2.
Elsevier ClinicalKey Clinical Overview
Screening and Prevention
Advise patients to avoid excessive moisture and trauma to the auditory canal
Acidification with a topical solution of 2% acetic acid is an effective drying technique after exposure to moisture
Application of topical isopropyl alcohol is suggested as an alternate regimen
Counsel swimmers on importance of evacuating water from external auditory canal after swimming (eg, head tilt and gentle ear traction to promote water evacuation)
Patient should dry wet ears with a hair dryer on low setting after exposure to moisture
Wear soft, malleable ear plugs while swimming
Patient should avoid manipulation or instrumentation of the external auditory canal to prevent self-induced trauma; stop frequent ear cleaning, especially with cotton-tipped applicators
Ensure that hearing aids are well fitting and removed nightly; avoid hard earplugs owing to risk of trauma
Ensure that underlying dermatologic conditions are adequately treated
Treatment
Recommend precipitant avoidance:
Reduce moisture exposure to the ear
Avoid water sports and swimming with head submersion under water; competitive swimmers should avoid swimming for at least 2 to 3 days
Use earplugs or cotton with petroleum jelly when bathing
Use a hair dryer on the lowest setting to reduce any remaining moisture in the external auditory canal after potential water exposure
Avoid hearing aids, ear phones, and ear plugs (when not protecting from water exposure while bathing) until pain and discharge have subsided
Recommend preventive measures to avoid precipitating factors and prevent recurrent or recalcitrant infection:
Dry external auditory canal thoroughly after exposure to moisture or swimming
Avoid self-induced trauma (eg, cleaning ears with foreign objects)