After swimming children’s ears must be carefully dried, because if the ear canal remains wet for a long time it can cause otitis externa, a painful infection that occurs when the skin in the ear canal is irritated.

What is otitis externa?

“Children’s ear problems, although they are much more common in the summer, due to the heat, humidity, long hours of playing in the sea – conditions that encourage their appearance and especially otitis externa – concern us all year round. This specific condition is an inflammation of the skin and subcutaneous tissue of the external auditory canal, which is often described as “swimmer’s ear”. It occurs more often in children aged 5 years and older, who take many dives and swim with the mask and head constantly in the water”, points out Mr. Ioannis Oikonomidis, Pediatric Director – Otorhinolaryngologist at the Metropolitan Hospital.

What causes otitis externa?

Otitis externa is caused by many types of germs, because the irritated ear from moisture is prone to bacteria or fungi. Mainly when we are with our head constantly in water, the external auditory canal of the ears undergoes significant changes, with the epidermis consisting of a stratum corneum being moistened to such an extent that it favors the growth of microbes.

But in addition to swimming and diving, there are other factors that cause otitis externa, such as dry skin or eczema, scratching the ear canal, cleaning the ears with cotton swabs, or inserting objects (such as pins or paper clips) in the ear.

How often does otitis externa occur?

Data from studies show that approximately 80% of children will experience at least one episode of otitis media during preschool age. This is often caused as a consequence of a viral infection of the upper respiratory system, while in 50-90% of cases bacterial growth is observed from the culture of the fluid isolated from the ear.

How can we prevent otitis externa and what are its symptoms?

“Ear pain is the main sign of otitis externa, which can be aggravated when the outer part of the ear is pulled or pressed. Infection can also make chewing painful. In addition, itching in the ear canal is a common symptom, as is swelling, with the outer ear appearing red or swollen and the lymph nodes around the area being swollen and tender.

Sometimes, there is discharge from the ear canal, which at first is clear and then becomes cloudy and yellowish, in the form of pus. Hearing may be temporarily affected if pus or swelling blocks the ear canal. At the same time, in some cases, fever is also a symptom, although it does not happen in the majority of children”, explains the expert.

“To prevent all this,” he continues, “we should definitely take the child to an otolaryngologist before the swimming lessons start, who will give him a good cleaning of the external auditory canals and remove any ear plugs, so that even if he enters water in the ear so that there is no wax which, if wet, will swell and act as a valve which can affect hearing and lead to otitis. Another way to prevent it is for the child’s parent to put an alcohol swab in the child’s ears after swimming, either at the sea, the pool or at home, to absorb the moisture or even dry their ears with a hairdryer.

Also, regarding the swabs, they are no longer allowed to be plastic but must be paper. Despite this, their use remains dangerous because no matter how careful parents are when applying them, children always make sudden movements and can get injured.”

How is otitis externa treated?

“The diagnosis must be made immediately and the duration of treatment depends on how severe and painful the infection is. In the first examination, it is necessary for the pediatric ENT to properly clean the child’s ear and check whether there is a rupture of the eardrum in order to prescribe the appropriate ear drops.

They usually contain an antibiotic to fight the infection, possibly mixed with a medicine to reduce the swelling of the ear canal. Ear drops are usually given several times a day for 7-10 days. If there is pus, the doctor may need to remove it with gentle cleaning or suction so the medicine can work better.

For more serious infections, the pediatric ENT may prescribe antibiotics taken by mouth, along with pain relievers to help manage the pain. Once the treatment starts, the child will start to feel better in a day or two and throughout it, there is a strong recommendation to avoid contact with water, both in swimming and in the shower” concludes Mr Economides.