Fungal ear infection is an infection of the outer ear. The medical term for it is otomycosis. It usually affects the area from the ear hole to the eardrum – the external auditory canal. One or both ears can become inflamed, with dry, itchy skin and possibly a smelly discharge. It can become chronic but often is easily treated with antifungal medication.
Who is at risk of fungal ear infection?
It mostly affects people who live in warm or tropical climates, or people who participate in water sports. People with diabetes or other chronic medical or skin conditions can also be at a higher risk of otomycosis.
I think I have fungal ear infection – what should I do?
If you have pain or a discharge in one or both of your ears, go and see your doctor as they will be able to make a diagnosis and prescribe the correct medication and/or treatment.
What happens when the doctor examines me?
Your doctor will collect your medical and family history to assess any risk factors. It will assist greatly to get a correct diagnosis if you tell your doctor all you can that may be relevant – for example, whether you’ve been scuba diving, whether you’ve been to a hot country on holiday, whether you have diabetes, and so on.
There will be a physical examination of your ears. Your doctor may look into your ears using an otoscope that helps them see your ear canal and eardrum. They may also take swabs of any discharge, fluid or build-up in your ears for laboratory tests. This will help them differentiate between a fungal and a bacterial infection.
What causes a fungal ear infection?
The lining of the ear is protected by wax, also known as cerumen. If this wax is washed away by swimming in the sea or a pool, or reduced by overuse of cotton buds, your ears are more susceptible to fungal infections.
Fungal ear infections are more common in warmer climates, and in the UK they occur more often in summer than winter – fungi prefer moisture and warmth to grow.
Having diabetes or a weakened immune system may make you more susceptible to otomycosis. Eczema inside the ear can also be a cause, as can any trauma to the ear canal.
What are the medical names of the fungi?
You may hear specific medical terms during your diagnosis and treatment. Most fungal ear infections are caused by the Aspergillus fungus and others by the Candida fungus.
Note – you may also come across the terms ‘superior semi-circular canal dehiscence syndrome’, SCD, SCDS or SSCD. They all relate to the same thing.
What are the symptoms of fungal ear infection?
There are several symptoms to look out for, although you may not experience all of them:
Itching more common symptom of fungal infections than bacterial ones
Discharge a thick fluid, most commonly yellow, though it can be grey, green, black or white
Redness especially in the outer part of the ear canal
Hearing problems a ringing in the ears, or a feeling of ‘fullness’
Swelling / inflammation
Please note that you may experience symptoms in only one ear
How are fungal ear infections treated?
There are several methods to treat otomycosis; your doctor will recommend the best for you.
Effective treatment starts with cleaning the ear to remove any discharge or debris buildup. This should only ever be done by a medical professional – do not try this yourself at home. You risk serious or even permanent damage to your ears. The doctor may rinse your ears or use a suction tool or syringe. The process may be uncomfortable; if so, your doctor may give you some painkillers.
Your ear is cleaned and dried. This will help inhibit the regrowth of any fungus. Avoid scratching your ear, however itchy it gets. You should avoid swimming until your fungal ear infection has cleared up.
You may be prescribed antifungal ear drops which you will need to use according to your doctor’s advice – this may be several times a day.
These ear drops may include:
- 1% Clotrimazole
- 2% Acetic acid
- 5% Aluminium acetate (also known as Burow’s solution)
Eardrops may also contain amphotericin B, econazole or miconazole
Antifungals may also be in the form of a cream or ointment that you will need to apply to your outer ear. These will treat the fungus and help relieve any hard crust that may have formed on your outer ear.
Some fungal ear infections may be resistant to ear drops and topical medications and you may have to take oral medications, such as itraconazole or voriconazole.
Do not take oral antifungal medication if you have liver disease.
How can I prevent otomycosis?
A few simple steps can help prevent otomycosis:
Never overclean your ears: leave a small amount of earwax for its natural antifungal properties
Dry your ears well after bathing or swimming. You may consider using earplugs when swimming to keep water out
Never insert cotton buds or swabs inside your ears. Your Grandma’s advice to never put anything smaller than your elbow in your ear is perfectly true.
Do not scratch your ears