An outer ear infection may not be as well-known as a middle ear infection but when they occur, the infection should be treated promptly.   Outer ear infections can prove to be life-threatening in the elderly or those with diabetes if the infection spreads to the bone of the skull.

Outer ear infections, also known as otitis extrema, occur in the ear canal between the surface of your ear and your eardrum.  In contrast, a middle ear infection occurs behind the eardrum.  They can occur at any age and at any time of year.

Causes

The glands in the ear canal secrete earwax (cerumen) which is the outer ear canal’s main defense against infections.  Earwax is necessary to form a protective, water-repellant surface on ear canal skin inhibiting bacterial growth.  In addition, dead skin cells, dirt and debris get stuck on earwax which then naturally moves them out of the ear.  This is the ear canal’s own built-in self-cleaning system that to keep the ear canal clean. 

What causes an outer ear infection is usually bacteria but they can also be caused by a fungus or virus.  If there is a breakdown of ear canal skin and protective earwax, this is when an infection can occur since it makes it easier for bacteria, fungi, or viruses to penetrate the skin leading to an infection.

Signs of an infection

The signs of an outer ear infection include:

·         Itching, redness, or swelling in the ear

·         Ear pain or pain when touching or tugging on the outer ear

·         Clear fluid or pus draining from the ear

·         A feeling of fullness in the ear

·         Decreased or muffled hearing

 More pain, redness, swelling and drainage will be noticed as the severity increases.

 Treatment

 Any symptoms of an outer ear infection need to be seen and diagnosed by a doctor.  The doctor will examine and clean out the ear looking for the possibility of a ruptured (perforated) eardrum.  Rupture of the eardrum can be due to an ear infection, sudden changes in air pressure, loud sounds or blasts, foreign object in the ear, or severe head trauma.

Eardrops usually in the form of an antibiotic, antiseptic, anti-inflammatory or antifungal which are highly effectivefor cleaning out the ear to rid an outer ear infection.   If the ear pain is severe, a pain medication may also be needed along with an antibiotic.

During the time of treating an outer ear infection, avoid getting the ears wet.  Swimming is discouraged for at least seven to 10 days and avoid getting the ears wet while taking a shower.  Also avoid wearing hearing aids or earphones.

Minimizing the risk of an outer ear infection

The best way to avoid an outer ear infection is to take steps to reduce the risk.  Here are certain things a person can do to minimize this:

·         Use earplugs when swimming and dry the ears after getting them wet. 

·         If the ears get water in them, shake and wiggle each ear until water drains out.  The ear canal can be dried using a hair dryer on cool setting or using swimmer’s ear drops.

·         Avoid putting anything smaller than your elbow in the ear is a true saying to heed.  If there is a buildup of earwax, have the doctor remove it.

·         Avoid wearing earphones, earplugs, or hearing aids for a prolonged time in the ear as they can damage the skin.  Remove hearing aids at night and clean them regularly.

·         If ears itch a lot, it could be due to a skin condition such as psoriasis or eczema leading to damaged skin.  Allergic reactions to hair spray, shampoo, jewelry or cosmetics can also damage ear canal skin.  A doctor can identify and prescribe treatment for a skin condition.