External Ear Pain

External ear pain can have many causes. Infections can be bacterial, viral or fungal in origin. Most external ear infections are easily treated with antibiotic therapy so it is important to see your doctor as soon as possible. External ear infections can cause severe pain and may have long-lasting complications if not treated promptly.

External Otitus

• External otitus, or swimmer's ear, is a common cause of external ear pain. External otitus is the inflammation and infection of the external ear and canal. External otitus is often caused by swimming in polluted water, which may contain bacteria. Some people may get external otitus just from scratching their ear. In rare cases, a fungi can cause external otitus. Symptoms of external otitus are severe ear pain that gets worse if you tug on the outer ear, hearing loss, itching and pus drainage from the ear. External otitus is generally treated with antibiotic ear drops, corticosteroids and pain relievers. If left untreated, complications include hearing loss, recurring ear infections and bone and cartilage damage. Some people are more prone to external otitus and can develop chronic infections.

  People with compromised immune systems or elderly diabetics may develop malignant external otitus. Malignant external otitus occurs when the infection spreads from the external ear to the skull bone, middle ear and temporal bone. Symptoms include a foul smelling discharge from the ear, severe ear ache and decreased hearing. Malignant external otitus can be life-threatening and is treated by a six-week course of intravenous antibiotics.

Furunculosis

• Furunculosis is a hair follicle infection that can occur in the ear. When you have an infected hair follicle, a boil will form. The main symptom is otalgia (ear ache or ear pain). Tugging at the outer ear is extremely painful. Milder cases can be treated with antibiotics (oral or topical). The infection will often drain spontaneously with topical medication such as polysporin or bacitracin. Severe cases may require a minor surgical procedure called incision and drainage. Incision and drainage will provide immediate relief from furunculosis. Furunculosis, once treated, rarely recurs.

Otomycosis

• Otomycosis is a fungal infection of the outer ear canal. The condition usually presents with extreme itching deep in the ear canal. After a short time, the itching will turn into a dull pain and there may be drainage from the ear. Tinnitus, or ringing in the ears, is also a common symptom of otomycosis. Treatment usually consists of a thorough cleaning of the ear canal and the application of topical antifungal medication. Oral antihistamines may be prescribed to control the severe itching associated with otomycosis.

Perichondritis

• Perichondritis is a bacterial infection of the perichondrium or cartilage of the ear. It is usually caused by trauma to the ear. Perichondritis can occur as a result of ear surgery or ear piercing. The symptoms of perichondritis are severe itching and pain. Mild cases of perichondritis can be treated with topical or oral antibiotic therapy. Severe cases involving trapped pus can require surgical excision of the necrotic tissue. Early treatment is crucial as perichondritis can spread to the ear cartilage causing part of the ear to die. If this happens, plastic surgery may be required to restore the appearance of the ear.

Herpes Zoster Oticus

• Herpes zoster oticus, or Ramsay Hunt syndrome, is a viral infection of the external ear caused by the varicella virus. Herpes zoster oticus is associated with shingles and affects the ear's sensory nerves. Symptoms include burning pain in one ear, headache, fever and malaise. Oral steroids and antiviral medication such as acyclovir will be prescribed. Your doctor may prescribe narcotic pain medication as the pain from herpes zoster oticus can be very intense. Hot compresses held on your ear can also help ease some of the pain while you are healing. A small percentage of people with herpes zoster oticus (less then 2 percent) have postherpetic neuralgia, which is pain that lingers after the infection ends.