swimmers and people who frequently expose their ears to water are at higher risk. Does frequent swimming increase the risk of outer ear infections? Indeed, it does. The constant exposure to water can wash away the protective earwax and allow microorganisms to thrive.

Mechanical Damage

Damage to the delicate skin of the ear canal can open the door to infections. This can occur from:

• Overzealous cleaning with cotton swabs
• Frequent use of earbuds or in-ear headphones
• Prolonged use of hearing aids

These practices can create micro-abrasions in the ear canal, providing entry points for pathogens.

Chemical Irritation

Various hair and skin care products can irritate the ear canal, making it more susceptible to infection. Products that commonly cause issues include:

• Shampoos and conditioners
• Hair sprays
• Hair dyes

The chemicals in these products can disrupt the natural protective barrier of the ear canal.

Skin Conditions and Allergies

Certain skin conditions and allergies can increase the likelihood of developing outer ear infections. These include:

• Dermatitis
• Psoriasis
• Eczema
• Acne
• Asthma
• Hay fever

These conditions can make the skin more vulnerable to infection and inflammation.

Anatomical Factors

Some people are more prone to outer ear infections due to the shape of their ear canals. Narrow ear canals can impede proper drainage, creating a moist environment that bacteria and fungi thrive in. Can the shape of your ear canal increase your risk of infections? Absolutely. Individuals with narrow ear canals may need to take extra precautions to keep their ears dry and clean.

Recognizing the Symptoms of Outer Ear Infections

Identifying the symptoms of an outer ear infection early can lead to prompt treatment and faster relief. While symptoms can vary, there are several common signs to watch for:

Pain and Discomfort

One of the most notable symptoms is ear pain, which can range from mild to severe. The pain may:

• Worsen when moving the ear or jaw
• Feel sharp or throbbing
• Increase in intensity over time

Is ear pain always a sign of infection? While ear pain is a common symptom of outer ear infections, it can also be caused by other conditions, so it’s important to consider other symptoms and consult a healthcare provider for an accurate diagnosis.

Itchiness and Irritation

Many people with outer ear infections experience significant itching in and around the ear canal. This itchiness can be intense and may lead to scratching, which can further damage the skin and exacerbate the infection.

Swelling and Redness

The ear canal and surrounding area may become swollen and red. In some cases, this swelling can be visible to others and may cause the ear to appear slightly different from the unaffected ear.

Skin Changes

The skin inside and around the ear may undergo changes, including:

• Peeling or flaking
• Feeling dry or scaly
• Appearing thickened or rough

These skin changes can contribute to discomfort and may indicate the severity of the infection.

Discharge

In some cases, fluid may drain from the ear. This discharge can vary in appearance and may:

• Be clear, yellowish, or greenish
• Have an unpleasant odor
• Indicate a more severe infection if present

Should you be concerned if there’s discharge from your ear? While some discharge can be normal, especially after swimming, persistent or foul-smelling discharge warrants medical attention.

Hearing Changes

Outer ear infections can sometimes affect hearing. You may experience:

• Muffled sounds
• Difficulty hearing clearly
• A feeling of fullness in the ear

These hearing changes are usually temporary and resolve with treatment of the infection.

Diagnosing Outer Ear Infections

Proper diagnosis of an outer ear infection is crucial for effective treatment. Healthcare providers use several methods to identify and assess the condition:

Medical History and Symptom Review

Your doctor will likely begin by asking about your symptoms, their duration, and any factors that may have contributed to the infection. They may inquire about:

• Recent water exposure
• Use of ear cleaning tools or products
• History of ear problems or allergies

This information helps paint a comprehensive picture of your condition.

Physical Examination

A thorough examination of the ear is essential for diagnosis. Your doctor will:

• Look into your ear canal using an otoscope
• Check for signs of swelling, redness, or discharge
• Gently touch the outer ear and surrounding area to assess pain and swelling

How does a doctor determine if you have an outer ear infection? Through a combination of your reported symptoms and the physical signs observed during examination.

Laboratory Tests

In some cases, especially if symptoms are severe or recurrent, your doctor may take a swab of your ear canal. This sample is sent to a laboratory for:

• Identification of the specific bacteria or fungus causing the infection
• Determining which antibiotics will be most effective (if bacterial)

These tests can be particularly helpful in cases of chronic or treatment-resistant infections.

Treatment Options for Outer Ear Pain and Swelling

Treating outer ear infections involves a combination of medical interventions and self-care measures. The goal is to eliminate the infection, reduce symptoms, and prevent complications.

Ear Drops

Ear drops are often the primary treatment for outer ear infections. They may contain:

• Antibiotics to fight bacterial infections
• Antifungals for fungal infections
• Steroids to reduce inflammation and swelling

How long does it typically take for ear drops to work? While improvement can be noticed within a few days, it’s important to complete the full course of treatment as prescribed, usually about a week.

Cleaning the Ear

In some cases, your doctor may need to clean your ear canal. This procedure, known as debridement, involves:

• Carefully removing debris and discharge from the ear canal
• Using specialized tools to clean without causing further damage
• Preparing the ear for more effective medication application

This cleaning can provide immediate relief and improve the efficacy of ear drops.

Pain Management

Over-the-counter pain relievers can help manage discomfort associated with outer ear infections. Options include:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)

Always follow dosage instructions and consult with a healthcare provider if you have any concerns.

Addressing Underlying Conditions

If the outer ear infection is related to an underlying skin condition or allergy, treating these issues is crucial. This may involve:

• Topical or oral medications for skin conditions
• Allergy management strategies
• Lifestyle modifications to reduce irritants

Addressing these underlying factors can help prevent recurrent infections.

Self-Care Measures for Outer Ear Infections

In addition to medical treatments, several self-care strategies can help manage symptoms and promote healing:

Keeping the Ear Dry

Moisture control is crucial in treating and preventing outer ear infections. To keep your ears dry:

• Use a shower cap while bathing
• Avoid swimming until the infection clears
• Gently dry your ears after exposure to water

How can you safely dry your ears after swimming or bathing? Tilt your head to the side and gently pull on your earlobe in different directions to help water drain out. You can also use a hairdryer on the lowest setting, held at arm’s length, to dry the outer ear.

Avoiding Irritants

During treatment and recovery, it’s important to avoid anything that might irritate your ears:

• Remove earrings or other ear jewelry
• Avoid using headphones or hearing aids if possible
• Stay away from hair products that might enter the ear canal

These precautions can help reduce irritation and promote faster healing.

Gentle Cleaning

While it’s important to keep the ear clean, aggressive cleaning can cause more harm than good. Follow these guidelines:

• Use a soft cloth to clean only the outer part of the ear
• Avoid inserting anything into the ear canal, including cotton swabs
• Let any excess water or medication drain out naturally

Is it safe to use cotton swabs to clean your ears? No, cotton swabs can push debris further into the ear canal and damage the delicate skin, potentially worsening the infection.

Preventing Recurrent Outer Ear Infections

While not all cases of outer ear infections can be prevented, several strategies can reduce your risk of recurrence:

Water Protection

If you’re prone to outer ear infections or spend a lot of time in water:

• Use earplugs or a swim cap when swimming
• Dry your ears thoroughly after water exposure
• Consider using alcohol-based ear drops after swimming to promote drying

These measures can help keep your ear canals dry and less hospitable to infection-causing organisms.

Proper Ear Cleaning

Maintaining good ear hygiene without overdoing it is key:

• Clean only the outer part of your ear with a washcloth
• Allow earwax to perform its natural protective function
• Consult a healthcare provider for safe earwax removal if necessary

How often should you clean your ears? For most people, cleaning the outer ear during regular bathing is sufficient. Avoid frequent or aggressive cleaning, which can disrupt the ear’s natural defenses.

Managing Underlying Conditions

If you have skin conditions or allergies that affect your ears:

• Follow your treatment plan diligently
• Keep follow-up appointments with your healthcare provider
• Be aware of any changes in your symptoms

Properly managing these conditions can significantly reduce your risk of outer ear infections.

Avoiding Irritants

Be mindful of products and practices that might irritate your ears:

• Choose gentle, hypoallergenic hair care products
• Avoid inserting objects into your ear canal
• Use caution with ear devices like headphones and hearing aids

Can changing your hair care routine help prevent ear infections? Yes, using gentler products and being careful to keep them out of your ears can reduce irritation and infection risk.

By understanding the causes, symptoms, and treatment options for outer ear infections, you can take proactive steps to maintain ear health. Remember, while many cases of outer ear pain and swelling can be managed at home, persistent or severe symptoms warrant professional medical attention. With proper care and prevention strategies, you can significantly reduce your risk of experiencing the discomfort of outer ear infections.

Outer ear infection (pokenga taringa)

An outer ear infection (pokenga taringa) affects the outer opening of your ear and the tube that runs from the outer ear to the middle ear (the ear canal). It causes pain, itchiness and swelling, so is sometimes called itchy ear. It is also known as otitis externa or swimmer’s ear.

Key points about outer ear pain and swelling

1. Outer ear infection or inflammation is also known as otitis externa or swimmer’s ear. It is different to otitis media, which affects your middle ear. 
2. It is often seen in swimmers or people whose ears are wet a lot of the time. Other causes include damage from cleaning, using earbuds or hearing aids, chemical irritation and infected hair follicles.
3. Symptoms can also be due to inflammation caused by an allergy or irritation.
4. People of all ages can be affected, but it most often occurs in adults aged 45–75 years.
5. Treatment options include keeping the infected ear dry and using ear drops.

What causes outer ear pain and swelling?

The most common cause of outer ear inflammation is an infection caused by bacteria, or less often, fungus. Your risk of getting an infection is increased if:

• Your ears are often wet. Dampness creates an ideal environment for bacteria and fungi to grow and make your ears more prone to infection.
• Skin damage. This could be from scratching, cleaning with cotton buds, or using ear buds, in-ear headphones or a hearing aid.
• Use of chemicals. These are found in products such as shampoo, conditioners, hair spray and hair dye that can irritate your ears, making them more prone to infection.
• Skin or allergic conditions. Such as dermatitis, psoriasis, eczema, acne, asthma or hay fever.
• Narrow ear canals. This stops water draining away easily.
• A health condition that affects your ability to fight infection. For example, diabetes or HIV or if you are undergoing certain treatments, such as chemotherapy.
• Infection of a hair follicle in your ear canal. This can cause a pimple or boil.
• Discharge from middle ear infections. Sometimes infections of the inner ear can produce a pussy discharge that gets stuck in the ear canal and this can cause an outer ear infection.

What are the symptoms of outer ear infection?

Often only one ear is affected. Symptoms affect your ear and surrounding area, including:

• ear pain or pain when moving your ear or jaw
• itchiness and irritation in or around the ear canal
• swelling and redness of the ear canal and surrounding area
• peeling skin inside and around the outside ear
• fluid from your ear, often with a bad smell
• hearing loss.

A very rare but dangerous complication is malignant otitis externa. This is the spread of infection to the bones of your ear canal and lower part of your skull. If you have an outer ear infection and experience strange symptoms, such as dizziness or muscular weakness in your face, seek immediate medical help.

