|The ear canal is lined with skin that is very similar to the skin on the arm or anywhere on the body. Chronic exposure of the skin to water or to trauma such as that from Q-tips, bobby pins, toothpicks, or any such instrument can predispose the skin to infection by breaking through its outer barrier and allowing an infection to begin.
Outer ear infections can be prevented by avoiding trauma to the ear canal and keeping the ear canal dry. Avoid traumatizing the ear canal when it itches. Often, this is a sign of ear canal dryness which can be relieved by placing a few drops of baby oil or mineral oil in the ear. If water has a tendency to get into your ears while showering, place a cotton ball coated with Vaseline over the entrance of the ear canal to prevent water from entering the ear. If you swim, place a few drops of a solution containing an alcohol base (sold in many stores under the name Swimmer’s Ear@) in your ear canal after each swim. The alcohol dries the ear canal. In addition, you can hold a blow dryer 6-12 inches from the ear canal and allow it to blow warm air towards the ear. This will dry the water in the ear over several minutes.
The first sign of an ear infection is usually a slight pain in the ear with a sensation of blockage in the ear canal. This may rapidly progress to severe ear pain which is aggravated when pressure is applied to the outer ear and may prevent you from sleeping. Sometimes the infection will be associated with a discharge of green or yellow mucous from the ear canal.
Treatment for this type of ear infection includes the use of antibiotic ear drops. Use the drops as prescribed for a total of 7-10 days unless otherwise instructed. When using the ear drops, lay down on your side with the infected ear toward the ceiling and place the prescribed number of drops in the ear. Once the drops have been placed in the ear, lay in this position for 5 minutes to allow the drops to penetrate the irritated ear canal. When resuming the upright position the drops will tend to drain from the ear. To prevent the drops from draining out of the ear and onto your clothes, place a dry cotton ball at the entrance to the ear canal. The cotton ball will absorb the excess medication and can be discarded after several minutes. Do NOT push the cotton ball into the ear canal as this may inhibit resolution of the infection.
Please use the prescribed ear drops for the FULL 7 to 10 DAYS prescribed even though you will feel better in half that time. This will prevent the infection from recurring. KEEP WATER OUT OF THE EAR CANAL to assist in rapidly clearing the infection. This means that you should not swim for 10 days. When you take a shower, place a cotton ball coated with Vaseline over the entrance of the ear canal as described above. If the infection is more severe, an antibiotic may be prescribed or an ear wick might be placed in the ear canal to help treat the infection. An ear wick is an expandable packing that is placed in the ear canal to keep it open and allow the antibiotic drops to get to the infection. This packing is often associated with significant pain and pressure in the ear canal. This pain is normal and results from the packing pressing on the swollen ear canal. The packing will be removed in our office 3-5 days after it was placed.
The pain you are experiencing usually gets worse over the first 24 hours of treatment and then starts to subside by the second or third day of treatment. Take Ibuprofen 400 mg. (equivalent to 2 Advil, Nuprin, or Motrin IB) every 4 hours around the clock. This means that you take this medicine every 4 hours even if the pain has not returned. Alternatively you make take 800 mg., or 4 Advil, Nuprin, or Motrin IB every 8 hours, however, this may cause more stomach upset. This will give you excellent pain relief in most cases and is usually more effective than narcotic pain medications. This medication should NOT be taken by patients with stomach ulcers, those known to be sensitive to Ibuprofen, or patients taking other medications that may interact with Ibuprofen. Contact our office or your regular physician if you have any questions.
If Ibuprofen fails to relieve the pain initially, a narcotic pain medication will be prescribed. This medication is helpful in allowing you to fall asleep with the ear pain. Opening and closing your mouth will normally increase the pain in the ear and is NOT an indication of the infection spreading to the jaw. This pain is not a cause for alarm.
Diabetics are at risk for life threatening external ear infections. Oral antibiotics and drops are usually prescribed together for these infection. Fever, chills, sweats, difficulty swallowing, and/or jaw pain are all important symptoms and should be reported to us if they persist more than 6 hours.
Call our office so that we may alter your treatment if the pain continues without any improvement after 48 hours, or if the pain is still present after 5 days of treatment.
We enjoy teaching our patients about their medical problems and the treatment plan that we have recommended. We believe that with this education, our patients are more likely to get better and to stay better.
These information sheets are intended for use by our patients in conjunction with regular care from Drs. Siegel and Bosworth. Use of these sheets by others can lead to a delay in diagnosis with potential worsening of health. If you are not one of our patients, please schedule an appointment so that we can help you to feel better as soon as possible.