What recommendations can be made to help prevent recurrent otitis externa (OE)?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Some patients experience multiple recurrences of OE and thus benefit from the adoption of a preventive strategy. The following recommendations related to ear hygiene may help prevent recurrent OE:

  • Eliminate any self-inflicted trauma to the ear canal, such as may occur with the use of cotton swabs or the insertion of objects (eg, bobby pins) into the EAC
  • Avoid frequent washing of the ears with soap; this leaves an alkaline residue that neutralizes the acidic pH of the EAC
  • Avoid swimming in polluted waters
  • Ensure that the ear canals are emptied of water after swimming or bathing; the use of a blow dryer on a low setting after swimming to dry the ear canal has been suggested as a preventive measure, though no studies have demonstrated this suggestion to be effective
  • Instill prophylactic eardrops after each exposure to water to assist in drying and acidifying the ear canal; a combination of 70% isopropyl alcohol and acetic acid in a 2:1 ratio may be used

Some have recommended wearing earplugs for swimming and bathing. If worn, earplugs should be wiped with rubbing alcohol after use. Others have argued that the use of earplugs should be avoided, on the grounds that they may cause trauma to the ear canal and thereby predispose to the development of OE.

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