To Swim or To Surf… Your Ears Want to Know!

To the beach or the pool, you ask? We say both, but take care of those ears!

There is a common misconception that Swimmer’s ear and Surfer’s ear are similar ailments, so we talked to Santa Cruz, CA family physician Hossein Hassani about dispelling that myth.

Swimmer’s ear, Hassani says, is an infection in the outer ear canal, most commonly caused when water is trapped in the external auditory canal, presenting a good medium for bacterial grow. This infection of the ear canal, otitis externa, is a common problem especially for children who spend a lot of time in the water.
Otitis Externa captured with the CellScope Oto

Otitis Externa captured with the CellScope Oto

Pain upon yawning or swallowing may indicate swimmer’s ear. If you gently wiggle the ear or press in front of the ear canal and the pain increases, there is a good chance there is an infection. Treat accordingly and avoid getting water in the ear until his treatment is done. To help prevent swimmer’s ear, after bathing or swimming, make sure to get all the water out of the ears by turning his head to each side,  dry gently with a towel, or use alcohol drops.
Hassani continues to explain that surfer’s ear, on the other hand, is excess cartilage growth in the external auditory canal due to prolonged exposure to cold water. Also referred to as exostosis or abnormal bone growth, it is most commonly seen in surfers who tend to spend hours in the ocean water. Irritation from cold wind and water exposure causes the bone surrounding the ear canal to develop new bony growth which constrict the ear canal. The ear canal is actually blocked by this condition, meaning that both water and wax can become trapped and give rise to infection.
Surfer's Ear taken with the CellScope Oto

Surfer’s Ear taken with the CellScope Oto

Surfer’s ear is a progressive condition, making it important to take preventative measures early, preferably whenever surfing. The condition is not limited to surfing and can occur in any activity with cold, wet, windy conditions (Kitesurfers, beware!).
Swimmers and surfers be warned, and take preventative measures and keep those ear canals as dry as possible. In case of an infection, consult your physician.

Dr. Q’s Tips for Summer Ear Care

Underwater portrait kids

In preparation for a summer full of fun in the sun, we asked Dr. Quillin, a Pediatrician in Webster, TX, to answer some burning questions we had about ear care this summer!

CellScope (CS): What are good ear practices for families spending a lot of time at the pool this summer?

Dr. Quillin (Dr. Q): A general recommendation is to make an alcohol:white vinegar solution in a 1:1 ratio and place drops in the ears every hour while swimming. The alcohol helps dry out residual water and the vinegar stabilizes the pH of the ear canal, so bacteria is less likely to grow and cause “swimmer’s ear”. (This should not be used in children with tubes or chronic perforation.)

CS: What is swimmer’s ear?

Dr. Q: Swimmer’s ear is an inflammation or infection of the outer ear canal. The infection is caused by bacteria infiltrating micro-fissures in the skin produced by drying of the ear canal.

CS: Is it more likely to be caused in a fresh water or the ocean?

Dr. Q: Fresh water and ocean water can both cause swimmer’s ear, but this occurrence is less common in those environments. It is most commonly caused from the chemicals that are used in swimming pools that can be more drying to the ear canal.

CS:  How do you identify swimmer’s ear?

Dr. Q: Swimmer’s ear is a very painful ear infection that is demonstrated by the tugging of the ear which in turn causes a stretch on the ear canal. A child may complain when a T-shirt is pulled over the head, pulling the ear. The child will also tend to guard the ear with a cupped hand.

CS:  If parents suspect swimmer’s ear what should they do?

Dr. Q: Seek care from their pediatrician to determine if antibiotic drops are needed.

CS:  Is it ok for kids with ear infections (AOM) to swim?

Dr. Q: Swimming with the typical otitis media (middle ear infection) is ok as long as the ear drum is not perforated.

CS: What do you tell parents who are flying with small kids and are nervous about the pressure?

Dr. Q: I advise that most children can equalize there eustachian tubes (pop their ears) without a problem. I caution parents who have children with colds, bad allergies and/or history of chronic ear infections that landings may create some pressure for these children. A physician might prescribe numbing drops in the latter case for air travel.

CS: What can they do in flight to soothe any pain from the pressure?

Dr. Q: Ibuprofen and/or topical anesthetic drops are my mainstay for children who are at risk. However, in-flight, if a child is experiencing problems popping their ears, I would recommend parents have kids chew on something, swallow liquids, or blow their nose to try and equalize the pressure. Ear pressure tends to be worse with longer flights and primarily on landing.

CS: Is it safe for kids with ear infections to travel or should an ear infection be cause to postpone a trip?

Dr. Q: A serious ear infection may be a cause for delaying travels. Milder ear infections and presence of fluid from a simple cold may present with similar ear pain. A preflight ear check once an ear infection has been treated is a good idea.