DR. HOOK- Say what? Now hear this about swimmer's ear

"I'm so glad we had this time together...." Sing it, Carol Burnett!  

I actually have an autographed photo of Carol. She's funny, vibrant, talented, and very giving. At the end of the show, she would always do her trademark move: the ear tug. Wiggle wiggle wiggle... Goodnight! 

But if someone has otitis externa (aka swimmer's ear), doing the ear tug could be quite painful. "It's time to say–OW!"

   About 10 percent of Americans get otitis externa sometime in their lives. It's an infection of the ear canal (not to be compared with the toxic waste in New York's Love Canal) usually caused by bacteria, though fungus can also be the culprit.

   Ears burning? For some strange reason, people say that means someone's talking about you. But really, it could be otitis externa. Itching, ear pain, and sometimes even hearing loss can occur with otitis externa– or it could be from listening to Fox News.

  The discharge can be like the colors of the rainbow– or not: gray, yellow, brown, or white. This comes from the ear canal in externa, but in otitis media (middle ear infection) if the ear drum perforates, the discharge might be from that. 

   Hearing loss can occur if too much crud builds up from the infection, or the ear canal itself might be so inflamed it closes up– like that Stallone movie, Daylight, in which a NYC tunnel collapses. (I didn't see it. I was deaf to the plot.)

   And as mentioned above, pulling on the earlobe can be painful. Usually the earlobe doesn't get infected. But in severe cases the infection can spread to the bones in the skull and earlobe. Elderly people, diabetics, and immuno-compromised persons are more at risk for getting what's called necrotizing otitis externa. This is a serious condition and requires immediate medical attention.

   So what causes otitis externa? Well, the ear is designed to be protected from the elements (like dust, dirt, cotton swabs– ahem). The earlobe is shaped like a funky Art Deco couch to keep things from coming in. And for you older men, you know what I'm talking about when I mention the hair in your ear canals. This hair also protects the ear canal from "the elements." (Isn't it sad that while the hair on your head thins, it thickens in your eyebrows, nose and ears?) 

   In particular, the ear canal is protected from infection by cerumen (aka ear wax). It coats the skin and creates an acidic environment to keep germs from invading the skin. 

   However, this nicely coated environment can be disrupted by excessive cleaning or scratching. And putting things in the ear not only strips the cerumen ("Wax on, Wax off") but can cut the skin to allow germs to infect the canal.

   It is called swimmer's ear because water in the canal can be a pool party for germs to grow. Cerumen repels water, but if the cerumen is lacking, the water can break down the skin. Other things can create a moist environment like ear plugs, headphones, and hearing aids. Oooh, makes me want to put on my iPod earphones while on the beach, "Everybody's surfin, Surfin US... ow!"

   A trip to the doctor is usually required, and ear drops are very effective to treat otitis media. Topical antibiotics, topical steroids, acidifying solution and antiseptics make the ear go, "Ah!" For swimmers, water sports should be avoided for 7-10 days.(Gee, I hope that doesn't happen to our Summer Olympics swimmers and divers.)

   So if your doctor gives you an earful for sticking things in your ear canal, now you can understand why. But more important than this, remember not to let Mike Tyson bite your ear off. You can't treat that: no deposit, no return.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.