Outer ear infection (Otitis externa)
This could be a very painful condition. Predisposing factors include swimming in polluted water (or even simply being in a humid environment), the use of cotton buds and narrow ear canals. The causative agents are usually bacteria, fungi or viruses. It is best treated by getting the debris or trapped wax out of the ear (once again with a tiny vacuum) and then using antibiotic ear drops and pain killers. In some situations the infection may be bad enough to need a foamy splint (pope wick) to be inserted in the ear. This splint absorbs the antibiotic ear drops and ensures that the antibiotic ear drops are in constant contact with the inflammed ear canal skin. The splint is removed after 48-72hrs by which time there is enough space for the ear drops to get in to the ear canal.
Repeated ear infections may be caused by skin conditions, allergies or narrow ear canals which are not self cleansing. A careful history and examination will usually help to arrive at this conclusion. Skin conditions can be treated and allergies controlled. Surgery to widen the ear canal (meatoplasty) may sometimes be required.