How is an outer ear infection diagnosed?

Your doctor will ask you about your symptoms and examine your ear. If your symptoms keep returning, then a swab (using a sterile cotton wool bud) from your ear will be taken and sent to the laboratory for testing.

What is the treatment for outer ear pain and swelling?

Initially, your doctor will clean the affected ear and prescribe ear drops and recommend you follow simple self-care measures. Further treatment depends on the severity and cause of the infection or inflammation. For example, specific treatments for skin conditions such as dermatitis, psoriasis or eczema may be prescribed. 

Self-care for outer ear pain and swelling

• Try to keep the affected ear dry.
  • Wear a shower cap while showering and avoid swimming until symptoms have fully cleared.
  • If water gets into your ears, turn your head to the side and pull your earlobe in different directions to help the water drain out.

• Gently clean any discharge from the outer ear with cotton wool. Do not insert cotton buds in your ear.
• Remove anything from the ear that may cause irritation, such as earrings or hearing aids.
• Take pain relief such as paracetamol or ibuprofen if necessary and according to medical advice.
• If a boil is the cause, holding a warm cloth over the affected ear can provide relief.

Ear candles do not help outer ear infection and are not recommended for treatment as they may cause more injury to the ears.

Ear drops for outer ear pain and swelling

Outer ear infection can get better without ear drops, but this may take weeks. Ear drops can help speed up the healing process.  Ear drops usually need to be used several times a day for about a week.

For the treatment of mild discomfort of your outer ear, usually caused by water in the ear, you can get ear drops from your pharmacy, such as Vosol^®. Other ear drops need to be prescribed by a doctor, such as:

• eardrops that contain antibiotics to treat infection, for example, Soframycin^®
• antibiotic eardrops combined with a steroid to reduce the inflammation (swelling) associated with the ear infection, for example, Ciproxin HC^®, Sofradex^®, Locacorten-Vioform^®and Kenacomb^®.  

Read more about eardrops.

Return to the doctor or nurse if things don’t settle. If problems with outer ear infection or inflammation are ongoing, your doctor may refer you to an audiologist or an ear specialist for further assessment and treatment.

How can outer ear pain and swelling be prevented?

It’s not always possible outer ear infection or inflammation, but there are things you can do to reduce your risk of developing the condition.

• Dry your ears thoroughly with a towel to remove water, sweat or moisture. Use a hair dryer on low to gently dry the ear canal. Don’t use the corner of a towel.
• Avoid damaging your ears by not putting anything inside your ear canal, including cotton wool buds.
• If you swim regularly, use a swim cap that covers your ears or use earplugs (inserted gently to avoid damage) to help prevent water getting into your ears.
• Give your ears a break from ear devices such as earplugs, hearing aids and in-ear headphones.
• Treat and prevent other conditions that may be triggering otitis externa, such as allergies, dermatitis, psoriasis and eczema.

Learn more about outer ear pain and swelling

Otitis externa DermNet New Zealand, NZ, 2005

Reviewed by

Dr Angus Shao is an ear, nose and throat consultant at North Shore Hospital, Waitematā DHB, and in private practice. Angus returned to Auckland in 2017 to provide specialist service as a fellowship-trained rhinologist and rhinoplastic surgeon. He has a broad interest in general ENT and paediatric ENT. He also specialises in surgery for nasal and paranasal disease, chronic sinusitis and rhinitis, and functional and cosmetic rhinoplasty. Angus is fluent in Mandarin and is interested in improving Asian health in Auckland.

References

1. Swimmer’s ear Better Health Channel, Australia, 2014
2. Otitis externa Patient Info, UK, 2016

Management of otitis externa

The following advice is from the Antibiotics guide – otitis externa BPAC, NZ, 2017:

• First-line management is gentle cleansing of the external ear canal, e. g. with suction, a wick or probe. If signs of infection persist after thorough cleansing, a solution containing an anti-infective and a corticosteroid may be considered. Underlying chronic otitis media should be excluded before treatment.
• Most topical antibacterials are contraindicated in the presence of a perforated drum or grommets; they may, however, be used with caution if cleansing of the ear canal alone has been unsuccessful in resolving symptoms.
• Antibiotic treatment (topical) should only be considered if secondary infection is present.
• Patients with acute infection should be advised to avoid immersing their ears while swimming or to wear a protective cap.

The following advice is from the Auckland HealthPathways, NZ, 2018:

• If any red flags, especially if patient has diabetes or is immunocompromised, consider malignant otitis externa with progression to skull base osteomyelitis and request acute ENT/Otolaryngology assessment.
• Treat with ear drops depending on the severity and suspected cause of the otitis externa, although studies have not shown any difference between the different types of ear drops. Eardrop options include topical acidifying agents, glucocorticoids, antibiotics, antifungals, and combination treatment.
• Explain how to use the ear drops properly:
• Mild otitis externa 2% acetic acid drops (Vosol) or 2% acetic acid mixed with 1% hydrocortisone. Apply 5 drops three times a day until symptoms resolve. Review after 1 week.
• Moderate to severe bacterial otitis externa Use an antibiotic and steroid drop such as Sofradex (about $11), 5 drops three times a day. Aim to fill the ear canal each time. Use for 3 to a maximum 5 days after symptoms resolve. Review after one week. More severe infections may need review by the ear nurse. If initial drops fail, seek ENT/Otorlaryngology advice or ear nurse advice.
• Moderate to severe fungal otitis externa Locorten Vioform 5 drops four times a day for 5 to 7 days. Review after 1 week. Be aware that this ear drop can stain hair, clothes and bed linen. Cleaning the ear canal is very important in fungal infection. If there is a lot of debris that is difficult to remove, the patient may require referral to the ear nurse for cleaning.

• If there is also a perforation of the tympanic membrane present secondary to acute otitis media, it is still advisable to use ear drops such as Sofradex to treat the otitis externa, but be aware of the small risk of damage to the inner ear.
• Give systemic analgesia if needed.
• Advise the patient to keep the ear canal dry for at least 14 days by avoiding water sports and wearing earplugs or a shower cap in the shower.
• If the patient is febrile, systemically unwell, or cellulitis is present, consider oral antibiotics and request acute ENT/Otolaryngology assessment.
• If recurrent otitis externa causing significant morbidity, or chronic otitis externa is not responding to recommended treatment, request non-acute paediatric ENT/Otolaryngology assessment (patient aged ≤ 15) or non-acute ENT/Otolaryngology assessment.
• If the patient is prone to repeat infections, advise them about prevention of recurrence.

Continuing professional development

Common ENT infections – Bruce Arroll (21 minutes)
(PHARMAC, 2019)

For more videos of the same series, visit PHARMAC seminars.

Regional HealthPathways NZ

Access to the following regional pathways is localised for each region and access is limited to health providers. If you do not know the login details, contact your DHB or PHO for more information: 

Outer Ear Infection – Causes, Symptoms, Treatment, Diagnosis

The Facts

The ear is divided into three separate compartments: the inner, middle, and outer ear. The inner ear contains the balance organs and the nerves vital to hearing. The middle ear contains the bones that link the eardrum to the inner ear. The eardrum separates the middle and outer ears. The outer ear is simply the earlobe and a short tube leading to the eardrum.

Infection of the inner ear is called labyrinthitis. Infection of the middle ear is called otitis media. It can cause temporary hearing loss and can progress to the inner ear if ignored. Infection of the outer ear is called otitis externa or swimmer’s ear. It’s rarely serious.

Outer ear infections can be acute (short-term) or chronic (lasting 3 or more months) and are more common in children 7 to 12 years of age. Outer ear infections also more commonly affect people in warm and humid climates, people who swim, and people who use devices that protect hearing.

Causes

Swimming isn’t the only way to get an outer ear infection. You can also be infected if hairspray or other liquids get into the ear canal. The bacteria (and occasionally fungi) that cause an outer ear infection don’t necessarily live in the water. Many of them are already in the ear canal or are picked up in everyday life. However, water or other foreign liquids in the ear can provide an ideal breeding ground for them.

You can also trap bacteria in the ear by using cotton ear swabs. The skin of the ear canal slowly moves outward like a conveyor belt, carrying shed fragments of skin away from the eardrum. Pushing a cotton swab into the ear goes against this process, and causes dead skin and earwax to build up. Occasionally, scratching the ear canal can also promote infection. This tends to trap moisture in the ear. Moist skin and tissue create a friendly environment for bacteria and allow them to multiply, causing infection.

People with the following conditions get outer ear infections more easily:

• allergies
• eczema
• psoriasis
• seborrheic dermatitis (in which dandruff is the most common symptom)









Symptoms and Complications




The main symptoms of an outer ear infection are severe pain, itching, or redness in the ear and tenderness in the earlobes.

The tissue in front of and below the ear may become swollen and tender. There’s often a lot of earwax and skin debris in the ear canal. More severe bacterial infection sometimes causes yellowish pus to drain out. This may have an unpleasant smell. Fungal infections can create a grey-white pus.

Pus, wax, and skin debris may block sound waves from reaching the eardrum, causing temporary reduced hearing. This isn’t a sign of ear damage. Generally, you don’t need to worry about the infection spreading to the middle or inner ear, as the eardrum won’t let fungus and bacteria to pass through. The middle ear is usually only infected through the tubes that connect it to the throat (the Eustachian tubes). The eardrum itself is not as delicate as most people think.

Complications of outer ear infections are extremely rare, except in people with diabetes or with weakened immune systems. One of the ear’s main ways of defending against bacteria is the acidity of earwax. Unfortunately, earwax in people with diabetes is often quite alkaline. A low level of acid in earwax encourages particularly severe infections that can spread into the surrounding bone. This is called malignant otitis externa.










Making the Diagnosis




A doctor will check to see if pulling the earlobe gently or pushing the tragus, the small flap of ear just in front of the canal opening, causes pain. If these symptoms are present, you can be pretty sure it’s an external infection and not otitis media.

The doctor can often make the diagnosis simply by looking in the ear with an otoscope (an instrument for examining the ear).

A lab culture may be ordered to identify the particular organism only if the first treatment recommended by the doctor doesn’t seem to be working.












Treatment and Prevention




For most outer ear infections, your doctor will prescribe an eardrop that contains a combination of:

• an acidic solution to make the ear canal a less favourable environment for bacteria to grow
• a steroid to reduce swelling and inflammation
• an antibiotic or antifungal

Your doctor will first clear the debris out of the ear canal. In severe cases, if the canal is partly closed by inflammation, a wick can be inserted to draw the eardrops in. The wick expands and holds the medication close to the infected area in the ear. When using eardrops, warm them to body temperature by holding the container in your hand for a few minutes before putting the drops in.

For severe infections, antibiotics taken by mouth will be prescribed. Treatment of malignant otitis externa requires several weeks of antibiotics given into a vein.

To help ease the pain associated with an outer ear infection, pain relievers such as acetaminophen*, ibuprofen, or naproxen can be used. Talk to your pharmacist or doctor about which pain medication is best for you.

