About external ear infection or otitis externa
If your child has an external ear infection, the lining of their ear canal on the outer side of their eardrum is infected with bacteria or fungus.
Children who swim a lot often get external ear infections. This is because water stays in their ears after swimming. This creates the moist, dark environments that bacteria or fungus can grow in.
External ear infections might also happen if your child’s ear canal is damaged by using cotton buds or scratching. A secondary bacterial or fungal infection often develops in this situation.
Children who have skin problems like eczema or dermatitis are more likely to get external ear infections.
The medical term for external ear infection is otitis externa. You might also hear it called ‘swimmer’s ear’.
The ear has 3 main parts – the outer ear (the ear canal and ear lobe), the middle ear (which is behind the eardrum and linked to the throat via a small tube), and the inner ear (which has the nerves that help to detect sound).
Symptoms of external ear infection
If your child has an external ear infection, they might have a painful or itchy ear. Younger children might spend a lot of time scratching their ears.
The ear usually feels blocked, and your child might have trouble hearing. Chewing can sometimes make the pain worse.
Sometimes there can be bleeding or even discharge from the infected ear. Your child might also have painful, swollen lymph nodes around their ear and neck.
Severe external ear infections can cause the whole ear to become swollen. The ear might look purple or grey on darker skin or red on lighter skin. The colour can spread onto your child’s face and neck.
Medical help: when to get it for children with external ear infection
You should take your child to your GP if your child:
- complains of an earache
- has discharge from the ear
- has swelling in or around their ear or their ear has changed colour
- is generally unwell, has a fever or is vomiting
- keeps getting external ear infections
- seems to be having trouble hearing.
Tests for external ear infection
Your GP will look carefully inside your child’s ear using an instrument called an otoscope. This is a small camera with a light at the end.
If there’s any discharge from the ear, your GP might take a swab for testing. This can help the GP work out what kind of germ is causing the earache.
Treatment for external ear infection
For mild external ear infections, your GP might prescribe ear drops for your child. These usually have a combination of corticosteroids and antibiotics in them. Some also include an antifungal treatment. Your child should use these for several days before you get their ear checked again.
For more severe external ear infections, your GP might insert a small length of gauze, called a wick, into your child’s ear. The wick is soaked in a solution of antibiotics and corticosteroids.
While your child has an external ear infection, you and your child should avoid touching or scratching the ear.
Your child’s ear also needs to be kept completely dry. Your child shouldn’t swim until the ear is completely healed. They should also cover their ear with a shower cap or bathing cap in the bath or shower. This will prevent water from getting into the ear.
You can use paracetamol or ibuprofen in recommended doses if your child is in pain.
Prevention of external ear infection
If your child keeps getting external ear infections, it might help to put drying drops in their ear after swimming and bathing. These drops dry out the ear canal. You could also try using a hair dryer on the cold setting to dry your child’s ears.
Wearing good-quality earplugs while swimming and bathing can also help prevent this condition.
Don’t use cotton buds to clean your child’s ears. They can damage the ear canal and ear drum. They can push ear wax in deeper, cause it to build up, or even damage the ear canal or drum. If you do need to clean your child’s ear, gently use the twisted corner of a tissue.