Otitis externa is swelling and irritation of the ear canal. It's usually caused by an infection with bacteria (a type of germ). Treatment with ear drops helps most kids feel better within a few days.

Using Ear Drops

• Even if symptoms are gone, it's important to give the medicine for the full number of days prescribed. Otherwise, the otitis externa could come back.
• Before using the drops:
  • Wash your hands with soap and water. Dry with a clean towel.
  • If there is yellow or white pus or blood in the ear canal, talk to your health care provider to see if it's OK to give the drops. If it is, wipe the outside of the ear with a clean tissue. Do not put anything inside your child's ear canal to clean it.
  • Rub the medicine bottle between the palms of your hands or place it in warm water to warm up the drops if the medicine was stored in the refrigerator.
• To use the drops:
  • Have your child lie on their side with the ear that is getting the medicine facing up. If your child needs help staying still, have someone help you. 
  • Gently pull the outer ear outward and upward or downward until you can see clearly into the ear canal. Steady the hand holding the medicine dropper by placing your wrist on your child's cheek or head.
  • Put the correct number of drops into your child's ear canal without touching the dropper to any part of the ear.
  • Have your child stay on their side for 5 minutes and gently rub the skin in front of the ear to help the ear drops flow inside the ear canal.
  • Before your child gets up, gently place a cotton ball into the ear canal to prevent the medicine from leaking out.
  • Rinse the tip of the dropper with clean water and put the cap on the medicine bottle right away.
  • Wash your hands.
  • Safely store the medicine out of the reach of children.

If Your Child Has Pain

• Try placing a warm compress against the ear.
• If your health care provider says it's OK, you can give acetaminophen (such as Tylenol^® or a store brand) or ibuprofen (such as Advil^®, Motrin^®, or a store brand). Do not give ibuprofen to babies under 6 months old. 

Caring for Your Child's Ears

• Your child should not get their ears wet until all the medicine is finished and the pain is gone. To keep the ears dry: 
  • While bathing or showering, your child can gently place a cotton ball coated with petroleum jelly (such as Vaseline^® or a store brand) into the ears or wear a shower cap over the ears.
  • Have your child avoid swimming or other water activities where water could get into the ears. 
• Your child should not use earbuds (earphones that go inside the ear) until all the medicine is finished and the pain is gone.

• The ear canal is too swollen for you to get the drops in.
• Your child's pain gets worse.
• Blood or pus is draining from the ear.
• Your child gets a fever.
• There is redness, swelling, or warmth of the ear or the area around it.
• Your child's hearing doesn't return to normal after treatment is done.

Your child:

• has increasing or severe pain
• looks sicker
• gets new symptoms like trouble swallowing, weakness of the face, or a hoarse voice

What are the signs of otitis externa? Kids with otitis externa usually have pain and itching of the ear canal. They can have a plugged-up feeling in the ear from the swelling and might feel that they can't hear as well as usual. Fluid also might be coming out of the ear.

What causes otitis externa? Otitis externa usually happens because a breakdown of the skin in the ear canal allows bacteria to grow. This can happen from:

• swimming a lot (Otitis externa is sometimes called "swimmer's ear.")
• scratching the ear canal with a fingernail or cotton swab
• hearing aids, headphones, and earplugs 
• skin irritation from allergies or eczema
• a middle ear infection with drainage into the ear canal

What can help prevent otitis externa? These tips can help protect kids from getting otitis externa:

• Do not put cotton-tipped swabs or any other objects into the ears. 
• Only let kids swim in pools and hot tubs that are checked regularly for bacteria and kept clean.
• Avoid swimming in rivers, lakes, or ponds with high bacteria levels. Check for posted signs about bacteria levels and if it's safe to swim. 
• After swimming or bathing:
  • Have kids tip their head to the side to help water drain out.
  • Dry the outer ear with a towel.
  • Use a hair dryer on the lowest heat setting, held at least 12 inches from the ear, to help dry the ear canal.
• If your health care provider recommends it, kids can:
  • Wear earplugs and a bathing cap for swimming.
  • Use over-the-counter ear drops such as Swim-EAR^®, Auro DRI^®, or a store brand after swimming. These drops should not be used if your child has ear tubes or a hole in the eardrum.