While you are being treated for an outer ear infection, don’t swim and keep water out of your ear.

To help prevent outer ear infections, it’s always a good idea to dry the ears thoroughly after showering or swimming. You can use a hair dryer set on the lowest setting. Never direct a shower jet directly into the ear canal. Also, don’t use cotton swabs to clean or dry the ear canal. To prevent outer ear infections due to swimming, wear a swimming cap or use over-the-counter ear drops with acetic acid or alcohol after swimming. Avoid ear plugs, as they actually can increase the risk of outer ear infections. If you or your child get recurrent infections, or if these preventative measures do not work, contact your doctor.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Outer-Ear-Infection

Four Ways to Spot the Difference

It’s summer, and the Land of 10,000 Lakes is a great place to swim and play. As your family enjoys the pools and lakes, make sure you know the difference between swimmer’s ear and a middle ear infection.  

Swimmer’s ear is an infection in the outer ear canal. It’s often brought on by water in the ear canal that remains after swimming, creating a moist environment where bacteria can grow. While it can affect anyone, swimmer’s ear is most common in children (because their ear canals are narrow) and during the
summer months (because of the increased use of swimming pools and lakes). Swimmer’s ear is not the same as a middle ear infection, which occurs behind the eardrum and is most often caused by a viral infection.  

Spot the symptoms of swimmer’s ear or a middle ear
infection

Symptoms of swimmer’s ear and a middle ear infection may appear the same to those unfamiliar with the differences. Here are four guidelines to help you understand the symptoms and determine why type of infection your child may have.

1. Determine where the pain is

With swimmer’s ear the pain is located in the outer ear canal, or the area near the ear opening, and increases when you pull on the earlobe. In a middle ear infection, pain is located in the inner ear, near the ear drum and will often increase with lying down, which can also cause
trouble sleeping.

2. Look for visible symptoms

If your child is experiencing ear pain, these signals are especially helpful: With swimmer’s ear, the outer ear may appear red and swollen and have a rash-like appearance. You may see your child frequently scratch at his ear or complain of an itchy ear. Also watch for a foul-smelling drainage
coming from the ear(s) bothering them. Symptoms to watch for with a middle ear infection include fever, pulling or tugging on the ear, decreased appetite, diarrhea or vomiting.

3. Check for difficulty hearing

Temporary hearing loss is a telltale sign for both a middle ear infection and swimmer’s ear, but it may be one of the first signs you notice.

4. Consider contributing factors

Did the ear pain start after a recent swim in a lake, pool or hot tub? Despite its name, you don’t have to swim to pick up swimmer’s ear. Simply cleaning your ears with a cotton swab or taking a shower or bath can also cause this condition. With a middle ear infection, your child may
exhibit signs of an upper respiratory infection, such as congestion, runny nose and watery eyes, in the days before the inner ear pain began.

Here is the infographic comparing swimmer’s ear vs ear infection in an alternative format.

Since swimmer’s ear is caused by germs that need water to survive, the best thing you can do to prevent an infection is to keep your ears dry.  Learn more about the simple ways you can prevent painful swimmer’s ear.

Treatment options for ear infections and pain

For relief of ear pain associated with swimmer’s ear or a middle ear infection, it’s OK to take an over-the-counter pain reliever like ibuprofen or Tylenol^® (be sure to follow the manufacturer’s directions for taking over-the-counter medication). A warm compress placed over the
affected ear can also relieve the pain from swimmer’s ear. You should consult with an expert to treat the cause of the infection.

Swimmer’s ear treatment

Swimmer’s ear can usually be treated in children and adults with an online visit, like
Allina Health Everyday Online. This is especially convenient if symptoms start while you’re away from home, after clinic hours or over the weekend, since most online clinics have 24-hour access. Whether you’re seen online or in person your provider will likely
prescribe antibiotic ear drops to treat swimmer’s ear.

Middle ear infection treatment

With
a middle ear infection, it’s best to have a provider examine your ear with an otoscope to look for signs of infection or blockages. For this reason you should be seen in person at urgent care, at a convenient care or walk-in clinic, or at your primary care clinic. If your provider
believes that bacteria may have caused the infection, she’ll prescribe an antibiotic. However, if a virus is causing the infection, an antibiotic won’t help, and you’ll have to treat the pain and wait for the infection to get better on its own.

More about When You Should Get Care About an Ear Infection.

Advocare Aroesty Ear, Nose & Throat Associates

Is this your symptom?

• Pain or discomfort in or near the ear

Some Basics…

• There are many causes of ear pain.
• In adults, swimmer’s ear (otitis externa) is more common than a middle ear infection (otitis media).
• Ear pain and stuffiness can occur during air travel. This happens because of rapid changes in air pressure.

Causes

Pain can come from the ear itself. Causes of this type of ear pain include:

• Ear pressure during travel: nearly everybody experiences ear pressure or pain during air travel. It mostly happens on take-off and landing. The medical term for this is barotitis media.
• Otitis media: this is a middle ear infection. It is more common in children than adults.
• Otitis externa: this is also called swimmer’s ear. It is an infection of the external ear canal. Swimmers and people who use Q-tips are more likely to get it.

Ear pain can also be caused by a disease outside of the ear. The ear shares nerves with other parts of the mouth and face. As a result, even though the ear is hurting, the problem can be from something else. Causes of this type of pain include:

• Severe toothache
• TMJ syndrome
• Tonsillitis

Pain Scale

• None: no pain. Pain score is 0 on a scale of 0 to 10.
• Mild: the pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
• Moderate: the pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
• Severe: the pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call for Earache

Care Advice

Mild Earache

1. What You Should Know:
   • There are many causes of ear pain.
   • You can treat mild ear pain at home.
   • Here is some care advice that should help.
2. Pain Medicine:
   • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   • Use the lowest amount of a drug that makes your pain feel better.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
   • Read the instructions and warnings on the package insert for all medicines you take.

3. Cold Pack: For pain, put a cold pack on the outer ear for 20 minutes. You can also use a wet washcloth. This will help with the pain as the drugs start to work. Some people like to use heat instead of cold for 20 minutes.

4. Avoid Earplugs: If pus or cloudy fluid is draining from the ear, wipe it away. Avoid plugging your ear with cotton. Pus can cause infection or more ear pain in the ear canal.

5. How It Is Spread: Ear infections are not contagious. They cannot be spread to other people.

6. Call Your Doctor If:
   • You think you need to be seen
   • You get worse

Earache During Air Travel

1. What You Should Know:
   • Ear pain and stuffiness can occur during air travel.
   • It happens because of rapid changes in air pressure. The change in pressure stretches the ear drum. This causes pain. The medical term for this is barotitis media.
   • There are many things you can do to help ear pressure and pain.
   • Here is some care advice that should help.
2. Treatment for Ear Pain – During Take Off:
   • Chew gum, or
   • Yawn, or
   • Swallow, or
   • Swallow while pinching nose.
3. Treatment for Ear Pain – During Landing:
   • Take a small breath, pinch off your nose. Try to gently blow out and force air through your pinched-off nostrils.
   • You should feel a slight clicking or popping in your ears as air moves into the middle ear.
4. Prevention: Using a nasal decongestant about 1 hour before take-off may help. These drugs shrink the swollen nasal passages. They open up the tube between the nose and ear. This helps bring ear pressure to normal. They can be taken as pills or as a nasal spray.
   • Pseudoephedrine (Sudafed): This is sold over-the-counter (OTC), but it is stored behind the drug store counter. You will need to ask the pharmacist or clerk for it. Normal adult dose is two 30 mg tablets every 6 hours.
   • Phenylephrine (Sudafed PE): This is sold OTC in pill form. Normal adult dose is one 10 mg tablet every 4 hours.
   • Phenylephrine nasal drops (Neo-Synephrine): Sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute and then spray a second time. Read all package instructions.
   • Do not take these drugs if you have high blood pressure, heart disease, or an enlarged prostate.
   • Do not use these drugs for more than 3 days.
   • Read the instructions and warnings on the package insert for all medicines you take.
5. Call Your Doctor If:
   • Pain does not go away
   • You think you need to be seen
   • You get worse

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

External Otitis (Acute) – Ear, Nose, and Throat Disorders

• Topical acetic acid and corticosteroids

• Sometimes topical antibiotics

In mild and moderate acute external otitis, topical antibiotics and corticosteroids are effective. First, the infected debris should be gently and thoroughly removed from the canal with suction or dry cotton swabs under adequate lighting. Water irrigation of the canal is contraindicated.

Mild external otitis can be treated by altering the ear canal’s pH with 2% acetic acid (or white vinegar) and by relieving inflammation with topical hydrocortisone; these are given as 5 drops 3 times a day for 7 days.

Moderate external otitis requires the addition of an antibacterial solution or suspension, such as ciprofloxacin, ofloxacin, or neomycin/polymyxin, (the neomycin component is highly sensitizing and allergy is common). When inflammation of the ear canal is relatively severe, an ear wick should be placed into the ear canal and wetted with Burow solution (5% aluminum acetate) or a topical antibiotic 4 times a day. The wick helps direct the drops deeper into the external canal when the canal is greatly swollen. The wick is left in place for 24 to 72 hours (or may fall out on its own), after which time the swelling may have receded enough to allow the instillation of drops directly into the canal.

Severe external otitis or the presence of cellulitis extending beyond the ear canal may require systemic antibiotics, such as cephalexin 500 mg orally 4 times a day for 10 days or ciprofloxacin 500 mg orally 2 times a day for 10 days. An analgesic, such as a nonsteroidal anti-inflammatory drug or even an oral opioid, may be necessary for the first 24 to 48 hours.

Fungal external otitis requires thorough cleaning of the ear canal and application of an antimycotic solution (eg, gentian violet, cresylate acetate, nystatin, clotrimazole, or even a combination of acetic acid and isopropyl alcohol). However, these solutions should not be used if the tympanic membrane is perforated, because they can cause severe pain or damage to the inner ear. Repeated cleanings and treatments may be needed to fully eradicate the infection.

Dry ear precautions (eg, wearing shower cap, avoiding swimming) are strongly advised for both external otitis and fungal external otitis. A blow dryer on a low setting can also be used to reduce the humidity and moisture in the canal.

A furuncle, if obviously pointing, should be incised and drained. Incision is of little value, however, if the patient is seen at an early stage. Topical antibiotics are ineffective; oral antistaphylococcal antibiotics should be given. Analgesics, such as oxycodone with acetaminophen, may be necessary for pain relief. Dry heat can also lessen pain and hasten resolution.

Outer Ear Infections – Glacier Ear Nose & Throat (ENT) Clinic

External Otitis Symptoms

The most common symptoms of external otitis include:

• Pain in the outer ear, especially when the ear is pulled or moved
• Itchiness or wet feeling of the ear
• Fluid or pus leaking from the ear
• Difficulty hearing

Is there a test for an outer ear infection?

No. There is no test. But your doctor should be able to tell if you have it by learning about your symptoms and looking in your ear. During the visit, your doctor might clean out your ear so that it can heal more quickly.

