Otomycosis is a common fungal infection of the outer ear. It often follows a bacterial infection or trauma to the skin. Doctors suspect it when an ear infection has been treated with antibiotics for long enough but there is still discharge from the ear. This is an indication that an antifungal medication needs to be used.

Currently the recommended guidelines for treatment suggest acetic acid (vinegar!) as the first line treatment for otitis externa. It is remarkable that in these days of worsening antibiotic resistance this ancient remedy is at the forefront of treatment.

Treatment also involves keeping the ear dry. It is a good idea to minimize swimming and wear ear plugs whilst showering or bathing. ZenPlugs are great because they are waterproof and fitted to the ears. They are also antibacterial and antifungal, helping to keep the nasties away from your ears.

If in doubt about the underlying organism causing the otitis then a combination treatment such as Sofradex may be used. This consists of an antibiotic, anti-fungal and a steroid to reduce inflammation. This covers all bases and is a safe bet.

If otitis externa spreads past the eardrum then otitis media may follow. This tends to be more painful as the eardrum can stretch. Pus builds up in the space behind the eardrum, increasing in volume and causing pressure. The pain often increases to the point of the drum bursting when it becomes very severe but is then relieved.

Pus rushes from the ear and the infection usually then resolves as air can get in to the middle ear space.

Otomycosis can cause itchy, sore ears. These invite probing fingers which can worsen the problem. More germs are introduced and the damaged skin can be easily torn.

Summary. Otomycosis is fungal infection of the outer ear. It is a possibility when a bacterial ear infection has been treated. Treatment is with acetic acid and keeping the ears dry. Sometimes outer infection can spread to the middle ear which causes pressure and tends to be more painful.

Dr Toby Bateson for ZenPlugs