Otitis externa or “Swimmers Ear” as it is commonly referred to is a very common ailment affecting swimmers, divers, surfers, and anyone else who spends a lot of time in water. Otitis externa is the fancy technical term for an external ear infection.
Contrary to popular belief and information posted on many diving websites and forums, bacteria in the water does not cause otitis externa. It is actually caused by bacteria that is already present and lurking inside our ear canals, waiting for an opportunity to strike.
Ear wax is created by sweat glands that have been modified to produce the waxy substance that is present inside our ear canals. This necessary wax acts as a waterproofing layer that coats the canal and prevents water and bacteria from getting into the cells of the canal lining.
When the cells become saturated from frequent immersion in water they swell and pull apart just enough to allow bacteria to slip between them and find a warm moist place to grow and multiply underneath the surface of the skin. Once the bacteria is allowed to multiply and affect surrounding tissues the resulting pain begins to be noticed.
One easy way to determine where the ear is infected is by gently tugging backwards on the pinna, which is shown in the above photo. You can also gently press on the fleshy lump just in front of the ear canal which is called the tragus, If this hurts, it is an outer ear infection, if not it is a middle or inner ear infection.
If left untreated, the swelling can spread to the nearby lymph nodes and cause enough pain that moving your jaw becomes uncomfortable. At this point, the only treatment is antibiotics, either with pills, and/or ear drops, and diving is definitely out of the question until the infection has cleared up. If the infection becomes extreme, an antibiotic injection may be necessary.
It is very easy to prevent otitis externa or swimmers ear, and it will not break the bank to do it, but the following steps need to be done precisely to be effective.
Create a solution of 50% distilled white wine vinegar and 50% isopropyl alcohol, both of which can be obtained from just about any grocery store. The white wine vinegar is approximately 4-6% acetic acid, and has a pH of 3.0, which is perfect to use as a bactericidal to prevent the bacteria from multiplying. The isopropyl alcohol acts as a drying agent to draw excess water out of the cells lining the ear canal.
To administer, lay on one side and drop enough of the mixture into the ear canal to fill the canal. The most important part of the treatment is to remain still and hold the solution in the ear canal for a full five minutes. After the solution has been in contact with the ear canal for a full five minutes, turn over to allow the solution to drain and repeat with the other ear canal.
If the solution does not stay in contact with the ear canal for a full five minutes, it’s effectiveness is greatly reduced. This procedure should be done twice daily, once before the first dive of the day, and then once more after the final dive of the day.
If there is a chance of a ruptured eardrum due to a squeeze, DO NOT place drops into the ear. Doing so may inadvertently flush bacteria into the middle ear causing a worse infection problem.
If the above steps are followed exactly as described, this will prevent you from having to miss a dive because of swimmers ear.