How is an outer ear infection treated?

1. Ear Drops – Ear drops kill germs and reduce pain and swelling. Be sure to finish all the medicine, even if you feel better after a few days. 
   • Lie on your side or tilt your head so gravity helps the drops get into the ear canal.
   • Pull your outer ear back, this straightens the ear canal, improving the delivery of the medication. Place the ear drops in the ear canal.
   • “Pump” the ear canal a few times by pressing on the tragus (small cartilage in the front of the ear) to disperse the drops.
   • Stay in the same position for several minutes (after the ear drops are in). This allows the medicine to stay in contact with the infected area.
2. Pain Medication – If you have bothersome ear pain, you can take a non-prescription pain medication.
3. Keep you ear dry – During treatment, you should avoid getting the inside of your ears wet. It is important to keep the inside of your ear dry while the infection heals and avoid swimming for several weeks after an infection or until your doctor indicates.  Typically, we recommend that “dry ear precautions” become a normal part of your routine.  It is common for these infections to re-occur because of moisture getting into the ear.
   • While showering, you can place a cotton ball coated with petroleum jelly or another ointment in the ear. Do not push the cotton ball into the ear canal.
   • You should also avoid wearing hearing aids or headphones in the infected ear until your symptoms improve. These tend to trap in moisture.
   • Use a hair dryer to evaporate moisture from your ear. Pull the outer ear back to straighten the canal, turn a hair dryer on low, place it 5-10 inches from the skin, and let it blow in the ear canal for several minutes daily.
4. Your physician may recommend the following:
   • Irrigate your ear canal liberally with a 1:1 mixture of rubbing alcohol and white vinegar. This can be done twice daily for active infections or every other day for maintenance.  Use a generous amount enough to fill the canal.  Let is sit for a few minutes then shake out the excess. Rubbing alcohol, isopropyl alcohol, is an antiseptic and evaporates quickly helping to removing water from the ear canals.  Vinegar, consists of 5–20% acetic acid.  The acidity makes it difficult for the harmful organisms to grow.  The volume of the liquid also mechanically helps flush out debris from the ear canal.  If you are using a medicated drop in addition, use the drop 30 minutes after any irrigation.  If this is painful stop and discuss with your physician.
   • Irrigate your ear canal liberally with hydrogen peroxide. Pull your ear back, tip your head over, or place a towel on your shoulder, and liberally flush out the ear canal.  Irrigate with a bulb, syringe, or medicine bottle that allows you to “squirt” the fluid into the ear canal.  Then “pump” the ear for 30-60 seconds to agitate the fluid and break up the wax.  Repeat the irrigation to flush out any wax or debris that was loosened up. The flush, pump, flush helps flush out wax or debris through the mechanical action.  Peroxide is also an antiseptic. If you are using a medicated drop in addition, use the drop 30 minutes after any irrigation.  If this is painful stop and discuss with your physician.

You should begin to feel better within 36 to 48 hours of starting treatment. If your pain worsens or does not improve within this time period, call your healthcare provider.

External Otitis Prevention

The ear is self-cleaning; fingers, towels, cotton-tipped applicators, and other devices should not be used to clean the inside of the ears.

If you feel that you need to clean excessive wax (cerumen) from your ears, talk to your healthcare provider first. Ear wax protects the ear canal.  It may be necessary to keep your ears dry for several months. If you swim frequently, experts recommend the following tips to reduce the chance of developing external otitis.

• Consider wearing ear plugs made for swimming.
• Use OTC ear drops or the alcohol/vinegar solution after swimming to prevent ear infections
• Blow dry your ears on a low setting, holding the dryer 12 inches away.

Otitis externa – Symptoms & Treatment from Healthily

What is otitis externa?

Otitis externa is a condition that causes inflammation (redness and swelling) of the external ear canal – the tube between the outer ear and eardrum.

Otitis externa is often referred to as “swimmer’s ear”, as repeated exposure to water can make the ear canal more vulnerable to inflammation (otitis externa is one of the most common conditions to affect competitive swimmers).

Symptoms of otitis externa include:

• ear pain, which can range from moderate to severe
• a discharge of liquid or pus from the ear
• some degree of temporary hearing loss

Usually only one ear is affected.

With treatment, these symptoms should clear up within two-to-three days.

In some cases the symptoms can persist for several months, which is known as chronic otitis externa. The symptoms of chronic otitis externa tend to be much milder.

Read more about the symptoms of otitis externa.

What causes otitis externa?

Repeated exposure to water increases your risk of otitis externa. This is because water can clear earwax out of the external ear canal, making it very itchy. If you try to scratch inside your ear, the sensitive skin of the canal can break down, allowing an infection to take place.

Water in the ear also creates a moist environment, which encourages bacteria to grow.

Other causes include:

• a spot (pimple) developing inside the ear
• a fungal infection
• something directly irritating the ear canal, such as a hearing aid or an ear plug

Read more about the causes of otitis externa.

Otitis externa treatment

If you think you may have otitis externa, see your doctor as it tends to last for several weeks if it is not treated.

Painkillers are used alongside eardrops to treat the underlying swelling and any infection.

In very severe cases of infection, antibiotics (that you take as a capsule, tablet or suspension that you drink), such as flucloxacillin, may be prescribed.

Read more about treating otitis externa.

Who is affected?

Otitis externa is relatively common. It is estimated that around 10% of the population will be affected at some point in their lives.

The condition is slightly more common in women than men (possibly because more women go swimming regularly).

People with certain long-term (chronic) conditions, such as eczema, asthma or allergic rhinitis, are at greater risk of developing otitis externa.

How to prevent otitis externa

If you are a regular swimmer, consider getting a swimmer’s hat to cover your ears and protect them from water. Ear plugs are not recommended as they can cause damage to your ear canals.

Make sure that you ear canals are clear of water after swimming, bathing or showering.

Read more about preventing otitis externa.

Complications of otitis externa

Complications of otitis externa are uncommon but some can be very serious.

A rare and potentially fatal complication of otitis externa is the infection spreading into the underlying bone – this is known as malignant otitis externa and may require surgery.

Read more about the complications of otitis externa.

What are the symptoms of otitis externa?

Most case of otitis externa are caused by inflammation (redness and swelling) of the external ear canal and will cause the following symptoms:

• ear pain
• a feeling of pressure and fullness inside your ear
• redness and swelling of your outer ear and ear canal, which can be very painful
• scaly skin in and around your ear canal, which may peel off
• discharge from your ear, which can be either thin and watery or pus-like
• itching and irritation in and around your ear canal
• tenderness when you move your ear or jaw
• swollen and sore glands (lymph nodes) in your throat
• some hearing loss

Otitis externa can develop as the result of a hair follicle becoming infected by bacteria – this then grows into a spot (pimple) or occasionally a boil. This is known as localised otitis externa.

You may be able to see the pimple or boil by twisting your ear up towards a mirror: it will often have yellow or white pus at its centre. (Do not attempt to squeeze the pimple or boil as this could lead to infection spreading elsewhere.)

Other symptoms include:

• severe ear pain, particularly when you move your ear
• occasional hearing loss, which can occur if the pimple or boil is obstructing your ear canal
• tender and painful glands behind your ears

Long-term (chronic otitis externa)

In some cases, for reasons that are not always clear, the symptoms of otitis externa can persist for several months and in some cases, years.

This is known as chronic otitis externa, which has a different pattern of symptoms, including:

• a constant itch in and around your ear canal, which is often the main symptom
• discomfort and pain in your ear which becomes worse when you move it – the pain is usually much milder compared to other types of otitis externa
• a thin and watery discharge that comes from your ear
• a lack of ear wax
• a build-up of thick, dry skin in your ear canal, known as stenosis, which can narrow your ear canal and affect your hearing

Discharge is when a liquid such as pus oozes from a part of your body.

Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Causes of otitis externa

There are several different causes of otitis externa, as well as a number things that make it more likely to occur. These are outlined below.

Bacterial infection

Bacterial infection is a common cause of acute otitis externa. The bacteria that cause the infection are usually either Pseudomonas aeruginosa or Staphylococcus aureus. In cases of chronic otitis externa, there may be an ongoing, mild infection, which is difficult to diagnose.

Seborrhoeic dermatitis

Seborrhoeic dermatitis is a common skin condition where the areas of your skin that are naturally greasy (sebaceous), such as the side of your nose, your forehead and your scalp, become irritated and inflamed (swollen). This may contribute to the development of otitis externa.

Middle ear infection

If you have had a middle ear infection, such as otitis media, your ear may have been producing discharge over a prolonged period of time. In some cases, the discharge may cause otitis externa.

Fungal infection

The type of fungus that can cause otitis externa includes the Aspergillus variety and the Candida albicans variety, which also causes thrush.

If you have been using antibacterial eardrops or aural corticosteroids (ear medication that relieves swelling) over a long period of time to treat another infection, you may develop a secondary fungal infection that can cause otitis externa.

Allergic and irritant reactions

Otitis externa can sometimes be caused by an allergic or irritant reaction to something that comes into contact with your ears, such as ear medication, ear plugs or shampoo. If you wear a hearing aid, you may find that it makes the inside of your ear sweaty, which sometimes can cause otitis externa.

Incomplete treatment

If you are being treated for acute otitis externa and you do not complete your treatment, you may go on to develop chronic (long-term) otitis externa.

Possible otitis externa triggers

The following things are not direct causes of otitis externa, but they may make developing the condition more likely.

Excessive moisture

You are more likely to get otitis externa if liquid gets into your ear canal. Water can wash away ear wax inside your ears making them itchy. If you scratch inside your ears, the skin can become damaged, making the external canal more vulnerable to infection.

Moisture also provides an ideal environment for bacteria (and to a lesser degree fungi) to grow. The link between exposure to water and otitis externa is why the condition is often referred to as “swimmer’s ear”.

Swimming (particularly in dirty or polluted water), sweating and humid environments may increase your risk of otitis externa.

Ear damage

Your ear canal is very sensitive and can easily become damaged through scratching, excessive cleaning, ear syringing and the insertion of cotton buds. You may also damage it by incorrectly or excessively wearing hearing aids, ear plugs or ear phones.

Chemicals

Your chances of getting otitis externa are increased if you use products that contain chemicals in or near your ears, such as hair sprays, hair dyes and earwax softeners.

Underlying skin conditions

As well as seborrhoeic dermatitis being a potential risk factor for otitis externa, underlying skin conditions such as psoriasis, eczema and acne can also increase your risk of developing the condition.

Allergic conditions

If you have allergic rhinitis or asthma, you may also be at a higher risk of developing otitis externa.

Weak immune system

If you have a condition that weakens your immune system, such as diabetes, HIV or AIDS, or if you have been having certain cancer treatments, such as chemotherapy, you may be at higher risk of developing otitis externa.

Inflammation Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

How is otitis externa diagnosed?

See your doctor if you think you may have otitis externa. They will ask you about your symptoms and whether you use any items that are inserted into your ears, such as hearing aids or ear plugs.

