Water in the ear from playing in water... Improper cleaning can worsen 'Otitis Externa' [Kok! Health]

Using Cotton Swabs and Picking Ears Are Major Causes
Small Amounts of Moisture Should Be Naturally Dried
Drying with a Hair Dryer or Fan Is Also Recommended

On the 22nd, as the daytime temperature in Seoul rose to 27 degrees Celsius, continuing the early summer heat, citizens visiting the Mulbit Square at Yeouido Hangang Park in Seoul cooled off by playing in the water. Photo by Kang Jin-hyung aymsdream@

[Asia Economy Reporter Lee Gwan-joo] As early summer weather arrives and social distancing measures are eased, more citizens are engaging in water activities. One common condition experienced during such water play is 'otitis externa.' Scratching the inside of the ear due to itchiness without caution can worsen inflammation, so care is needed.

Otitis externa is inflammation of the external auditory canal, the passage from the auricle to the eardrum, caused by bacterial or fungal infections. The main symptoms are ear pain and itching. It is especially common after swimming, which is why otitis externa is also called "swimmer's ear."

Otitis externa can occur at all ages, from children and adolescents to adults and the elderly. It typically occurs in hot and humid environments, so it has traditionally required caution mainly during the summer. However, with early water activities at hotels and resorts, it has become a condition that requires attention regardless of the season.

The most important preventive measure against otitis externa is not to clean the ear canal with cotton swabs. Scratching inside the ear with a cotton swab due to water entry or itchiness can weaken the skin of the ear canal, creating an environment prone to otitis externa. Moreover, for some high-risk groups, otitis externa can lead to fatal outcomes, so caution is necessary.

Professor Ahn Yong-hwi of the Department of Otorhinolaryngology at Nowon Eulji University Hospital explained, "Sometimes ear pain is overlooked and left untreated, but if the ear canal swells severely or becomes blocked with inflammatory debris, a feeling of fullness and hearing loss may occur. Especially in elderly patients over 70 with diabetes, cleaning earwax with cotton swabs can cause wounds that allow Pseudomonas aeruginosa to enter the skin, leading to malignant otitis externa. If the wound does not heal well and inflammation worsens, it can result in fatal conditions such as skull base osteomyelitis and stroke, which can lead to death."

If water enters the ear, it is best to let a small amount of moisture evaporate naturally and dry on its own. If the ear feels blocked due to water, tilting the affected ear downward and shaking or jumping can help remove the water. Using a hairdryer or fan with warm but not hot and gentle airflow to dry the ear canal is also advisable.

Otitis externa is diagnosed through a simple medical history and otoscopic examination. If it is simple otitis externa, treatment begins with pain control and keeping the ear canal clean. Ear drops containing antibiotics or steroid-containing solutions to reduce inflammation are used.

Removing discharge and necrotic skin from the ear canal and washing with acidic solutions to restore the ear canal's acidity is also effective. A normal ear canal has an acidic protective layer with a pH of about 6.0 that inhibits bacterial growth, and the ear canal skin naturally cleanses itself through continuous shedding and earwax movement. However, exposure to swimming pool water and cotton swab use can alter the ear canal's acidity, disrupting its defense function, so restoring acidity is necessary. Most cases improve within 3 to 7 days, but if inflammation is suspected to have spread beyond the ear canal, radiological examination is needed to rule out skull base osteomyelitis.

Professor Ahn emphasized, "Chronic otitis externa can sometimes occur when the condition persists for several months. Acute otitis externa is mainly caused by bacteria or fungi, but chronic otitis externa can have various causes such as contact allergies, sensitization to ear drops, seborrheic dermatitis, and psoriasis. Therefore, people with allergies or skin diseases should be especially careful."