Tuesday, 12 February 2013

Swimmers Ear, it's not just about Surfing!

Swimming can cause a condition known as ‘Swimmers Ear’ the medical term is Acute Otitis Externa. Swimmers Ear is an infection of the epithelial skin lining of the ear caused by chlorine or dirty water depleting the natural protective acidic properties of the ear canal. The ear can become itchy, moist and inflamed and more susceptible to infection. Where the ear canal is left wet and infected from repeated swimming then this can cause repeated discomfort, infection and localised pain.

Is there anything about swimming outside or in cold water that can cause additional problems?

Yes, repeated cold water immersion can lead to ‘Surfers Ear’ the medical term is Exostoses. This is caused by the cooling effect of wind and water against the ear canal which promotes blood flow to the ear canal and results in the layering down of new bony growth which ultimately narrows the ear canal. This narrowing can trap water and debris causing painful infections and in extreme cases may require surgery to correct this.

What are the symptoms of these problems?

A feeling of fullness or difficulty clearing water from the ears after swimming is a possible indication of inflamed or narrow ear canals, as is itchy, painful or recurrent ear infections. Swimmer's ear may also cause your outer ear to appear red with scaly or flaking skin and in more serious cases swelling in your ear or lymph nodes in your neck may be experienced and pus may drain from the ear. Swimmer's ear is not usually an emergency, but it's important to see a doctor right away who can confirm this with a simple ear examination, especially if you have diabetes or an underlying immune system disease.

How can these problems be reduced or prevented?

In the first instance avoid water, especially polluted water, getting into the ear canals. We realise this is not practical for swim sports so the simple answer is earplugs. There are several types available to swimmers, these include silicone swim putty, push-fit earplugs or custom moulded earplugs such as Surfplugs. Finding a product that fits well into your own ears that are comfortable in use during swimming and training may take a bit of experimentation. But there are several types out there and generally you get what you pay for.  There are now also several types of ear drop on the market designed for swimmers that help to maintain the natural protective layers of the ear canal during swimming.Where irritation may have already occurred then avoid digging and scratching at the ear, an inflamed skin lining of the ear canal is extremely fragile and finger nails will easily rip or tear this exposing the ear to further infection.

What is the advantage of using ear plugs, and why are custom made ear plugs better than self-moulded ones?

Earplugs will keep the ears dry and warm preventing the conditions of both Swimmers Ear and Surfers Ear. Custom made products, such as Surfplugs, are designed for long term comfort and will provide a really good watertight fit in all ear shapes. Off-the-shelf products that rely on a pressure fit within the ear canal do rely on having a ‘normal’ ear shape. Where ear canal narrowing has already occurred or small or tortuous ear canal shapes exist then the fit of these may be compromised and a satisfactory watertight and comfortable fit may be harder to achieve.

If one of these problems has already arisen, what is the treatment?

Where infection is present then it is important to get this treated. Your local GP will be able to provide suitable advice and antibiotic drops to treat the type of infection. Surfers Ear and advanced narrowing of the ear canals will require more invasive treatment but the good news is that it doesn’t normally get to this stage without infections and ear related problems first. So therefore getting ear infections and discomfort investigated and treated early may highlight any potentially more complex or serious problems with the ear.

image: swimtechnique