Ear examination

Your doctor may use an instrument that has a light at one end, known as an otoscope, to examine your outer ear (pinna) and your ear canal. They will check your ear for redness and inflammation (swelling).

During the examination, your doctor may also check for flaky skin, any visible sign of a fungal infection and whether or not your eardrum (tympanic membrane) is perforated (has a hole in it).

Ear swab

If you have recurring episodes of otitis externa or if medication that you have previously been prescribed hasn’t worked, your doctor may take a sample from your ear using an ear swab. This will help determine whether your infection is bacterial or fungal so that the appropriate medication can be prescribed.

Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some others are good for you.

What is the treatment for otitis externa?

There are various treatment options for otitis externa which can be broken down into three main categories:

• treatments you can use to help manage the symptoms at home
• treatments your doctor can provide
• treatments that a specialist can provide

Managing your symptoms at home

The advice below should help relieve symptoms (to a certain extent) and prevent complications.

• Avoid getting your affected ear wet. It can help to wear a shower cap while showering and bathing. Remove any discharge or debris by gently swabbing your outer ear with cotton wool, being careful not to damage it; don’t stick cotton wool or a cotton bud inside your ear as this could damage it.
• Remove anything from your affected ear that may cause an allergic reaction, such as hearing aids, earplugs and earrings.
• Use painkillers, such as paracetamol or ibuprofen, to relieve ear pain. However, don’t take ibuprofen if you are asthmatic or have stomach problems, such as stomach ulcers (past or present). If you’re unsure whether you should take it, check with your doctor, practice nurse or pharmacist. Children under the age of 16 shouldn’t take aspirin.
• Placing a warm flannel or cloth over the affected ear may also help to relieve pain.
• Avoid swimming until you are sure that the infection has passed.

Treatments your doctor can provide

While otitis externa can clear up by itself, this can take several weeks without treatment.

Your doctor can usually prescribe medicated eardrops that speed up the healing process. There are four main types of eardrops used to treat otitis externa:

• antibiotic eardrops – which can treat an underlying bacterial infection
• corticosteroid eardrops – which can help reduce swelling
• antifungal eardrops – which can treat an underlying fungal infection
• acidic eardrops – the acid can help kill bacteria

Sometimes you may be given medication that’s a combination of the above, such as antibiotic and corticosteroid eardrops.

Applying eardrops

Ear drops may not work as well if they are not used in the right way so it’s important to apply them correctly. Ideally, ask somebody else to apply the drops for you as this makes the process much easier.

You (or your helper) will need to follow these steps:

• Gently remove any discharge, ear wax or debris from your outer ear and ear canal using a twist of cotton wool (do not use a cotton bud).
• Warm the eardrops by holding them in your hands for a few minutes – cold eardrops can make you feel dizzy.
• Lie on your side with your affected ear facing up before applying the drops directly into your external ear canal and then gently push and pull your ear to work the drops in and to get any trapped air out.
• Stay lying down for 3-5 minutes to ensure that the eardrops do not come out of your ear canal.
• Leave the ear canal open to dry.

Other treatments

Other treatments your doctor can provide include:

• stronger prescription painkillers such as codeine for severe cases
• antibiotics tablets or capsules to treat a severe infection – an antibiotic called flucloxacillin is usually the preferred choice
• treatment for underlying skin conditions that may aggravate your otitis externa, such as seborrhoeic dermatitis, psoriasis or eczema
• if a boil develops inside your ear your doctor may decide to pierce it with a sterile needle and drain the pus; this is known as incision and drainage (never attempt to do this yourself)

Specialist treatment

You may be referred to a specialist if your symptoms are severe or they fail to respond to treatment.

One option is to remove earwax from inside your ears to help make eardrops more effective. This can be done in a number of ways, such as:

• syringing or irrigation, where water is injected through the nozzle of a syringe into the ear canal to dislodge and wash away any ear wax
• microsuction, where a small suction device is used to remove any ear wax, discharge and debris from your outer ear (pinna) and ear canal
• dry swabbing to gently mop out any ear wax from your ear canal

You may also need an ear wick, which is a soft cotton gauze plug covered with medication and inserted into your ear canal.

An ear wick allows the medication to reach the end of your ear canal. It should be changed every two or three days.

Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. Examples of antibiotics include amoxicillin, streptomycin and erythromycin.

Discharge is when a liquid such as pus oozes from a part of your body.

Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Can otitis externa cause other problems?

Complications associated with otitis externa are usually uncommon. However, the the following complications can sometimes occur.

Abscesses

Abscesses are usually painful, pus-filled growths that can form in and around the affected ear after an infection. They usually heal on their own but, in some cases, your doctor may need to drain the pus from them.

Stenosis of the ear canal

Stenosis is the name given to the build-up of thick, dry skin in your ear canal, which can occur if you have the condition chronic otitis externa.

It can affect your hearing because the build-up of skin makes your ear canal narrower. In rare cases, it can cause deafness. Stenosis of the ear canal can be treated using eardrops.

Inflamed or perforated eardrum

It is possible for any infection to spread to your eardrum.

In some cases, the infection may cause pus to build up inside your inner ear and may rupture (tear) your eardrum. This is know as a perforated eardrum.

Symptoms include:

• temporary hearing loss
• earache or discomfort
• a discharge of mucus from your ear
• ringing or buzzing in your ear (tinnitus)

In many cases a perforated eardrum will heal without treatment in around two months. If it shows no signs of healing after this time then surgery may be recommended.

Cellulitis

Cellulitis is a bacterial skin infection that can occur after otitis externa. It’s when bacteria, which normally live harmlessly on the surface of your skin, enter your skin’s deeper layers through damaged areas, such as those caused by otitis externa.

Cellulitis causes affected areas of skin to become red, painful, hot and tender to the touch.

Other symptoms include:

• feeling sick
• shivering
• chills
• a general sense of feeling unwell

Most cases of cellulitis can be treated with a seven-day course of antibiotics.

If cellulitis occurs in a person who was already very ill or who is very vulnerable to the effects of infection, they may need to be admitted to hospital as a precaution.

Malignant otitis externa

Malignant otitis externa is a serious but very rare complication of otitis externa, in which the infection spreads to the bone that surrounds your ear canal.

Malignant otitis externa usually affects adults more than children. In particular, adults who are immunocompromised (have a weakened immune system) have an increased risk of developing it. This includes people having chemotherapy treatment or who have a chronic (long-term) health condition, such as diabetes, HIV or AIDS.

If you have malignant otitis externa, you may have one or more of the following symptoms:

• severe ear pain and headaches
• exposed bone visible in your ear canal
• facial nerve palsy, where your face droops on the side of the affected ear

Without treatment, malignant otitis externa can be fatal. However, it can be effectively treated using antibiotics and surgery to remove any damaged tissue.

How to prevent otitis externa

You can take several steps to avoid otitis externa and prevent it from recurring. These are described below.

Avoid damaging your ears

• Don’t insert cotton wool buds or other objects into your ears. Wax works its way out naturally and cotton buds should only be used to sweep around your outer ear (pinna).
• If earwax build-up is a problem, have it removed by a healthcare professional.

Keep your ears dry and clean

• Don’t let water, soap or shampoo get inside your ears when you wash them. Wear a shower cap while you shower or bathe.
• After washing, dry your ears using a hairdryer on a low setting. Never push the corners of a towel into your ears to dry them because this can cause damage.
• If you swim regularly, wear a swimming hat that covers your ears or use ear plugs.

Treat and prevent other skin conditions

• If you develop otitis externa and you have an allergic disposition (a tendency to get allergies), tell your doctor or practice nurse. Eardrops that contain certain substances, such as neomycin or propylene glycol, are more likely to cause an allergic reaction than others. Your doctor, practice nurse or pharmacist can advise you about which eardrops are most suitable for you.
• If you have an allergic reaction to anything that is placed inside your ears, such as hearing aids, earplugs or earrings, remove the item. A mild allergic reaction will usually clear up on its own. Using hypoallergenic products (products that have a lower potential for causing allergic reactions) may also help.
• Seek medical advice for any other skin conditions, such as psoriasis or eczema, so they can be treated using the right medication.
• Try using acidifying eardrops or spray to help keep your ears clean, particularly before and after swimming. They may help prevent otitis externa recurring, and are available without a prescription in most pharmacies.

90,000 Otitis externa – effective treatment methods

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90,000 Parotid fistula: why the additional canal in the ear is dangerous

Parotid fistula is a rather unpredictable disease.In some cases, the anomaly may not bother a person throughout his life, and sometimes makes itself felt immediately after birth and threatens with severe complications. Alexander Mikhailovich Ivanenko, an otorhinolaryngologist at the Morozov Children’s Hospital with 25 years of experience in treating the disease, Ph.D.

How does the anomaly manifest itself?

Externally, the parotid fistula looks like a barely noticeable point at the curl of the auricle.With an atypical location, the mouth can be located anywhere in the auricle, including the lobe. But this is very rare. The fistula itself is an additional skin-covered passage of 1.5-2 cm in length, which has a sinuous structure. Sometimes the fistula bifurcates or ends in a thick cystic expansion. It can be formed both in one ear and in two at the same time.

What are the causes of the disease?

Congenital parotid fistulas are the most common developmental anomaly of the outer ear.Occurs in 15 – 43 children per 100,000, depending on the region. In 30% the disease is hereditary, in 70% it is sporadic, that is, it occurs from time to time. The appearance of a fistula is associated with abnormalities in the development of the fetus. The defect is formed at 9-11 weeks of intrauterine development. At this time, six ear tubercles are formed from I and II branchial arches, from which the structures of the auricle subsequently develop. Pathological processes during pregnancy (stress, respiratory diseases) lead to the occurrence of a defect.

Why is a parotid fistula dangerous?

The canal of the fistula is lined with skin containing sweat and sebaceous glands, therefore, the contents of a yellow-curdled consistency are accumulated and periodically released in it. When a bacterial infection is attached, an inflammatory process develops that spreads to soft tissues. Huge pyogenic ulcers are formed on the skin, reaching 5 cm in diameter. A cosmetic defect significantly reduces the child’s quality of life. If the cartilage of the auricle is included in the inflammatory process, perichondritis occurs, which leads to deformation of the auricles.

It happens that a congenital anomaly is misdiagnosed, mistaking it for other diseases: atopic dermatitis, eczema, osteomyelitis, skin tuberculosis and even systemic lupus erythematosus. Children often come to us after a long but ineffective treatment.

Can parents independently detect a parotid fistula in a child?

This is possible in most cases. It is necessary to carefully examine the child and understand whether he has a small hole at the base of the ear curl or not.If there is a hole, but it looks like a small puncture of a needle and does not bother the child, do not worry. The fistula is not dangerous and does not need to be removed. If the mouth turns red, a secret is released from the hole, discomfort or pain appears – it is necessary to treat the mouth with a solution of chlorhexidine and consult an otorhinolaryngologist.

How is a congenital anomaly treated?

