Acute Otitis Externa
Acute otitis externa is inflammation or infection of the outer ear canal, commonly causing pain when the ear is pulled, itching, swelling and discharge.
Key takeaways
- Water exposure, scratching, cotton buds, hearing aids and skin disorders can damage the canal’s protective barrier.
- Ear drops are often used, but the product must be suitable if the eardrum may be perforated or a tube is present.
- Diabetes or immune suppression increases concern when pain is severe or extends beyond the ear canal.
The listings below do not distinguish bacterial infection from fungal or inflammatory causes; examination should guide ear-drop selection.
What examination checks
The canal may be red, narrowed and tender, with debris obscuring the eardrum. Cleaning by a trained clinician can improve delivery of drops; inserting objects at home can worsen injury. A swab is not necessary for every uncomplicated episode but may help when treatment fails or infection recurs.
Treatment and prevention
Topical antimicrobial or anti-inflammatory drops may be prescribed according to the appearance of the canal and eardrum. Keep the ear dry during recovery and avoid cotton buds. Recurrent episodes may require management of eczema, fungal infection or problems with hearing devices.
When to seek urgent care
Seek urgent assessment for severe deep pain, fever, redness spreading around the ear, facial weakness, dizziness, or symptoms in a person with diabetes or significant immune suppression.