Otitis externa can usually be treated effectively with ear drops prescribed by your GP and some simple self-care techniques.
In most cases, your symptoms will start to improve within a few days of starting treatment.
If your symptoms are severe or they fail to respond to initial treatment, your GP may refer you to a specialist for further treatment and advice.
Managing your symptoms at home
The advice below should help to relieve your symptoms to some extent and help to prevent complications:
- avoid getting your affected ear wet – wearing a shower cap while showering and bathing can help, but you should avoid swimming until the condition has fully cleared
- remove any discharge or debris by gently swabbing your outer ear with cotton wool, being careful not to damage it – don't stick cotton wool or a cotton bud inside your ear
- remove anything from your affected ear that may cause an allergic reaction, such as hearing aids, ear plugs and earrings
- use painkillers such as paracetamol or ibuprofen to relieve ear pain – these aren't suitable for everyone, so make sure you check the information leaflet that comes with the medication first; if you're still unsure, check with your GP, practice nurse or pharmacist
- if your condition is caused by a boil in your ear, placing a warm flannel or cloth over the affected ear can help it heal faster
Treatments your GP can provide
While otitis externa can clear up by itself, this can take several weeks without treatment. Your GP can usually prescribe medicated ear drops that speed up the healing process. These usually need to be taken several times a day for about a week.
There are four main types of ear drops used to treat otitis externa:
Sometimes you may be given medication that's a combination of the above, such as antibiotic and corticosteroid ear drops.
Once treatment is complete and the inflammation has settled, your doctor may want to re-examine your ear to check for any underlying physical problems that could have contributed to the condition, such as having an abnormal or perforated (torn) ear drum.
Applying ear drops
Ear drops may not work as well if they're not used in the right way, so it's important to apply them correctly. Ideally, ask somebody else to apply the drops for you, as this makes the process much easier.
You (or your helper) will need to follow these steps:
- gently remove any discharge, earwax or debris from your outer ear using a twist of cotton wool
- warm the ear drops by holding them in your hands for a few minutes, as cold ear drops can make you feel dizzy
- lie on your side with your affected ear facing up before applying the drops directly into your external ear canal
- gently push and pull your ear for about 30 seconds to work the drops in and get any trapped air out
- stay lying down for three to five minutes, to ensure the ear drops don't come out of your ear canal
- leave the ear canal open to dry
If necessary, there are some other treatments your GP can provide to help treat otitis externa, such as:
- stronger prescription painkillers such as codeine for severe cases
- antibiotic tablets or capsules to treat a severe infection – an antibiotic called flucloxacillin is usually the preferred choice
- treatment for underlying skin conditions that may aggravate your otitis externa, such as seborrhoeic dermatitis, psoriasis or eczema
- if a boil develops inside your ear, your GP may decide to pierce it with a sterile needle and drain the pus – this is known as incision and drainage, and you shouldn't attempt to do it yourself
If necessary, your GP may refer you to a specialist for further treatment.
The specialist may decide to remove earwax from inside your ears to help make ear drops more effective. This can be done in a number of ways:
- syringing or irrigation – where water is injected through the nozzle of a syringe into the ear canal to dislodge and wash away any earwax
- microsuction – where a small suction device is used to remove any earwax, discharge and debris from your outer ear and ear canal
- dry swabbing – this gently mops out earwax from your ear canal
You may also need an ear wick, which is a soft cotton gauze plug covered with medication and inserted into your ear canal.
An ear wick allows the medication to reach the end of your ear canal. It should be changed every two to three days.