As a rule, patients come to us for the first time with an exacerbation of the disease. We treat the abscess and prescribe elective fistula excision surgery.Surgical removal is performed only in the cold period, that is, not in the active phase of inflammation. Otherwise, complications may arise. It takes about one and a half months to restore the skin after removing the inflammatory process.

There is no age limit for the intervention. Our youngest patient was only three months old. Since birth, his fistula has inflamed twice.

How is the operation going?

The point of surgical treatment is to completely remove the entire fistulous tract.However, the surrounding tissue cannot be damaged. The method based on the property of diaphanoscopy helps to recognize and highlight the pathological zone. My colleagues and I developed and patented the method several years ago, and we are successfully applying it in practice.

During the operation, a sterile light guide catheter with a diameter of 0.75 mm is inserted through the orifice into the fistula canal. The catheter lights up and we accurately assess the length, shape and direction of the fistula, the presence of possible branches. Then we gradually isolate the fistula from the surrounding tissues.The operation lasts from 40 minutes to an hour. This is a low-traumatic intervention. Previously, children after surgery spent 7-10 days in the hospital, and now they are discharged for 3-4 days. There is no need to remove the stitches – we use absorbable suture material. If the child has a bilateral fistula, we simultaneously remove the pathology from both sides.

Every year we carry out from 20 to 30 such operations. Over the past years, a vast experience has been accumulated in the effective surgical treatment of congenital anomalies.

90,000 Why do my ears hurt after headphones?

The myth about the dangers of headphones for hearing is, of course, only a myth, but it has a true background. Many music lovers do not know the measure, especially when their favorite song is playing – how can you resist and not turn the volume up at full volume? But you can’t.

In this article, we will understand why your ears hurt from headphones and how to enjoy good sound without the threat of hearing loss.

Frequent Causes of ear pain from headphones

First, let’s figure out why the ears hurt after the headphones? Here the matter may be both in the design of the device itself and in the health of the music lover.After a little peeking in medical sources and wandering around audiophile forums, I can identify several reasons for discomfort :

• Unsuccessful design of the headphones themselves, anatomically inappropriate to the shape of your ear. I also include ear pads here, since they can be selected separately and improve / worsen the overall impression of using the technology.
• Twisted to the maximum volume . Ordinary speech is about 40–45 dB, screaming is 65 dB, it is perceived, of course, already uncomfortable.However, the favorite track is often made louder, and meanwhile the db increases. The critical value is 80 dB, listening at this volume for more than an hour every day, you can get serious health problems.
• Pain arises from the banal sulfur plug . It’s strange to say this, but no matter how punk you are, you need to clean your ears. If you listen loudly with a cerumen plug, unwanted pressure is created in the ear canal – and this can result in a clinical case.
• Outside or middle otitis media at an early stage .Here, discomfort can even be beneficial – consult a doctor and diagnose the disease in time.

And here are a few symptoms that make it clear that it’s time to to see a doctor at full speed :

• acoustic trauma, the speech of the wife, children and others seems to be illegible, there are false noises in the head;
• the volume has become not loud enough, sound vibrations are perceived worse;
• sounds from afar are difficult to distinguish;
• after removing the headphones, the head hurts;
• insomnia and irritability appeared.

As a rule, owners of headphones of certain designs suffer from this. Most often these are vacuum and intracanal, since they are located according to the principle of earplugs deep enough in the ear canal and completely isolate from the outside world.

I hope why the ears hurt from the earplugs (the popular name for in-ear models) is more or less clear. By the way, I wrote in this article how to choose a convenient design so as not to suffer later.

I will also add that using such models as earplugs is a deliberately bad idea.If the manufacturer has not stated that you can sleep in them, it is better not to do so, no matter how convenient it may seem.

Do your ears hurt from over-ear headphones? Of course, this also happens. In this case, case is in the wrong size of “cymbals” , unadjusted temples , or simply too hard ear cushions .

Tip: Do not hesitate to ask to try on in the store, take the softest and most comfortable models. Sometimes the discomfort does not appear immediately, but after a few days – it can be eliminated by choosing other ear pads, and in the case of an authorized dealer, return or exchange the defective model.

Prevention Headphone Ear Pain

The best solution to a problem is to anticipate and avoid it. So, observing a few simple recommendations, you can prevent a lot of bad things:

• listen to music at 3-4 volume levels, you will definitely have enough;
• it is better to do this no more than 1 hour a day with an economy class headset, however, if the equipment is of high quality, more is possible;
• headphones are not equal to earplugs, the exception is a specialized device declared by the manufacturer;
• Let your ears rest in silence at least once a day;
• do not try to completely isolate yourself from external noise, with too high a degree of noise reduction, you can lose your orientation in space;
• on-ear models are preferable to vacuum ones, as they do not close the ear canal and do not contribute to the accumulation of wax.

Of course, avoid disposable Chinese models for three dimes. Yes, cheap and cheerful, but it is low-quality equipment that is most often the cause of pain after headphones.

What to use then?

Can headphones hurt my ear if they are expensive? And there is a risk here, I don’t deny it. The main thing is to buy from a trusted seller with a guarantee, because the anatomy is different for everyone, and it is impossible to adapt to all ears in the world.

From the Bose brand, I can recommend several models from my top.There have never been any problems with these guys. We’re talking about Bose Headphones 700 and Bose QuietComfort Earbuds.

I’ll start with Bose Headphones 700 . These are on-ear headphones with a battery life of up to 20 hours. They have as many as 11 levels of noise reduction, which implies the ability to customize as conveniently as possible. By the way, you can walk in them all day and not feel tired – the manufacturer has thought through everything to the smallest detail, and the Alcantara ear cushions gently and unobtrusively take the shape of the ear, so that the model does not press or rub.

I wrote a review about Headphones 700, if you wish, you can look here.

What can I say about the Bose QuietComfort Earbuds ? This is an in-ear model. It works up to 6 hours, which is pretty good considering that the headphones are completely wireless.

Silicone ear cushions, the standard set includes large, medium and small sizes, so you can fit both a child’s and an adult’s ear. Also included is a butterfly mount that secures the earpiece securely to the outside of your ear.Thanks to this, the model can be worn for a run or put on for fitness.

I will add that this new product in the Bose line has been on the market for a little over six months. QuietComfort Earbuds are more compact than previous models, new and more comfortable earbuds. As I said, these headphones are ideal for sports, but will delight in everyday life. They are very cool on the plane – 11 levels of noise cancellation will save even from loud neighbors, the shape of QuietComfort Earbuds allows you to sit comfortably in a chair and take a nap, because there are no large arches of full-size headphones on your head.

For now, I say goodbye. With you was Mark Avershin, an invited expert.

See you soon!

What to do if it shoots in the ear

Shooting pain in the ear is a short phenomenon, but due to its intensity it is memorable. And it is right. The fact is that lumbago is not necessarily associated with the ear. They can be symptoms of many extremely unpleasant diseases. With severe pain, the body draws your attention to possible danger.

Why does it shoot in the ear

There can be many reasons for a sharp short pain that appears at first glance in the ear.

1. Ear plug

A sulfur plug or a foreign object in the ear canal may press on the eardrum. This is caught by the nerve endings that surround the middle and inner ear in abundance, and you feel a shooting pain.

2. Acoustic trauma

A powerful sound attack – for example, at a rock concert, in a nightclub, at a fireworks show or in noisy production – can cause barotrauma: a stretching or even ruptured eardrum. Ear pain is a frequent companion of ^{such lesions.}

3. Incipient otitis media

Shooting pain in the ear is a common symptom of ear infection ^{, such as otitis media. This unpleasant disease is fraught with hearing loss and the development of serious complications. Therefore, at the slightest suspicion of otitis media, you should immediately consult a doctor. Especially when it comes to babies up to two years old.}

4. Caries, dental abscess or gum disease

The medical journal WebMD lists ^{oral problems as one of the possible causes of ear pain.The fact is that the nerve endings in the head are closely related to each other and the pain felt in one area (for example, in an inflamed tooth root) is often projected somewhere else.}

5. Inflammatory processes in the nasopharynx

Angina, pharyngitis, tonsillitis often also echo with lumbago in the ears. The reason is the same as in the paragraph above: the close interconnection of nerve endings.

6. Neuralgia

Damage to the facial nerve ^{or nasopharyngeal nerve , caused, for example, by hypothermia, makes itself felt including ear pains.}

When to see a doctor

The above is not a complete list of reasons for shooting in the ear. In some cases, the start of pain is given by:

1. Inflammation of the scalp after an unsuccessful piercing.
2. Arthritis or injury to the jaw joint.
3. Brain inflammation – meningitis.
4. All kinds of intracranial tumors.

These diseases can be extremely dangerous. Therefore, if the ear is shooting for more than 24 hours, you need to visit the lore as soon as possible.Other symptoms that require an urgent visit to a doctor are ^:

1. Dizziness, headache, swelling around the ear, weakness of the facial muscles.
2. High temperature (a sign of a developing inflammatory process).
3. Sharp, prolonged ear pain that suddenly stops (this may be a symptom of a ruptured eardrum).

How to reduce pain immediately

If you are sure that pain is not caused by dangerous causes

For example, water getting into your ear while bathing or, for example, a pressure drop during an air flight.

1. Chew gum or eat lollipop

The work of the jaw joint will help ^{to equalize the pressure in the ear canal.}

2. Swallow several times or yawn widely.

Doing this will also force the jaw joint to work, which will help equalize the pressure.

3. Drip ear drops from plugs or liquid oil

Pharmacy drops from plugs contain substances that help soften and remove sulfur plug (for example, allantoin).Camphor or liquid paraffin heated in a water bath to body temperature has the same sulfur-softening effect.

Use pharmacy drops in accordance with the instructions. Instill 2-3 drops of oil (repeat if necessary after 6-8 hours).

4. Use anti-inflammatory ear drops, peroxide or alcohol solutions

These will help if the pain is caused by an infection in the ear canal. This happens, for example, while swimming in an open reservoir or if there are tiny wounds and scratches in the ear canal.This ear pain is usually not accompanied by a fever.

The pharmaceutical drops contain analgesics and antiseptics (for example, lidocaine and phenazone), which relieve pain and fight inflammation.

Hydrogen peroxide or alcohol solutions have a similar antiseptic effect: tinctures of calendula, chamomile. If none of the above funds are at hand, you can use vodka.

Use pharmacy drops according to the instructions. Instill 2-3 drops of peroxide and alcohol solutions.If necessary, the procedure can be repeated after 6-8 hours.

5. Try drying your ear with a hairdryer

This will help remove excess moisture that may be blocking your ear canal. Naturally, the hair dryer should be set to a comfortable thermal mode.

If you have no idea about the causes of pain

In this case, your goal is simply to alleviate the condition before going to the doctor.

1. Apply a cold compress to the ear

For about 20 minutes ^{, until pain is relieved.But it is categorically not recommended to put a hot compress: it can accelerate the development of inflammation and a purulent process, if any.}

2. Take pain reliever

For example, ibuprofen.

3. Chew vigorously

Chewing can relieve pain caused by excessive pressure in the middle ear from otitis media.

