Key points about outer ear infections
- outer ear infections are infections of the skin inside the ear canal or around the outer ear
- outer ear infections are common in tamariki (children) and rangatahi (young people)
- they can happen if water gets trapped in the ear canal
Illustration of a child showing the difference between a healthy ear and an infected outer ear.
Source: KidsHealth
transcribeTranscript
The image shows the side profile of a young child looking to the left. A circle is drawn around the child’s ear, highlighting it. Two close-up circles zoom in to show comparisons of a normal ear and an outer ear infection.
- The top close-up circle shows a healthy outer ear and ear canal with the label 'Normal'.
- The bottom close-up circle shows an outer ear infection, with the ear looking red and swollen with yellow discharge coming from the ear canal.
- The infected ear is labelled: 'Outer ear infection – Inflammation of the outer ear and ear canal with discharge'.
At the top right is the KidsHealth logo with the website: kidshealth.org.nz.
What is an outer ear infection?
An outer ear infection causes redness and swelling of the outer ear canal. The ear canal connects the outer ear to the eardrum. Another name for an outer ear infection is swimmer's ear. The medical term is otitis externa.
Illustration of a child's normal outer ear showing the outer ear and ear canal.
Source: KidsHealth
transcribeTranscript
This illustration shows the inside of a normal ear.
It labels the outer ear, which is the part you can see on the side of the head.
It also labels the ear canal, which is the tube that goes from the outer ear to the inside of the ear.
The ear looks healthy with no redness, swelling, or fluid.
The word Normal is written underneath the image.
At the top left is the KidsHealth logo with the website: kidshealth.org.nz.
Illustration of a child's ear showing an outer ear infection.
Source: KidsHealth
transcribeTranscript
This illustration shows the inside of a child's ear with an outer ear infection.
The outer part of the ear is red and swollen. There is also some discharge or fluid coming out of the ear canal.
The text says: Outer ear infection. Redness and swelling of the ear canal with discharge.
At the top left is the KidsHealth logo with the website: kidshealth.org.nz.
Causes of outer ear infections
A common cause of outer ear infections is water trapped in the ear canal. This can happen after swimming or after baths or showers. Trapped water creates an environment for bacteria or fungi to grow.
Other causes include:
- trauma to the ear canal from things like cotton buds or fingernails
- infection spreading from the inner ear to the ear canal
- objects like little toys and beads getting stuck in the ear
Symptoms of an outer ear infection
Symptoms of an outer ear infection can include:
- pain in the ear
- itchiness in and around the ear
- the ear feeling blocked or full
- coloured discharge from the ear
For some tamariki, an outer ear infection can be very painful. The outer ear can become red and swollen.
Rarely, tamariki may have reduced hearing when they have an outer ear infection.
Who gets outer ear infections?
Outer ear infections are most common in tamariki and rangatahi who spend a lot of time swimming or in water.
Other things that can make tamariki more likely to get outer ear infections include:
- narrow ear canals
- lots of ear wax
- skin conditions such as eczema
How an outer ear infection is different from other ear infections
There are 3 parts to the ear:
- the outer ear
- the middle ear
- the inner ear
Illustration showing the anatomy of the ear including the inner, middle and outer ear.
Source: KidsHealth
transcribeTranscript
This ear anatomy illustration shows the main parts of the ear divided into the inner ear, middle ear and outer ear.
Labelled parts:
- Ear canal
- Eardrum
- Ossicles
- Cochlea
- Eustachian tube
- Nasal cavity
At the top left is the KidsHealth logo with the website: kidshealth.org.nz.
An outer ear infection affects the outer ear, which includes the ear canal and the part of the ear you can see.
A middle ear infection, also known as otitis media, is an infection behind the ear drum. Middle ear infections are common with colds.
See the page on ear infections to learn more about middle ear infections.
Diagnosing an outer ear infection
If you think your child may have an ear infection, take them to a health professional.
A health professional can diagnose an outer ear infection. They do this by using an otoscope to look inside your child's ear canal. An otoscope is a small, powerful light with a magnifying lens. Your health professional will also look at the outside of your child’s ear for signs of infection.
A video showing a health professional looking inside a young boy's ear canal with an otoscope.
Source: KidsHealth
Holding your child while they have an ear exam
Many tamariki do not like having an ear exam. To make it easier, the health professional may encourage you to comfort your child by:
- holding your child sitting sideways on your lap
- hugging their arms firmly with one of your arms
- holding their head firmly against your chest with your other arm
Photo showing how to comfort and hold your child during an ear exam.
Source: KidsHealth
Managing an outer ear infection
Ear drops
A health professional may prescribe ear drops for your child for a mild outer ear infection. These eardrops usually have antibiotic and steroid medicine in them. This helps to kill the infection and reduce the inflammation. Some ear drops also have an antifungal medicine that can treat fungal infections.
Your child may need ear drops for several days. Make sure they finish the total amount.
A health professional may prescribe oral antibiotics for more severe or ongoing infections.
Gentle cleaning
Your child’s ear may need gentle cleaning. Your health professional may do this or they may refer you to a specialist ear clinic.
Pain relief
If your child has discomfort, you can give paracetamol to make them more comfortable. You must follow the dosage instructions on the bottle or packet. It is dangerous to give more than the recommended dose.
Caring for your child with an outer ear infection at home
Ear drops
Your health professional will explain how to give the ear drops to your child. These are the main steps.
Have your child lie on their side with the infected ear facing upwards.
Put the ear drops in the ear canal.
Your child will need to stay lying on their side for 3 minutes, if possible. This position stops the ear drops from draining out of the ear when your child stands up.
Avoid touching the ear
While your child has an outer ear infection, encourage them not to touch or scratch their ear.
Don’t put cotton buds or anything else in your child's ear. This can be painful and can make the infection worse.
Keep the ear dry
Keep your child’s ear dry for at least 14 days after an outer ear infection. Cover their ears with a shower cap in the bath or shower. Your child shouldn’t swim until their ear infection is completely better.
When to get urgent medical help for your child
Take your child to a health professional urgently if:
- they have swelling in or around their ear
- they have severe pain or pain that isn’t getting better
- their ear has changed colour
- they seem to have trouble hearing
- they have discharge or blood coming from the ear
- they are unwell with fever or vomiting
If your child is not getting better despite treatment, take them to see a health professional again.
Possible complications from an outer ear infection
Most tamariki with outer ear infections get completely better.
Some tamariki may develop a recurrent or chronic outer ear infection. Recurrent outer ear infections can cause the ear canal to narrow. This narrowing is due to scar tissue forming.
Rarely, an outer ear infection can spread if the infection isn’t treated or if someone has reduced immunity. It may spread to the bones and cartilage behind the ear at the base of the skull.
Preventing outer ear infections
Wearing a good swimming cap or swimming earplugs when swimming can help. Make sure your child dries their ears well after swimming or showering.
A health professional may recommend using drying ear drops after swimming or bathing. This is useful for tamariki who often get outer ear infections.
Do you need to clear ear wax out of your child’s ears?
You don’t need to remove ear wax from your child’s ears. The ears are self-cleaning. If you can see large clumps of wax at the opening of the ear, you can gently remove these. Never use cotton buds to clean your child’s ears.
If you’re worried that ear wax is a problem for your child, talk to your health professional. They may suggest ear drops to help soften the ear wax.
Make sure your child doesn’t put cotton buds or anything else in their ears.
Acknowledgements
Illustrations by Dr Greta File - property of KidsHealth.
