What are the differences between otitis externa and otitis media?

The inflammation is usually due to an infection. Otitis externa means that the inflammation is confined to the external part of the ear canal and does not go further than the eardrum. See separate leaflet called Ear Infection (Otitis Media), for an infection of the middle ear.

Otitis externa is an inflammation of the ear canal. The inflammation is usually caused by infection, although it can sometimes be due to allergy or irritation. Treatment with ear drops is usually effective. Further episodes of the condition can often be prevented by the tips given below.

Otitis externa usually clears within a week or so. When otitis externa is short-lasting, it is described as 'acute otitis externa'. However, sometimes it persists for three months or more and is then described as 'chronic otitis externa'.

Otitis means inflammation of the ear. The inflammation is usually due to an infection. Otitis externa means that the inflammation is confined to the external part of the ear canal and does not go further than the eardrum.

Otitis externa is an infection of the skin of the ear canal and is very common. The ear canal is a narrow, warm, blind-ended tunnel, which makes it a good protected environment for germs to grow in if they are given a chance. Most infections are caused by a germ (bacterium). Occasionally, they can be due to a fungal or yeast infection.

Some things can make you more prone to otitis externa - for example:

Substances entering the ear
If you regularly get water in an ear then this may provide moisture for germs to grow. It may also cause itching. You may then scratch or poke the ear. This can damage the skin in the ear canal and cause inflammation. Inflamed skin can quickly become infected. A vicious circle may then develop. The inflammation and infection cause more itch, you then scratch more, which then can makes things worse.

If you get shampoo, hairspray or other products into your ear this may have the same effect and may be worse, as the chemicals may additionally irritate the sensitive skin of the canal.

Swimming
Otitis externa is much more common in regular swimmers, due to water getting into the ear canal. In fact, otitis externa is sometimes called swimmer's ear. It is more likely if you are swimming in water which isn't clean, such as ponds.

Warm weather
Otitis externa is more likely to develop in hot, humid and 'sweaty' weather. It is more common in hot countries.

Skin problems
Eczema or psoriasis may affect the ear canal and make the skin inflamed and flaky. If this happens then otitis externa is more likely.

Excessive earwax
This can lead to trapping of water and debris in the ear canal. Bugs (bacteria) can thrive in these conditions and infection then occurs easily.

Ear syringing to clear earwax
This may irritate the delicate lining of the ear canal and cause inflammation. Earwax is protective of the ear canal, and if too little is left it is easier for infection to take hold.

Middle ear infections
Sometimes middle ear infections (otitis media) can produce persisting discharge which can become stuck in the ear canal and then cause otitis externa.

The only difference between these three 'types' of otitis externa is the length of time for which you have had the condition.

Acute otitis externa - this term means you have had the condition for less than three months. Usually, in fact, you will only have it for a week or so.

Recurrent otitis externa - this term means the condition keeps coming back. You have episodes that get better (or seem to get better) but then you develop the same symptoms again.

Chronic otitis externa - this term means the condition has lasted (persisted) for more than three months. Sometimes it can last for years. This is often because, even though you have had treatment, the underlying reasons for it are still there.

Most people with otitis externa are given treatment without having any tests, as the diagnosis is usually clear from examination of the ear. If you recognise the condition yourself you could try some ear drops for otitis externa. These are available without prescription, such as those containing 2% acetic acid.

Ear drops are usually enough to cure a bout of short-lasting (acute) otitis externa. However, other treatments are sometimes added. This is more likely to be necessary if you notice any of the following:

Your ears are particularly painful or swollen.
Your ears are completely blocked (so that the drops can't penetrate properly).
Your otitis externa keeps coming back or has become persistent (chronic).
It is also very important that you take steps to help things settle down, as if the conditions that caused the otitis externa in the first place are unchanged, it may well come back.

The inflammation is usually due to an infection. Otitis externa means that the inflammation is confined to the external part of the ear canal and does not go further than the eardrum. See separate leaflet called Ear Infection (Otitis Media), for an infection of the middle ear

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