Otitis externa

What is otitis externa

Otitis externa is a condition of the outer ear caused by inflammation of the skin in the ear canal, with or without associated infection. If infective, it could be caused by bacteria or yeasts- fungal infection.

This inflammation affects the ear canal and does not go further than the eardrum. This condition can be a single episode, recurrent condition or a chronic persistent issue.

Common causes

  • Getting water, shampoo or soap into the ear canal causing irritation of the skin
  • Water getting into the ear while swimming, having a bath or shower (water sometimes carries germs). Sometimes called swimmer ears.
  • Damage of the skin, trauma caused by cotton buds, scratching or fiddling with the ear
  • Hot and humid environment may encourage bacterial growth
  • Skin conditions such as eczema or psoriasis
  • A wax build up causing irritation or water getting trapped behind the wax build up.
  • Wearing ear plugs, hearing aids or head phones preventing ventilation in the ears
  • Over the counter drops can cause irritation of the skin of the canals

Dos and don’ts to prevent otitis externa

  • Avoid getting water, soap or shampoo in the ear when having a bath or shower. Place a cotton wool coated with Vaseline in the ear bowl to prevent water entering the ear. Do not push the cotton wool down into the canal.
  • Avoid inserting anything in the ears even when they are itchy, do not use cotton buds.
  • Avoid over the counter eardrops as some of these can cause irritation of the skin
  • Discuss the use of eardrops with an ENT specialist, GP, nurse.
  • Use earplugs if swimming, prevention eardrops
  • Do not have ear syringing or water irrigation if you have inflamed ear canals
  • Keep ears dry


The choice of treatment can be antibiotic eardrops, steroid eardrops, or a combination of both. Sometimes it’s a cream inserted into the canal or ribbon gauze soaked in medicated cream, or a pope wick which is a little sponge absorbing the eardrops and spreading the medication in the canal. Sometimes micro suction is recommended to clear debris and discharge for medication to work more effectively. Sometimes oral antibiotics are prescribed, in addition to the topical treatment.

Your GP may refer you to a specialist for further advice if symptoms are severe or they have failed to respond to treatment. The ear specialist will offer a treatment of choice based on clinical judgement.

Water precautions are paramount in the management of otitits externa. 


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