Chronic Otitis Externa

chronic otitis externa

Otitis externa is an inflammation of the ear canal which may be caused by infection, allergy or other causes. Symptoms include itch, ear discharge, temporary dulled hearing and pain.

What are the symptoms of chronic otitis externa?

In addition to the classical symptoms of otitis externa mentioned above there is:

  • Constant itch in and around your ear canal.
  • Discomfort and pain in your ear.
  • A discharge from your ear.
  • Your hearing can also be affected. This can be due to some thick, dry skin building up in your ear canal which then narrows it.

Causes of chronic otitis externa include:

Sensitive ears

If you get water, shampoo, soap, hairspray, etc, in your ears it may cause irritation or itch. This may cause you to scratch or poke the ear. This can damage the skin in the ear canal and cause inflammation.

Do not clean the ear canal with cotton buds. They may scratch and irritate, and push wax or dirt further into the ear. The ear cleans itself, and bits of wax will fall out now and then.

Ear drops

Sometimes otitis externa does not clear because ear drops are not used correctly.

Resistant bacteria

Some bacteria (germs) which infect the ear canal are resistant to some antibiotic ear drops. A change to a different type of ear drop may be advised if you have used the first one correctly, but there has been little improvement after a week or so.

Clearing the discharge may be advised

A doctor or nurse may clean the ear canal. They do this by using cotton wool on the end of a special stick which is gently pushed inside the ear canal to mop up any discharge or debris.

A wick may be advised if the ear canal is very swollen

A wick is a piece of gauze material which is soaked in antibiotic drops. It is gently placed in the ear canal by a doctor or nurse. The wick ensures that an antibiotic is always present and reaches to the inner part of the ear canal. A wick is usually changed regularly.


Paracetamol or ibuprofen will usually ease any pain. Stronger painkillers are occasionally needed.


Some people develop an allergy or sensitivity to ear drops that are used for otitis externa. The itch and discharge may then become worse rather than better. If this is suspected then a change to an ear drop low in allergy reactions may be advised.

Fungal infections

Most infections of the ear canal are caused by bacteria. These germs usually clear up with antibiotic drops. An uncommon cause of persistent otitis externa is due to a fungal infection. Fungal germs are not killed by antibiotics - in fact antibiotic and steroid ear drops can make a fungal infection worse.

Middle ear infections

If the ear canal is full of discharge it may be difficult for a doctor to tell whether it is from the outer ear (otitis externa) or from a middle ear infection which has come through a burst eardrum.

Skin disorders

Sometimes the inflammation in the ear canal is a local area of a skin disorder, such as a small patch of eczema or psoriasis. The symptoms in the ear may be similar to an infection, but bacteria or fungal germs are not the cause.

Preventing otitis externa

Try to keep the ear canal dry, and avoid soap or shampoo from getting in. The most important thing is to avoid scratching or poking the ear canal with fingers, towels, cotton wool buds or anything else

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