Call­ing Dr Bratt

It’s now the so-called sum­mer va­ca­tion. When I was a school child, this was known as Au­gust hol­i­days. For us it meant a time to run up and down Scott Bushe Street in Cor­beau Town, play hide and seek in near­by Vic­to­ria Square and bare­foot foot­ball in the lit­tle patch of green in front of the Fire Sta­tion on Wright­son Road.

Nowa­days, if you haven’t been to Dis­ney World in hot, mug­gy Or­lan­do, you haven’t lived.

It was al­so the time when, if you were lucky and your un­cle George was so in­clined, you would be tak­en on an all-day ex­cur­sion to Care­nage to get sun­burn, step on sea urchins and eat stale rock cake when you got hun­gry. If you were un­lucky, you al­so got a painful, ten­der ear called “swim­mer’s ear” or “ex­ter­nal oti­tis” be­cause it af­fects the vis­i­ble, out­er part of the ear which con­tains the pas­sage lead­ing from the out­side to the eardrum.

“Swim­mer’s ear” is not the pleas­ant thing you might imag­ine it to be. It’s pain “for so” es­pe­cial­ly wors­ened when­ev­er the ear is touched. That means you can­not lie down in your favourite sleep­ing po­si­tion be­cause any­thing touch­ing the ear dur­ing sleep caus­es pain and the pain from “swim­mer’s ear” is mas­sive.

You get swim­mer’s ear when wa­ter, es­pe­cial­ly dirty wa­ter, gets in­to the ear canal and gets trapped be­hind wax in the dark, warm en­vi­ron­ment near the eardrum. Wax is a nor­mal prod­uct of the ear canal. Sim­i­lar to the oil on your skin, it’s there to pro­tect the skin of the ear canal. There is no need to clean the ear of wax. The ear clears the ear canal of wax us­ing a nat­ur­al self-clean­ing con­vey­or belt sys­tem: new skin forms deep in the ear canal near the eardrum and as the skin ages, new skin is formed be­hind it and push­es the old skin to­wards the en­trance. Ear­wax sticks to the mov­ing skin and trav­els out.

When well-mean­ing peo­ple at­tempt to re­move ear wax (cot­ton buds or hair clips!), they pack the wax back down in the ear canal and dam­age the del­i­cate lin­ing of the canal. That dam­aged area be­comes an ide­al breed­ing ground for bac­te­ria to flour­ish. Wax trapped in the ear canal de­hy­drates, hard­ens and fur­ther ir­ri­tates the skin as bac­te­ria from con­t­a­m­i­nat­ed wa­ter bur­row in­to the dam­aged skin. Bac­te­ria mul­ti­ply, cre­at­ing in­fec­tion and the ear be­gins to itch and hurt.

Chil­dren do not have to go swim­ming to get “swim­mer’s ear”.

Wa­ter that is trapped in the ear canal dur­ing a show­er or a sham­poo can have the same ef­fect.

The symp­toms and signs of swim­mer’s ear are:

* Ear­ache that wors­ens when the ear is touched or pulled

* Red­ness or swelling of the out­er ear or ear canal.

* Flu­id or pus drain­ing from the ear

* Crust­ing in the ear canal

* In the ad­vanced stages, hear­ing im­pair­ment due to pus buildup and in­flam­ma­tion.

You need to see a doc­tor to have the ear cleaned out and to get ear drops to treat the in­flam­ma­tion. While you are wait­ing to see the doc­tor, ap­ply heat to re­duce the pain us­ing a heat­ing pad or a cov­ered hot wa­ter bot­tle on the af­fect­ed ear and give the usu­al dose of parac­eta­mol or ibupro­fen.

If the ear is filled with ear­wax then the wax needs to be re­moved be­fore the in­fec­tion can be prop­er­ly treat­ed with an­tibi­ot­ic and cor­ti­sone ear drops. Clean­ing ear­wax from an in­fect­ed, in­flamed ear canal is painful un­less it is done by an ENT sur­geon. Since most chil­dren (or adults) do not go to a spe­cial­ist for un­com­pli­cat­ed ear prob­lems, clean­ing out ear­wax needs to be done slow­ly us­ing spe­cial ear drops while at the same time us­ing the an­tibi­ot­ic ear drops in the ex­pec­ta­tion that some may get to the ir­ri­tat­ed and in­fect­ed area.

There are some things you can do to pre­vent swim­mer’s ear, in chil­dren who seem prone to ear in­fec­tions:

1) Make sure that the child does not have a fun­gal ear in­fec­tion or eczema­tous skin. A vis­it to an ENT spe­cial­ist may be nec­es­sary.

2) Use earplugs when­ev­er the child swims or show­ers. Use the ones that are form-fit­ting. Keep­ing out wa­ter will help pre­vent in­fec­tion.

3) On­ly al­low your child to swim in clean, well-treat­ed swim­ming pools. Avoid ponds and stag­nant wa­ter.

4) Use a so­lu­tion of white vine­gar (acetic acid) in wa­ter (50/50 mix). Put a few body-tem­per­a­ture drops in your ear dai­ly, es­pe­cial­ly af­ter you swim. Bac­te­ria do not grow well in an acid en­vi­ron­ment.

By fol­low­ing these sim­ple home treat­ment pro­ce­dures, you help al­le­vi­ate your child’s dis­com­fort and re­duce the risk of fu­ture cas­es of swim­mer’s ear.