External Ear Infections

Infections of the external ear (otitis externa) are characterized by redness, burning, itching and aching in the ear canal. Sometimes the fleshy part of the outer ear (the pinna) is also involved. Otitis externa is often referred to as swimmer's ear, especially when it is a result of a fungal infection.

WHAT CAUSES EXTERNAL EAR INFECTIONS?
External ear infections may be caused by many different microorganisms—bacteria, fungi, yeasts, viruses or parasites. Chances of infection taking hold are greatest if the ear is irritated and the protective, waxy lining of the ear canal is removed—a common occurence among children who spend long periods swimming or playing in the bathtub. A break in the skin of the ear canal, caused by an insect bite or foreign object, can also set the stage for infection to develop. Allergic reactions to haircare products sometimes inflame the ear canal and lead to infection as well.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS AN EXTERNAL EAR INFECTION?
Children with external ear infections may complain of itching, burning and pain in the ear. The ear canal may look red and moist, and the entire ear may be tender to the touch.

IS MEDICAL ATTENTION NECESSARY?
Yes. External ear infections may spread to the middle ear. They also cause intense discomfort, which easily can be relieved with proper treatment.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS AN EXTERNAL EAR INFECTION?
The doctor usually can identify such an infection by examining the ear with an otoscope (a lighted, hand-held viewing instrument). If standard treatment fails to clear up the infection within two days, material is scraped from the ear canal and sent to a laboratory for a culture test to determine what organism is involved.

WHAT TREATMENTS ARE AVAILABLE?
Initial treatment consists of applying an antibiotic cream or antibiotic drops. In some cases, the doctor leaves a strip of gauze soaked in an antibiotic solution in the ear canal for about two days. If the infection seems to be caused by fungus, antifungal drops or ointment will be used.

ADMINISTERING EAR DROPS

• Have the child lie face up on a flat surface and turn the head to the side opposite the affected ear.

• Pull the fleshy part of the ear (the pinna) down and back to straighten the ear canal in a child under age three. Pull the pinna up and back in children over three.

• Hold the medication dropper in the other hand, resting the forearm, if necessary, on the head to prevent movement.

• Put the tip of the dropper in the ear and release the prescribed number of drops.

• Have the child remain lying down in the same position to allow the drops to pass down the ear canal.

• Apply slight pressure to the area just in front of the ear canal (between the jawline and the ear) to push the drops downward.

GETTING HELP
Call your doctor if:

• Your infant or child has any symptoms of an external ear infection.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.