November 1, 2020


Andrew Camilleri

Holiday Ear

Have ear infections complicated your holidays in the past?

A few years ago, my family and I were invited out to a Dordogne farm with pool for two weeks by an old school friend of mine. When I got there, he explained that he invited me out because I was an ENT surgeon and his family always get ear infections while on swimming holidays! If you can’t afford to take me on holiday with you then follow some simple advice and don’t let your ears spoil your holiday this year.

Ear infections most commonly occur in the external ear as a result of bathing in dirty water. The sea is usually clean due to its high salt level but swimming pools of fresh water need regular cleaning and chemical disinfectants to keep them safe. Any green algae in a pool should be enough to warn you off! The longer you stay in the water, the more likely you are to get infection. Children are therefore most susceptible.

Why do some people get infections and others are spared even when swimming together? Recent studies have shown that swimming in dirty water alone is not enough to cause infection. The affected ear skin has to be damaged to allow the bacteria to penetrate. Vigorous cleaning with cotton buds or the corner of the towel causes small lacerations. It is the combination of contaminated water and trauma which causes infection.

You do not need to put anything into your ear to get the water out. Nature has provided ear wax specifically to waterproof the skin of the external ear. Merely inclining your head to the side and wiggling the ear will allow the water to come out with gravity. Be patient, it can take a minute or so.

Some people have a skin disease (e.g. eczema) or eardrum perforation which impairs the skin defence against bacteria. They should keep their ears dry by using earplugs and a swim cap to keep them from falling out.

If you already have an infection then the best treatment is to have your ear cleaned with suction (by an ENT surgeon in the clinic) and then take antibiotic eardrops for one week. Tablet antibiotics are only useful if the infection spreads to the skin around the ear making it bright red and tender. After the infection, the ear feels itchy for many weeks before it finally settles down. Do not scratch it or you will develop a further infection from your bath water! Instead, treat your ear with steroid eardrops which soothe itch.

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