Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Swimmer’s ear (otitis externa) is an affliction that affects scuba divers, swimmers, windsurfers, surfers, kayakers and many others who spend considerable time in the water. The prevailing opinion is that the most effective measure to prevent swimmer’s ear is to dry out the ears after each entry into the water, to eliminate the moisture that promotes maceration of skin and proliferation of infection-causing bacteria. This can be done mechanically by blowing warm air into the external ear canal, or by instilling liquid drops (such as a combination of vinegar and rubbing alcohol) that change the pH within the ear canal and evaporate readily, leaving behind a relatively dry environment. It is generally advised to not stick any foreign object, such as a cotton-tipped swab, into the ear, avoid traumatizing the external ear canal or, worse yet, the eardrum.

Wearing earplugs gets mixed reviews. In a scuba diving situation, the pressure of the external water at depth can force them into the ear canal in such a way as to make them difficult or impossible to retrieve and/or to cause injury. In a surface swimming situation, they may prevent water from entering the ear, but may also cause abrasions to the external ear canal.

A new product, ClearEars (Cirrhus Healthcare Products, LLC), are foam earplugs intended to be placed in the external ear canal after swimming or otherwise filling the canal with water. They are reusable and designed to absorb water. They’re as easy to insert as are noise barrier plugs used by persons such as hunters or industrial workers. After the water is absorbed, they retain the water that they have absorbed, so when they are removed, they cannot be wrung out. So, you get a few uses out of each earplug and then it must be discarded. They certainly absorb water, so the mission is accomplished.

Are they better than the traditional approach of ear drops? They may be better tolerated by children, but are not recommended for children under the age of 3 years. It has been suggested that foam may be abrasive, so micro-trauma to the skin of the external ear canal is a possibility. All in all, they seem like a reasonable approach to a common problem, particularly in a situation where instillation of ear drops is impractical or not going to be tolerated. I’ve used a tightly-swirled peak of unattached cotton (NOT “on a stick”) to accomplish the same purpose, sometimes when ear drops did not clear easily from one of my ears. The important thing is to remain gentle with any approach to the external ear canal, because if you trigger an infection, you could be buying an unintended vacation from the water for a few days or even a trip to the doctor.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.