And do not hesitate to visit the otolaryngologist. At best, your doctor will simply flush your ear canal. But it is possible that antibiotics or even surgery will be required to get rid of the pain.

Read also

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Why you don’t need antiviral drugs →

Auricle hurts outside – causes and treatment

Why does the external auricle hurt?

Auricle

The cartilage of the auricle very often becomes painful due to trauma to the outer part of the ear.Injury to the hearing organ can occur even in a dream if a person’s ear turns out to be bent during a night’s rest, but bruises, cuts, punctures, chemical or thermal burns, frostbite, insect bites are usually provoking factors for such damage. Inflammatory processes of a fungal, viral or bacterial nature can also provoke the appearance of a pathological symptom, the main place among which is otitis media. Pain in this otolaryngological disease is felt not only in the inner part of the ear, as is commonly believed.Very often the auricle itself, its extreme part or the cartilage of the ear also hurt.

In addition, the following reasons can provoke pain in the auricle:

• Mastoiditis. In this case, the process of inflammation affects the mastoid process, provoking the appearance of pain in the cartilaginous tissue of the outer ear. The disease most often occurs as a complication of untreated otitis media.
• Furunculosis. Unpleasant sensations on the surface of the skin of the outer part of the ear and this inflammatory process have a clear localization.They appear exclusively in the area of ​​the sebaceous gland that has undergone inflammation.
• Perichondritis. In this disease, inflammation spreads to the perichondrium and cartilage of the auricle. The pathological process develops outside the organ of hearing and can be both primary and secondary, as well as additionally affect the cartilage of the larynx.
• Inflammation of the nerves. With neuralgia of the trigeminal, intermediate or vagus nerve, a person has pain in the internal cavity and cartilage of the ear.
• Dental problems.In this case, the pain in the auricle is radiating and occurs as a result of the reflection of pain from the growing wisdom teeth, caries or arthritis (inflammation of the lower jaw) to the departments located in the immediate vicinity.

Often, the auricle begins to hurt as a result of the development of an allergic reaction. Usually, the appearance of manifestations of allergies on the ears is noted in people suffering from insufficient production of sulfur and the associated dryness of the ear canal.

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How does auricle cartilage pain manifest itself?

Inflammation of the cartilage of the auricle

The initial pain syndrome usually appears in a certain area of ​​the ear canal or the place of its articulation with the outer ear, and only after that it begins to spread over its entire surface, with the exception of the lobe. In addition to pain affecting the cartilage of the auricle, the following symptoms may be present:

• The entire surface of the outer ear becomes hyperemic and edematous.
• Local hyperthermia of the skin covering the outside of the ear cartilage is noted.
• An allergic reaction, in addition to pain, is accompanied by peeling and itching of the skin.
• In the presence of a bacterial lesion on the auricle, single or multiple purulent foci appear, which look like bubbles or red bumps on the ear surface.

Worth knowing! Many patients who have ear cartilage pain are interested in why it is worth paying attention to additional symptoms and talking about their presence to a specialist at the first appointment.It is the signs accompanying the pain syndrome that allow the doctor to determine with the greatest accuracy the cause that provoked the development of the pathological process and make the correct diagnosis. The effectiveness of the treatment prescribed to the patient depends on this, which is different in cases of trauma, catarrhal inflammation or bacterial infection.

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How to eliminate pain outside the auricle?

Therapeutic measures

With the appearance of such a pathological symptom as an inflamed surface of the auricle and painful cartilage of the ear, which can occur in completely different diseases, therapeutic measures are prescribed depending on the ailment that became its root cause.If negative symptoms appeared under the influence of the inflammatory process in the ear or cartilaginous tissue of the hearing organ, patients are prescribed the following therapeutic measures:

• Antibacterial therapy. Systemic (oral or injection) antibiotics are prescribed. The drugs of choice are Ciprofloxacin, Sulfadimezin, Tetracycline, Erythromycin.
• Treatment of the surface of the auricle with local antiseptic and anti-inflammatory agents.The best therapeutic effect, according to most experts, is provided by Vishnevsky ointment, Sofradex, Levomikol.
• Reducing pain with simultaneous relief of the inflammatory process is carried out with non-steroidal anti-inflammatory drugs. Usually, patients are advised to take Diclofenac, Paracetamol, or Ibuprofen to relieve pain.

The dosage of drugs and the duration of the therapeutic course are determined only by the attending physician, taking into account, when selecting treatment, the individual characteristics of the patient’s body, the contraindications present in him and the severity of the pathological condition.

In case of ear injuries, therapeutic measures are prescribed depending on the severity of the injuries and can consist both in local treatment of injuries with antiseptic agents, and in the use of surgical intervention. For any pathologies that provoked pain in the outer ear, which increases with pressure, treatment can be carried out using physiotherapy. In the absence of temperature, patients are prescribed UHF, ultraviolet irradiation or microwave therapy. These procedures effectively stop the inflammatory process developing in the cartilaginous tissue of the auricle and eliminate painful sensations.

In the event that the outer ear not only hurts, but also festered, the treatment is carried out with the help of a surgical intervention. During the operation, the auricle is cut parallel to the contours and cartilage tissue that has undergone necrosis is removed from it. After completing these steps, the surgeon treats the operated ear with an antiseptic solution and sutures it.

Important! Regardless of what causes the inflammatory process in the auditory tube and auricle, accompanied by the appearance of acute pain, treatment should be carried out only by a specialist.It is strongly discouraged to take any independent actions in the treatment of the disease that caused pain in the outer ear, as they can lead to serious complications.

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Useful advice of traditional medicine

From time immemorial, recipes have been passed from person to person that can help if the outer part of the hearing organ hurts. A large number of folk remedies that eliminate such pain can be found on the Internet. But treatment with their help is not always acceptable.First of all, you should undergo diagnostic diagnostics, and only based on its results, the doctor can authorize or prohibit their use. Basically, folk methods, if the ear hurts, are used in the absence of purulent processes in it.

The use of home therapy is permissible in the following cases:

• In case of frostbite or burns. To eliminate painful sensations and accelerate the process of tissue regeneration, the auricle is lubricated with agave juice, treated with an aqueous extract of calendula.Helps eliminate pain and a cabbage leaf scalded with boiling water applied to the affected area.
• For the relief of symptoms caused by furunculosis. If the ear hurts because of the boil that has appeared on its surface, the gruel of garlic and onion, fried in vegetable oil, taken in equal quantities, helps well. It is applied to the sore spot every day until complete recovery.

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Consequences of pain

The independent disappearance of the pathological process from the auricle in clinical practice has never been noted, which is why, if swelling and pain appears in it, it is necessary to urgently consult a specialist.An experienced doctor will help you quickly identify the problem that provoked the onset of the pathological condition and select the most appropriate treatment to eliminate it. If timely therapy is absent, or a sick person prefers to carry it out on their own, with the help of alternative medicine, the disease that provoked the appearance of soreness in the outer ear will progress and lead to serious consequences, among which the main place is occupied by:

• Changes in the structure of the ear cartilage and its necrotic lesion.The death of its tissue structures is accompanied by the rejection of necrotic areas by the body. Getting rid of this complication is possible only with the help of a surgical operation, after which rhinoplasty cannot be dispensed with – during the operation, extensive deformation of the outer surface of the ear is possible.
• The complete absence of the therapy necessary in a particular case and the admission of errors in its conduct provoke the spread of inflammation to the tympanic membrane, as a result of which a person develops hearing loss or completely loses his hearing.

To avoid these consequences, a timely visit to a medical institution and consultation with an experienced specialist will allow. If there are even minor pains in the auricle that do not cause anxiety at first glance, you need to take all the therapeutic procedures prescribed by the doctor seriously. Only the strict implementation of the recommendations of a specialist will help to quickly get rid of the pathological phenomenon and prevent the occurrence of more serious health problems.

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Informative video

Be healthy!

Crushed his head like a helmet. Why does the head hurt, but the disease is not found? | HEALTH

From conversations at the everyday level, one gets the feeling: the vast majority of headache sufferers experience nothing more than a migraine.

About whether this is really so and how widespread other types of headache are, whether this pain is hereditary and how to deal with it, the head of the Department of Neurology named after A.I.VP Pervushina PSMU, professor Yulia Karakulova.

Medical orphan

Vera Shuvaeva, “AiF-Prikamye”: Yulia Vladimirovna, why are the diagnoses that people prone to headaches make to themselves, are reduced mainly to migraines?

Yulia Karakulova: I think that the images of literary and cinematic “migraines”, widely known among the people, are working. The same Pontius Pilate from Bulgakov’s The Master and Margarita. And where, in what novel or film, the hero complains, for example, of a cluster headache or a tension headache ?! Although in life it is the latter that occurs most often: eight out of ten people experience it.As a rule, it is episodic, occurring two to three times a month. But in about 3-5% it turns into chronic, when the head hurts almost daily.

Of course, he cannot determine on his own what kind of headache torments a person (this is the question of self-diagnosis), and he should not. This is the doctor’s task.

25% of the world’s population is sick with migraines.

– But sometimes people turn from specialist to specialist, examine blood vessels, brain, fundus – everything is fine.That is, no one finds the disease, but the head hurts. What’s the matter here?

– A similar situation is perfectly illustrated by the phrase belonging to one of the largest neurologists Russell Packard: “A person suffering from a headache is a medical orphan.” In some cases, this is true. What pathological symptoms can be found in patients with tension headache when their soul hurts?

– Are you saying that stress is at the root of this pain?

– In most cases, stress only causes a headache, the causes of its occurrence are much deeper.This can be a feeling of guilt and inadequacy, low self-esteem, failure in life, loneliness, chronic overwork and lack of sleep. It is clear how important it is to make a diagnosis in such cases, the correct collection of anamnesis. Not only clearly formulated questions of the doctor are important, but also the patient’s frank answers, which help to determine the true nature of the disease.

Asking, for example, one of my patients, at what age she had a headache, I learned that as a child she suffered a lot of psychogenics: she was drowning in a river, in the forest she was almost crushed by a falling Christmas tree.She herself does not really remember those emotions, but her brain remembers everything! The state of tightness, the fear of death live in a woman. As a result – chronic tension headache, literally exhausting her, leading to decreased performance, weakness.

Pull yourself out by the hair!

– Women, as more emotional natures, experience stress pain more often?

– Certainly. But do not forget about today’s pace of life, about work sometimes without days off and holidays.It is no coincidence that tension headache becomes one of the symptoms of the so-called office syndrome. Therefore, when a businessman turns to me, complaining of constant pain, squeezing his head like a hoop or a helmet, I advise him to postpone all business, turn off the phone and go to rest.

– Valerian, a warm bath and other soothing things won’t help?

– Yes, for episodic headaches that occur after stress, sedatives of herbal origin can be recommended: tincture of valerian, motherwort, peony.It is better to replace the bath with a shower, so that jets of warm water fall on the neck and head: these pains are caused by spasms of the muscles of the skull and small vessels under them. It is also useful to massage the scalp, for someone – even to pull themselves by the hair, grabbing it closer to the root. Of the drugs, it is preferable to take one-time analgesics, aspirin or nurofen.

