Outer Ear Infections Treatment in Singapore

Otitis externa, or an outer ear infection, affects the ear canal, the passage between the outer ear and the eardrum. It occurs when moisture, bacteria, or other irritants trigger inflammation or infection in the ear canal’s skin

This condition is more common in frequent swimmers and those in humid environments, often causing discomfort, pain, and temporary hearing issues.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Symptoms Causes Types Diagnosis Treatment Prevention FAQ

Symptoms of Outer Ear Infections

Patients with otitis externa may experience various symptoms that typically develop over a few days. Common symptoms include:

Ear Pain and Discomfort: The ear canal becomes tender when touched, particularly while moving the outer ear or jaw during eating.
Itching: The ear canal develops persistent itching sensations, which often precede other symptoms.
Discharge: A clear, yellow, or sometimes greenish fluid drains from the ear canal, which may produce an unpleasant odour.
Hearing Changes: Temporary hearing reduction occurs when the ear canal swells or fills with discharge.
Redness and Swelling: The ear canal’s skin becomes inflamed, causing visible redness and narrowing of the canal.
Flaky Skin: The ear canal’s skin may become scaly or flaky as the infection progresses.

Causes and Risk Factors

Several factors can trigger or increase the likelihood of developing an outer ear infection. Common causes include:

Water Exposure

Regular swimming or extended water contact removes protective earwax and creates conditions that promote bacterial growth.

Mechanical Damage

Using cotton buds, fingernails, or other objects to clean ears can create scratches in the canal, allowing bacteria to enter.

Skin Conditions

Conditions like eczema or psoriasis can make the ear canal more susceptible to infection.

Chemical Irritation

Hair products, certain earplugs, or hearing aids can irritate the ear canal’s delicate skin.

Types of Outer Ear Infections

Acute Diffuse Otitis Externa

The most common type, affecting the entire ear canal. The infection develops over a few days, causing widespread inflammation. With treatment, it typically resolves within 2-3 weeks.

Chronic Otitis Externa

A persistent condition lasting more than 3 months or with 4 or more episodes per year. The ear canal remains irritated and inflamed, often requiring extended treatment periods and investigation of underlying causes.

Necrotising Otitis Externa

A severe infection that spreads to the surrounding bone tissue. This type primarily affects elderly patients with diabetes or those with compromised immune systems. It requires immediate medical attention and long-term antibiotic treatment.

Diagnostic Methods

Physical Examination: An otoscope, which provides light and magnification, is used to inspect the ear canal. This helps ENT doctor assess swelling, discharge, redness, or any visible damage to the ear canal lining and determine the severity of the infection.
Ear Swab Culture: In severe, recurrent, or treatment-resistant infections, a sample of ear discharge may be collected for laboratory testing. This helps identify specific bacteria or fungi causing the infection, allowing for targeted treatment with appropriate antibiotics or antifungal medication.
Additional Testing: If necrotising otitis externa is suspected, a CT scan or MRI scan may be needed to check whether the infection has spread beyond the ear canal to nearby bone or tissue. These imaging tests provide a clearer picture of the condition’s extent and guide treatment decisions.

Treatment Options

The treatment approach varies based on the type and severity of the infection, addressing both the underlying cause and symptoms.

Topical & Oral Treatment

Ear Drops: Antibiotic drops treat bacterial infections, while antifungal drops target fungal infections. Many also contain anti-inflammatory ingredients to reduce swelling and discomfort.
Ear Cleaning: The ear canal may be cleaned to remove debris or discharge that could block ear drops from reaching the infection. This can be done using gentle suction or specialised tools.
Oral Medications: For more severe infections, our clinic may prescribe oral antibiotics or anti-inflammatory medications alongside ear drops to help clear the infection and relieve pain.

Minimally Invasive Treatment

Wick Placement: When the ear canal is severely swollen, a small foam wick may be inserted to absorb and gradually release ear drops deeper into the canal. This helps maintain drainage and ensures the medication reaches the affected area more effectively.
Debridement: In some cases, removing infected tissue, debris, or excessive ear wax may be necessary to improve airflow, enhance medication absorption, and promote healing. This can be done using gentle suction or specialised instruments.

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Prevention and Management

Wearing earplugs or a swimming cap can help keep water out of the ear canals while swimming or bathing, reducing the risk of infection. After water exposure, tilting the head to each side allows any trapped water to drain naturally. Avoid inserting objects like cotton buds into the ear canal, as this can cause irritation or push debris deeper. For those prone to recurring infections, using acidic ear drops after swimming or maintaining a regular ear-drying routine can help prevent flare-ups.

For Singaporeans & Singapore Permanent Residents

Medisave & Insurance Shield Plan approved

Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.

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Frequently Asked Questions (FAQ)

How long does an outer ear infection last?

With proper treatment, most infections improve within 7 to 10 days. Symptoms such as pain, swelling, and discharge usually start to ease within the first few days of using medication. However, without treatment, the infection may persist, worsen, or lead to complications.

Can an outer ear infection affect my hearing?

Swelling and discharge in the ear canal can cause temporary hearing reduction, which typically improves as the infection clears. In rare cases, if the infection becomes severe or leads to complications, hearing loss may last longer, but permanent damage is uncommon.

When should I seek emergency care?

Immediate medical attention is needed if you experience severe or worsening pain, high fever, facial weakness, or redness spreading beyond the ear. These symptoms may indicate a more serious condition, such as a deep tissue infection or necrotising otitis externa, which requires urgent ENT specialist treatment.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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