What is an outer ear infection?
It is when the skin in the outer ear canal is red, hot, and swollen. The infection can also spread to the outer ear and the eardrum.
Sometimes it's called "swimmer's ear" or “tropical ear” because it often happens after getting the ear wet.
Who can get outer ear infections?
- Anyone can get it.
- About 1 in 10 people can get an outer ear infection at some point in their lives.
- Girls and women under 65 years old get it a little more often than boys and men.
- It's more common in summer especially in children.
What increases my risk of getting an outer ear infection?
- Germs such bacteria
This can happen from swimming or having wet ears.
- Fungus
Using antibiotic or steroid ear drops for a long time will wipe out the bacteria that normally live on the skin of the ear canal, which can cause the growth of fungus.
- Skin conditions
This includes eczema, psoriasis or seborrhoeic dermatitis.
- Injuries
Cleaning your ears too much, using earplugs or wearing hearing aids can cause scratches to the ear canal skin. The bacteria that normally live on the skin of the ear canal have a route to get into the skin, which causes infections.
- Allergies
From things like shampoo.
- Activities
Like swimming.
What symptoms can I have?
- Itchy ears
- Ear pain (especially when you touch your ear) or sometimes jaw pain
- Fluid leaking from the ear
- Trouble hearing
What can I do to treat an outer ear infection?
Keep your ears dry:
- Do not swim or get your ears wet for at least 7-10 days.
- Use ear plugs and/or a tight-fighting cap when swimming.
- Keep shampoo, soap and water out of your ear when bathing.
- Use earplugs or cotton wool with petroleum jelly when showering.
- Dry your ears gently with a towel or hair dryer on a low setting.
Don’t put anything in your ears:
- No cotton buds (Q-tips) or other objects.
- Don't scratch or poke inside your ear.
If you have long nails or false nails, you should cut them short, remove false nails and nail polish and use a nail brush every time you wash your hands.
Reduce your risk of getting outer ear infections:
- Seek treatment for skin conditions.
- Avoid allergies.
Pain relief:
- Take simple pain killers such as paracetamol or ibuprofen.
Consider seeing your local pharmacist:
- For anyone 12 years or older, you can consider buying over-the-counter acetic acid 2% ear drops. This is a mild vinegar solution that stops the overgrowth of germs and helps with itchy ears. Spray it in the ear morning and evening for a maximum of 7 days.
What is the normal response to treatment?
Your ear should improve 48 – 72 hours after starting treatment. Most people get better within 7 – 10 days.
What happens if the infection has settled but my ear is still itchy?
- This is caused by irritation of the skin in the outer ear canal. For anyone 12 years or older, you can consider buying over-the-counter acetic acid 2% ear drops. This is a mild vinegar solution that helps with itchy ears. Spray it in the ear morning and evening for a maximum of 7 days.
What can happen if the infection does not settle?
- The infection may spread to the skin outside the outer ear canal
- The ear canal may close
- The infection can spread to the surface of the ear drum.
- If you have diabetes or are on medication that lowers your immune system, or have another condition that lowers your immune system, you may have a severe infection of the skin in the outer ear canal which may spread to the bone under the outer ear canal. This is called necrotising otitis externa. You will have very severe pain, especially at night. It can sometimes affect the movement of your face.
If you have any of these symptoms, see your GP urgently or go to your nearest emergency department.
What increases your risk of a complication?
- Badly controlled diabetes
- Other conditions or medications that lower your immune system
- Old age
- Radiotherapy to the ear, head or neck
- Previous ear surgery or ear irrigation
When should I see a General Practitioner?
- If you have any symptoms of an outer ear infection and have:
- Badly controlled diabetes
- Other conditions or medications that lower your immune system
- Old age
- Radiotherapy to the ear, head or neck
- Previous ear surgery or ear irrigation
- If you have symptoms of outer ear infection that do not improve within 48 – 72 hours
- If you have regular ear infections
What can a doctor do?
Your doctor might give you ear drops containing an antibiotic or steroid to use for 7-14 days. Please follow the instructions on how to use ear drops.
What if my outer ear infection doesn’t get better?
You may need to see an Ear Nose and Throat (ENT) specialist.
- They will examine your ear using an instrument called a microscopy and may clean debris from your ear canal using a small hoover.
- They may take an ear swab if you have recurrent infections or infections resistant to simple treatment.
- They may give you different medicines
When is an outer ear infection serious?
An outer ear infection can become serious if it doesn’t get better or you develop a complication. You might need to go to the hospital for further tests and treatment.
Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.