– What if the pain turns into chronic?

– Then you need to work with a psychotherapist and a fairly long intake of antidepressants.By raising the level of serotonin, the mediator of our mood, they change a person’s perception of the surrounding reality, allow them to react differently to stress. What kind of antidepressants to prescribe is already the prerogative of a neurologist observing a particular patient.

But the main thing is to try to exclude from life the factors that, in fact, generate stress. At least those that depend on the person himself. Words about optimizing work and rest, daily exercise are commonplace, but in this situation it is difficult to refrain from repeating them.

Anti-migraine sleep

– Well, what can you say about the words of the main “migraine” Pontius Pilate, “an invincible, terrible disease in which half your head hurts.” There is no money from it, there is no salvation “?

– If we understand by salvation the elimination of the cause of migraine, then it is really impossible: the predisposition to this disease is inherited. No other headache is more closely related to genetics. However, whether this predisposition is realized or not depends, again, on many factors.

Women suffer from migraines 3-4 times more often. Their migraine debuts in adolescence, along with menarche, and ends with menopause.

– And what can trigger a migraine attack in the first place?

– Everything is very individual here. I can give a list of the most typical “provocateurs”, but which of them are the main ones – each patient must eventually determine for himself:

• stress;
• change of weather;
• physical activity;
• menstruation;
• Certain products containing tyramine: cocoa, chocolate, cheese, nuts, tomatoes, celery, citrus fruits;
• alcohol, mainly red wine;
• long breaks between meals;
• bright light, noise, TV, unpleasant odors.
  

  Attacks of severe throbbing migraine headache, often with nausea and vomiting, can last up to 3 days in the absence of treatment.

– Are the manifestations of migraine also various?

– Yes. A unilateral, throbbing headache is a classic. But the whole head may also hurt, or first one half of it, then the other. In 5-7 people out of a hundred, suffering from migraines, an attack is preceded by its harbinger – a visual aura, when spots flicker in front of the eyes or a person ceases to see on the right or left.Usually it lasts about half an hour, although it is possible that it is prolonged. Also, with migraine, there is a prodrome in the form of hypersensitivity to odors: Bulgakov’s Pontius Pilate, remember, was haunted by the smell of rose oil for almost a day.

– But do different types of migraine have something in common?

– The disease is always paroxysmal. And another characteristic symptom of migraine is the removal of a headache with sleep. So during an attack, you must try to fall asleep.It is very useful to tightly tie a towel around the head: by squeezing the sharply expanded vessels of the skull, you can reduce the throbbing headache. And as for special anti-migraine drugs, they exist, but they should be prescribed by the doctor who is observing the patient.

By the way

Memo to fighter with tension headache:

• Tension headache (HDN) – bilateral pressure pain, usually not accompanied by nausea and vomiting.
• Not paroxysmal. Softer than migraine.
• HDN can occur at any age.
• During interesting work (the psychogenic factor goes away!), You can forget about HDN.
• Psychogenias are literally “cleaned up” by physical distraction. Daily gymnastics, swimming, walking are useful.
• Positive emotions are very important: from meeting your loved ones, buying a desired thing, visiting a theater – and from anything! Therefore, please yourself more often.

Why ears itch – causes, treatment

What part of the ear is itchy?

The problem can manifest itself in different ways. In some cases itching covers the auditory canal, in others the earlobe or the concha may itch . And sometimes this sensation covers all the ears – it is difficult to figure out exactly where it is located.

What are the causes of ear itching?

Quite often, this is a warning about the onset of serious diseases and negative changes in the human body.To understand why itching in the ears, you need to know the main factors causing itching :

We also recommend reading the following articles:

• Allergic dermatitis
• Sulfur plugs
• Chronic otitis media of the external ear
• Fungal infection of the external auditory canal
• Eczema of the ear canal
• Metabolic disorders
• Diabetes mellitus
• Old age

You also often have to deal with the so-called idiopathic itching in the ear – for no apparent reason.

Allergic dermatitis

This disease can be caused by an allergic reaction to drugs, certain types of plants, cosmetics, aggressive components of household chemicals, wearing earrings, etc. Dermatitis of this kind is often observed in people with chronic diseases:

• Intestinal dysbiosis
• Bronchial asthma
• Adenoid hypertrophy
• External chronic otitis media
• Rhinitis

The decisive factor can be the genetic predisposition of the organism, a weak immune system, smoking.

At first, a person cannot understand why the ear itches constantly . Gradually itching covers the ear canal and auricle. The ear skin turns red, begins to peel off, becomes covered with small bubbles. Scratching causes them to burst and form patches of inflamed, oozing skin. In especially advanced cases, this can lead to the formation of cracks. Without timely treatment, the disease becomes chronic.

Sulfur plugs

Nature has taken care of the human ear.In its outer sections, there are glands that produce sulfur. It moisturizes, lubricates, cleanses and protects the ear. Serves as a barrier against bacteria, dust and insects. Sometimes, for a number of reasons, sulfur can accumulate in large quantities and plugs form.

Excessive sulfur production and the formation of plugs can be triggered by:

• Frequent wear of headphones and earplugs
• Long stay in very dusty rooms
• Use for cleaning cotton swabs
• Frequent ingress of water into the ear
• Genetic predisposition
• Inflammatory ear diseases
• Skin irritation
• Elevated blood cholesterol
• Old age

At the same time, a person’s hearing is significantly reduced, itching , bursting pain and noise in the ear worries, sometimes vomiting occurs, and the head is dizzy.Removing the sulfur plug yourself at home is dangerous. The right decision would be to see a doctor.

Otitis externa

Various viruses, bacteria and fungi provoke the development of otitis externa. The causes of the disease can be: hypothermia, improper ear cleaning techniques, mechanical injuries, chemical and thermal burns, self-extraction of sulfur plugs, foreign objects from the ear. Otitis externa is divided into two types – limited and diffuse.

Limited otitis media begins with itching and pain . The cover of the ear turns red, sometimes swells, the lumen of the auditory canal becomes narrow. A boil is often formed in the ear. As it matures, the pain increases, covers part of the head from the side of the sore ear, especially intensely disturbing at night.

Diffuse otitis media is usually caused by bacteria. The entire ear canal becomes inflamed, the patient suffers from itching and severe pain. Congestion, fluid and pus appear in the ear. The intensity of the pain increases from chewing, the body temperature rises.Otitis media is treated in a hospital setting. Launched – threatens with complications, hearing loss or loss.

With frequent otitis externa, the disease turns into a chronic form, which is accompanied by periodical itching.

Fungal infection of the external auditory canal

Fungal infection of the ear (otomycosis) is a very insidious disease. At first, a person does not suspect that he is already a carrier of a fungal infection. Then he feels tingling, noise, congestion, pain. The color of the sulfur becomes darker, there is a cheesy discharge from the ear, which can also be black, gray, in the form of flakes or skin scales.The auricle becomes inflamed. Itching, burning, pain and dizziness appear. It seems to the patient that there is a foreign body in the ear. Sometimes otomycosis shows only one symptom – severe itching in the ears.

There are many reasons that can cause fungal infections of the ear canal:

• Weak immune system
• Injury
• Incorrect ear cleaning
• Water penetration into the ear
• Increased sweating
• Intrusion of foreign objects
• Effect of certain drugs
• Wearing or trying on other people’s hats and headphones
• Inflammatory ear diseases

Mycosis – one of the causes itching inside the ear .Curdled discharge acts aggressively on the skin, irritating it and causing inflammation. At the first symptoms, you need to see a doctor, treatment on your own can provoke a deterioration in the condition and lead to a chronic form of the disease.

Eczema of the ear canal

A very common ailment in all age groups. The onset of the disease can be provoked by:

• Chronic diseases of the organs of hearing
• Allergy
• Emotional stress
• Rickets
• Diathesis
• Intestinal infections
• Increased sulfur production
• Improper use of ointments and creams
• Injuries from headphones and hearing aids

Why does the ear itch badly with eczema? The skin becomes inflamed, swollen, covered with a rash and weeping erosions, crusts form.The itching is so debilitating that a person scratches his ear until it bleeds.

Without therapy, the disease becomes chronic. Relapses give way to remission, and sometimes eczema lasts for years. At the same time, cracks form in the external auditory canal, the skin of the auricle becomes denser, which narrows the ear canal. Timely treatment by an otolaryngologist and dermatologist will save you from complications and hearing loss. It is very important to know and eliminate the causes and risk factors of infection.

Metabolic disorders with autointoxication

The cause of itching in the ears may be liver and kidney failure.It is observed in patients with hepatitis, cirrhosis, obstructive jaundice. The ingestion of metabolic products into the bloodstream and an increase in the level of bile salts in the plasma is a common reason why itching in the ear. Chronic diseases or a hereditary defect in the structure of the kidneys disrupt the formation and excretion of metabolic products from the body, which causes itching of the skin all over the body and in the ears.

Diabetes mellitus

This disease is associated with a violation of carbohydrate metabolism. In the blood and urine of the patient, the glucose content increases.This condition leads to a delay in the body of decay products and toxins. As a result, the skin loses moisture and elasticity, becomes dry, rough, and itchy. It can be so strong that the patient scratches the skin, the structure of the cover is disturbed, an infection easily penetrates into it and causes serious complications.

Old age

With aging, human skin becomes dehydrated, loses its elasticity and firmness. Due to age-related changes, metabolic processes are inhibited, cell renewal is suspended.The work of the sebaceous glands significantly deteriorates, water and lipid metabolism is disrupted.

The body has almost exhausted its potential, and the skin no longer receives protective resources. Older people often complain of burning, irritation and itching. Why ears itch in the elderly? There are many reasons for this, and diagnosis is often difficult due to chronic diseases that have accumulated over the years.

Idiopathic itching in the ears

The name of such a phenomenon is translated as independent, primary, having an unknown cause.Without visible and obvious factors, a person is worried about obsessive itching in the ear canal. Even a doctor cannot determine the cause of the problem. Most often this is the result of too frequent intensive cleaning of the ears.

How to get rid of itchy ears

Therapy is selected individually, taking into account the cause of the problem:

• Otomycosis is treated with antifungal drugs.
• Sulfur plugs are removed by rinsing or special drops.
• Otitis media is treated with antibiotics, topical drops and antiseptic washes.Also, the patient is prescribed medical procedures.
• For allergies, antihistamines are prescribed and it is advised to protect the ears from allergens.
• In case of injuries, the ear is washed with an antiseptic to prevent the development of inflammation. Medicinal turundas are also prescribed to speed up healing.

The doctors of our ENT center know how to treat itching in the ear . An experienced doctor will conduct an examination using modern equipment. He will accurately determine the cause of the problem and select an individual therapy plan.

Prevention of symptoms

The most important rule is to maintain ear hygiene. They must be cleaned carefully, without going deep into the ear canal. It is not recommended to use sticks to clean the ears. It is correct and safe to use gauze or cotton wool for these purposes.

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