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Otitis Externa Treatment Overview

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Care Plan


First steps to consider

  • If you think you have otitis externa (swimmer’s ear), see a healthcare provider to get treated.
  • A primary care provider or an ear, nose, and throat (ENT) doctor will likely treat it with antibiotics or other medications.
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Emergency Care

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Go to the ER if you have any of the following symptoms:

  • Severe and worsening ear pain that is more painful at night or when chewing
  • Ear drainage that is yellow or green, contains pus, and smells bad
  • Pain when you touch the area behind your ear
  • Hearing loss
  • Difficulty swallowing
  • Facial weakness

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All treatments for otitis externa
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Read more about otitis externa care options

When to see a healthcare provider

If you have ear pain or itching, you should see a healthcare provider. If not treated, swimmer’s ear can become chronic or spread to other areas of the body.

It’s also important to see your provider so they can rule out other conditions that cause symptoms similar to those of otitis externa, like temporomandibular joint syndrome.

Getting diagnosed

  • Your provider will diagnose otitis externa based on your symptoms and a physical exam.
  • Depending on the stage and severity of the infection, your provider may take a sample from your ear canal to look for bacteria or fungus.

What to expect from your doctor visit

  • Your provider may remove pus, drainage, and debris from your ear during the appointment. Medications for otitis externa work better when the ear is clean.
  • The standard treatment for bacterial otitis externa is topical antibiotic drops like polymyxin B and neomycin. Some antibiotics also contain a corticosteroid to calm inflammation and swelling. You should start to feel better within 2 days of starting the medication.
  • For otitis externa caused by a fungus, you may be prescribed a topical antifungal medication like ciclopirox (Ciclodan) or nystatin (Bio-Statin).
  • If the ear canal is very swollen, a small wick might be placed in the ear to help ear drops get inside the canal.
  • While oral antibiotics like ciprofloxacin (Cipro) usually aren’t needed for otitis externa, they may be prescribed if you have a condition that weakens the immune system, like diabetes or HIV. Or if the infection has spread to other areas of your body.

Prescription otitis externa medications

  • Topical antibiotic drops: polymyxin B, neomycin, hydrocortisone, ofloxacin, ciprofloxacin and hydrocortisone (Cipro HC), ciprofloxacin and dexamethasone (Ciprodex), acetic acid with hydrocortisone (Vosol HC)
  • Antifungal medication: clotrimazole solution (drops), fluconazole (oral), voriconazole (oral)
  • Oral antibiotics: ciprofloxacin (Cipro)

Types of providers who treat swimmer’s ear

  • A primary care provider can treat mild to moderate symptoms.
  • An ear, nose, and throat doctor (ENT) has specialized training in treating ear infections. You may be referred to an ENT if your infection is severe or won’t go away or if your eardrum is damaged or torn.
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