Outer Ear Infection
(Otitis Externa · Ear Infection · Swimmer's Ear · External Ear Infection)
In this condition factsheet:
The Facts on Outer Ear Infection
The ear is divided into three separate compartments: the inner, middle, and outer ear. The inner ear contains the balance organs and the nerves vital to hearing. The middle ear contains the bones that link the eardrum to the inner ear. The eardrum separates the middle and outer ears. The outer ear is simply the earlobe and a short tube leading to the eardrum.
Infection of the inner ear is called labyrinthitis. Infection of the middle ear is called otitis media. Infection of the outer ear is called otitis externa or swimmer's ear.
Outer ear infections can be acute (short-term) or chronic (lasting 3 or more months) and are more common in children 7 to 12 years of age. Outer ear infections also more commonly affect people in warm and humid climates, people who swim, and people who use devices that protect hearing.
Causes of Outer Ear Infection
Swimming isn't the only way to get an outer ear infection. You can also be infected if hairspray or other liquids get into the ear canal. The bacteria (and occasionally fungi) that cause an outer ear infection don't necessarily live in the water. Many of them are already in the ear canal or are picked up in everyday life. However, water or other foreign liquids in the ear can provide an ideal breeding ground for them.
You can also trap bacteria in the ear by using cotton ear swabs. The skin of the ear canal slowly moves outward like a conveyor belt, carrying shed fragments of skin away from the eardrum. Pushing a cotton swab into the ear goes against this process, and causes dead skin and earwax to build up. Occasionally, scratching the ear canal can also promote infection. This tends to trap moisture in the ear. Moist skin and tissue create a friendly environment for bacteria and allow them to multiply, causing infection.
People with the following conditions get outer ear infections more easily:
- diabetes mellitus
- seborrheic dermatitis (in which dandruff is the most common symptom)
Symptoms and Complications of Outer Ear Infection
The main symptoms of an outer ear infection are severe pain, itching, or redness in the ear and tenderness in the earlobes.
The tissue in front of and below the ear may become swollen and tender. There's often a lot of earwax and skin debris in the ear canal. More severe bacterial infection sometimes causes yellowish pus to drain out. This may have an unpleasant smell. Fungal infections can create a grey-white pus.
Pus, wax, and skin debris may block sound waves from reaching the eardrum, causing temporary reduced hearing. This isn't a sign of ear damage.
Complications of outer ear infecyions are extremely rare, except in people with diabetes or with weakened immune systems. When severe infections spread into the surrounding bone, this is called malignant otitis externa.