Summertime downers: Swimmer’s Ear and Poison Ivy

Spring and Summer means pool time fun coupled with planting flowers and doing yard work. Sometimes though, the fun turns to “frown” when dealing with two common Summertime downers: swimmer’s ear and poison ivy.

Swimmer’s ear, or Otitis Externa as we doctors like to call it, is an infection of the ear canal usually caused by bacteria or fungi (yuck!). Water from swimming or bathing gets stuck in the ear canal and creates an ideal environment for the bacteria or fungi to grow and cause problems. Tiny little breaks in the skin barrier allow these germs to infect the canal and cause rapid and significant inflammation. Typical symptoms are pain in the ear, pain with moving the ear around or laying on it, ear discharge, and a feeling of fullness or blockage if the external ear canal has become very swollen. The ear canal has many little sensory nerves inside, so the pain from this infection can be very intense, often preventing sleep. If left untreated, it can spread (malignant otitis externa) to the bone becoming life threatening. Diabetics are at increased risk for this.

Ways to prevent swimmer’s ear include preventing entry of water (well fitted swim cap), drying the ear out after swimming (hair dryer on the lowest setting), and using an acidifying drop such Swim-Ear. Also, avoidance of Q-tips and other irritants to the ear is important as this can traumatize and strip out the ear’s natural protectants. Treatment for Otitis Externa typically includes combination antibiotic-steroidal-acidifying drops, oral antibiotics and / or antifungal agents.

Poison Ivy Contact Dermatitis is a skin disorder caused by contact with Toxicodendron radicans (poison ivy), a poisonous plant common in the Southeast. The offending agent in poison ivy (as well as poison oak and sumac) is urushiol, a substance found in the sap of these plants. About 70% of people are allergic to urushiol, and if you are one of these unlucky people and you come in contact with urushiol, about 24 hours later you will start itching and seeing the characteristic linear red lines, blisters, and red bumps where your body had contact with the plant. The rash itself is not contagious, including the fluid in any blisters (assuming you have washed off any urushiol).

Prevention of poison ivy is important. Poison ivy can be identified by noting plants that have: clusters of three leaflets, that alternate leaf arrangement, lack of thorns, and whose groups of three leaflets grows on its own stem, which connects to the main vine. If you suspect you have come in contact with poison ivy, wash your skin thoroughly as soon as possible with soap and water. Soap is very important as urushiol is an oil. There are some commercial agents, such as Zanfel® that claim to clean better, but this has not been well studied. If the rash develops anyway, calamine lotion and oatmeal baths, and OTC cortisone can help relieve symptoms. More often, however, the intensity of the itching requires medical treatment, usually in the form of oral or injectable steroids. Without treatment the rash can take 2-3 weeks to resolve. The sooner one presents for treatment, the more likely that medicine can help. Once treatment is started it is critical that you take all your medication as directed. It usually takes a 10 day course of oral steroids to do the trick, and stopping prematurely can cause a nasty rebound of symptoms that’s even more difficult to control. Another thing to watch out for is something called bacterial “super-infection”, where bacteria can cause an infection by entering the open blisters or vesicles. In these bacterial infections, pain, warmth, increasing redness, and fever can be present. Seek immediate medical attention for any of these signs or symptoms.

So if you or a loved one has come down with a painful ear or itchy rash, and OTC medications are not relieving your symptoms and your Primary Care Provider is unavailable, come see your local Piedmont Urgent Care by Wellstreet Provider and we will do our best to have you Well on Your Way!

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