Otomycosis is a fungal infection in the outer ear. Symptoms include inflammation, dry skin, and a smelly discharge in the ear canal.
People most likely to be affected by otomycosis include those who live in warm, tropical climates, and those who participate in water sports. Otomycosis is often easily treated with topical antifungal medications.
In this article, we look closely at otomycosis, including its causes, symptoms, treatment, and prevention.
Otomycosis is an infection caused by a fungus. There are several different types of fungus that can cause this infection, but most otomycosis infections are related to Aspergillus species or, less commonly, Candida.
People come into contact with fungi every day in the environment, but fungi do not typically pose a problem.
However, those with weakened immune systems can catch an infection more easily than others when they come into contact with a fungus.
Also, people who live in hot or tropical climates are more likely to experience otomycosis, as fungi thrive in warm, damp places.
Other risk factors include:
- trauma to the ear from hearing aids or cotton swabs
- chronic skin conditions, such as eczema
- having diabetes mellitus
- participating in water sports, including swimming or surfing
- swimming in contaminated water
- lack of cerumen, or earwax, which suppresses bacterial or fungal growth and stops the ear canal drying out
Typical symptoms of otomycosis include:
- hearing loss, which can be mistaken for deafness
- a feeling of fullness in the ear
- redness of the outer ear
- itching, a more common symptom of fungal infections than bacterial ones
- inflammation or swelling
- flaky skin
- ringing in the ears
- discharge from the ear, which can be white, yellow, gray, black, or green
These symptoms typically occur in one ear, but it is possible that both ears can be affected at the same time.
Symptoms of otomycosis should always be evaluated by a doctor in order to get the correct diagnosis and treatment.
The doctor will take a thorough medical history to determine if any risk factors are present. They will perform a physical exam with an instrument called an otoscope to look inside the ear canal and eardrum.
The doctor may also take a sample of cells or fluid from the ear and look at them under a microscope. This will help them to differentiate between a fungal or bacterial infection.
A doctor will prescribe the correct treatment once a diagnosis of otomycosis is made. Treatment can be eardrops, topical cream, or oral medication.
Firstly, a doctor usually needs to clean the ear. They may use a rinse or a suction tool to do this. Cleaning will get rid of debris or a buildup of material and allow the medication to work better.
Next, the ear is cleaned and dried, as much as possible, to inhibit further growth of fungus.
Note that a person should not attempt to clean their own ears with cotton swabs or other tools, as this could worsen the situation.
Eardrops or topical agents
A doctor may prescribe eardrops that contain an antifungal agent.
Eardrops may also contain econazole, miconazole, or amphotericin B, among other chemicals.
Antifungals may also be in the form of a topical cream that is applied to the outer ear.
Other topical medications might include:
- aluminum acetate
- salicylic acid
- hydrogen peroxide
These agents can help to treat the fungus or soften the crust that forms to help other medications penetrate better.
Oral medications, such as itraconazole or voriconazole, are usually reserved for more severe infections, or infections that are difficult to get rid of with topical agents. Some fungus species are resistant to antifungal eardrops.
Oral antifungals can be a problem for people who have liver disease.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to ease any minor pain.
Although uncommon, complications can arise from otomycosis.
Otomycosis can become a chronic condition if not adequately treated, or if it does not respond to treatment. This can also happen if a person has continued exposure to contaminated water that contains a fungus.
Otomycosis can invade further than the outer ear and perforate the eardrum or travel to places that may include the inner ear or base of the skull.
These types of infections typically require oral antifungal treatment and surgical management. A complication such as this is more likely to occur in those who have a weakened immune system or diabetes mellitus.
There are a few factors that can help prevent otomycosis, including:
- leaving a small amount of earwax in the ears for its natural anti-fungal properties
- drying the ears well after swimming and bathing
- using earplugs when swimming to keep water out
- using a hairdryer on low speed to dry ears, being careful not to burn the skin
- avoiding scratching the ears as this may damage the skin and make it easier for a fungus to invade
- avoiding putting cotton swabs in the ears
In general, otomycosis is not dangerous, and it is easily treated with antifungal treatments.
Otomycosis can become chronic if someone does not respond to treatment or has a weakened immune system, diabetes mellitus, or a chronic skin condition, such as eczema.
Otomycosis can usually be prevented by keeping the ears dry and avoiding contaminated water sources.