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Your Hearing is Precious. Protect Don't Treat

This article is sponsored by SwimSeal

Many people believe ‘dirty’ water is the cause of “swimmer’s ear” and pain. This is NOT the case!

We evolved to live on the land - not underwater, however being in the water is a great past time and passion for many of us.

Mammals that do immerse themselves in the water have developed physiological adaptations to prevent water from entering their ears or substantially reducing exposure of water to the ear canal.

Sadly, humans have not!

The evolutionary process provided us with minimal protective mechanisms to protect our ears when under water.

So what happens then when water enters the external ear canal?

Well for many ears, the natural structure of the ear will facilitate the water to trickle out with little fuss. Ear wax also plays a significant factor in helping expel water and in this way is our only natural protective adaptation. Everyone’s ear is a little unique in its shape, size, ear lobes, depth of ear canal, and angle of the ear canal and yes the amount of ear wax it produces. Some shapes will cause water to be trapped in the ear canal which is not only annoying but can lead to problems. Ear pain and infections, commonly referred to as Swimmer Ear can be the outcome. This is caused by repeated exposure of our ears to water and water being trapped or retained in the ear. If you have ever suffered from ear pain or infections you will know that it is no laughing matter.

Exposure to water, especially when it becomes trapped, can deplete the natural protective layer of ear wax that lines the ear canal this layer. Without this protective layer of wax, water can easily remain causing irritation with resultant pain and swelling. This painful inflammation can become infected with bacteria and fungi known as swimmer’s ear.

“Trapped water is one of the causes of outer ear infections.”

(Drs.Patrick H Allwright and Peter Tunguy-Desmarais ENT Surgeons and developers of SwimSeal Ear Drops)

This infection, (otitis externa), can be common in children or anyone with repeated water exposure. Water trapped in the ear canal from swimming, diving or simply showering is a primary cause of this condition. So yes, even the cleanest water, if retained in the ear, can cause ear problems. Swimmers Ear symptoms include pain, itching, dulled hearing and a discharge from the ear.

Infections require topical antibiotic or antifungal treatment initially. Oral antibiotics may need to be prescribed. In addition proper care requires keeping the ear dry until the infection resolves. This can mean 2 weeks out of the water. Whether you are an elite aquatic athlete, a weekend warrior or a parent looking after a child with an infection, two weeks can be a very long time. Swim teachers get frustrated too when their pupils miss classes or drop out all together because or “water in the ear” issues. We will write about this in a future post.

Over one million people per year are affected by infections and pain caused by retained water in the ear. The cost the health system is approximately $70M per annum in treating infections with antibiotics and the necessary doctor visits.

Apart from the inconvenience, repeated ear infections causes a build-up of scar tissue which makes it even more difficult for water to escape leading to higher risk of an infection. It is a sinister vicious cycle.

Now that we understand that the problem is water being retained in the ear, what can we do about it to stop it?

There are strategies that attempt to treat the problem.

Applying solutions that usually contain iso-propyl alcohol which acts like a drying agent to help remove the water. These products do not protect your ear canal from the water, and many people will experience a stinging when it is applied. The alcohol causes the delicate lining of the ear canal to dry out, crack and become macerated. Irritation and soreness is often the outcome. Micro cracks in the ear canal are also a great place for bacteria and fungi to find a home and flourish leading to an infection.

Exposure to isopropyl alcohol over a prolonged period or at high concentrations may have adverse health outcomes and is recommended to be avoided. If someone with a perforated ear drum inadvertently applies these alcohol based drops to their ears and it then enters the middle ear, deafness is a highly likely outcome.

Physical barriers such as ear plugs attempt to prevent the water getting into the ear in the first place. Whilst a good idea, this brings about its own issues. Ear plugs provide a physical barrier, however they make hearing what is happening around you impossible. They often tend not to completely seal (i.e.leak) can fall out and get lost. Children in swim classes can be distracted by them and the instructor’s guidance will not be heard and time, money and effort is lost. The incorrect use of ear plugs can cause ear wax to be impacted near the ear drum. If this happens then it will be an unpleasant experience and undoubtedly leads to another visit to doctor.

Home remedies can be in the form of solutions and physical intervention. Some people mix up their own solutions using combinations of alcohols, oils even vinegar and are aimed at drying the ear out. In addition to having no quality control on the contents or formulation these concoctions will cause more harm than good in the long term and are to be avoided. What happens if these concoctions become trapped in the ear ?

The use of cotton buds in the ear to try to soak up retained water should be avoided at all costs. Reasons for this are 1) they can impact the ear wax in the ear; 2) it is very easy to slip or push too far down and perforate you ear drum and 3) the fibres of the cotton can remain in the ear and rolling them around in the ear does cause abrasions of the ear canal lining, again providing an environment for an infection. Another practice is the use of ear putty or Blutac, again to seal off the ear. As you will imagine these can easily become lodged in the ear, fragments might break off in the ear, they are far from hygienic and will most likely not seal completely.

Preventative ear drops (e.g SwimSeal) prevent water being trapped at the same time as allowing hearing. A bit like an invisible ear plug. In this instance drops are applied before entering the water. So are a true preventative option. The drops comprise a medical grade silicone material that mimics some of the properties of natural ear wax, by forming a water repelling coating on the lining of the ear canal that expels water from the ear. It also contains tea tree oil which is well published for its anti-sceptic properties. This is a powerful and unique combination that is ear friendly as it is alcohol free.

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