Otitis Externa

Otitis externa occurs if the skin of the ear canal becomes inflamed. This can be due to an eczema type problem or infection. This can cause: pain, itchiness, ear discharge and deafness. Things that precipitate this include water getting into the ear canal, poking the ear (cotton buds), infection of hair follicles.

Treatment

Do not allow water/soap/shampoo to get in your ears. Use a fresh piece of cotton wool smeared with vaseline when you have a shower or bath. Clean/Wipe the ear with a wet flannel.

Do not poke your ears. Usually wax in the ear will migrate out by itself.

Earcalm: This is an over the counter medication which can be of help. It contains a dilute solution of acetic acid: 2 to 3 puffs three time a day for 1 week.

If the ear has a lot of debris this will need to be cleared out. Syringing may not be appropriate if there is infection as it can worsen the infection. Microsuction can be used to clear the debris.

Steroid Drops: Betamethasone (prescription) drops can be used. Fill ear (15-20 drops) while lying on your side (for 20 minutes) twice a day for 2 weeks.

Antiobiotic or Antifungal drops. Sometimes if there is an infection of the ear canal anti-bacterial or anti-fungal drops are required. e.g. Otomize ear spray (antibiotic for bacteria, steroid to reduced inflammation and acetic acid to suppress fungal growth) or Canestan ear drops (anti-fungal).

In cases where the problem does not improve there may be other problems such as a perforated ear drum or infection of the ear bone (Necrotising Otitis Externa). Infection in the bone around the ear canal often occurs in elderly diabetics and causes severe pain which is worse at night. This can be a very serious condition. This requires urgent ENT review. The treatment usually requires specific prolonged antibiotics under care of an ENT expert.