The ears are among the most sensitive organs of the human body. Even the smallest inflammation in the ear area, such as ear boils, can lead to severe pain if not treated early.
What is an ear boil?
An ear furuncle, also known as otitis externa circumscripta among medical professionals, is an inflammatory change in the external auditory canal. There are particularly fine hairs, which are hardly perceptible to the human eye due to their small size and thickness. Despite their small size, these hairs also have hair roots, which may reach deep into the skin of the external auditory canal. The last end of the hair that leads into the hair root is called the hair follicle: a part of the hair that is particularly susceptible to inflammation. If inflammation occurs here, it may grow to such an extent that it reaches the surface of the skin. And this is exactly what is called an ear furuncle. The more the inflammation progresses, the more the bacteria multiply. As a result, highly infectious pus forms under the skin, which can cause severe pain to sufferers.
Causes
The inflammation of the hair follicle that ultimately leads to ear furuncle is usually caused by a particular type of bacteria: the staphylococcus family. Many subtypes of this bacterial family belong to the natural skin flora of humans, which not only do not cause disease or inflammation, but are actually of considerable importance to humans as a protective film. Other species, on the other hand, can cause inflammations such as ear furuncles. Due to their relatively low infectivity, not every contact with staphylococci must lead to the outbreak of an ear furuncle. On the contrary, the natural skin flora already mentioned provides effective protection in this respect. Only when this skin flora is impaired and the natural protective mechanism is disturbed can ear boils form. In particular, cleaning the ear canal with cotton swabs promotes the formation of ear furuncles. This is because, in addition to removing the skin flora layer, the mechanical cleaning also injures the sensitive hairs, which ultimately promotes inflammation.
Symptoms, complaints and signs
An ear furuncle may be noticeable by hot ears and severe pain in the ear. When carefully feeling for the cause of the pain, the sensitivity to pain is still increased. Severe swelling in the inner ear may be noted. The medical professional called in may also notice redness in the ear. If the ear furuncle has matured sufficiently, it will form a yellow pus focus. The attending physician can ensure that the symptoms are indeed indicative of an ear boil by visual inspection and swabbing. The trigger of an ear boil is usually, but not always, staphylococci. If these spread in the body, it can lead to further symptoms and subsequent complaints. The affected person feels weakened throughout the body. He has severe, sometimes radiating pain in one ear. In addition, there may be headaches or pain in the limbs. The quality of life is impaired by the severe pain. Pus formation in the boil may cause contamination in the ear when it opens at night. There may also be abscess formation in ear furuncles. There is a risk of blood poisoning if the causative germs or staphylococci enter the bloodstream. The typical symptoms of an ear furuncle favor such complications. Therefore, even the ear furuncle symptoms that appear early should be clarified and treated by a doctor. Self-treatment of ear furuncles is prohibited in view of the complication-prone complaint situation.
Diagnosis and course
Ear furuncles are easily diagnosed clinically because of their characteristic appearance. Only when it is suspected that staphylococci are not the usual causative agent, but others that require appropriate therapy, further diagnostic measures become necessary. These include, among other things, the smear test. By taking a smear of the inflamed area, to which some pathogens adhere, the attending physician can determine the specific pathogen by laboratory means and prescribe an appropriate medication to combat the causative agent of ear furuncle.
Complications
An ear furuncle is an inflammation, so various complications are also possible with this clinical picture. An inflammation in the ear is of course also associated with intense pain, so that the affected person is significantly limited in everyday life. Complications such as headaches and pain in the limbs can also occur. Pus formation is also a common complication that can occur in connection with an ear furuncle. Those who forego treatment with the help of medication or a doctor in the case of pus formation run a great risk of promoting further complications. These include, for example, the development of an abscess. An abscess is an accumulation of pus fluid. If this pus fluid enters the human bloodstream, then there is a risk of dangerous blood poisoning. If you want to avoid these complications, you should take medication as soon as possible if you have an ear furuncle or consult an appropriate doctor. Thus, if you suffer from an ear furuncle, you must also expect various complications at the same time. However, those who resort to taking medication have a good chance of being cured soon.
When should you go to the doctor?
Swelling or pain in the ear is considered unusual and should be sought medical attention. If there is pressure pain or hypersensitivity of the ear to touch, a doctor should be consulted. If there is a formation of pus inside the ear or an unpleasant odor coming from the ear, the complaints should be understood as signs of a health irregularity. A doctor should be consulted so that clarification of the cause can be made. If the complaints increase or persist unabated for several days, action is required. In severe cases, there is a risk of blood poisoning and thus a potential threat to life. In the case of an acute health-threatening condition, an ambulance service must be alerted. Headaches, a tilted position of the head or discomfort in the neck are further signs of a disorder. If sleep disturbances set in, physical and mental performance is reduced, or the person concerned complains of feeling unwell and generally ill, a visit to the doctor is necessary. In case of dizziness, disturbances of the balance as well as gait unsteadiness, a clarification of the symptoms is advisable. Pain in the limbs, irregularities in attention or deficits in concentration should be presented to a doctor. If the affected person’s zest for life or sense of well-being declines due to the impairments, a medical examination is needed. Changes in behavior as well as mood should also be understood as warning signs of existing physical ailments.
Treatment and therapy
Since bacteria are responsible for the majority of ear furuncles, the primary treatment option is the administration of antibiotics. Before antibiotics are administered, it is recommended that the inflamed area be disinfected with a special alcohol-based disinfectant. This initial killing of superficial pathogens helps the antibiotic, as it has fewer pathogens to fight. However, the initial alcoholic disinfection should only be carried out by doctors, since not all disinfectants are suitable for this purpose and, in case of doubt, not only make the pathogens of the ear furuncle resistant to the antibiotic, but can also lead to severe damage to the middle ear. In the case of particularly large ear furuncles, it may be necessary to cut them open surgically. The reason for this is that pus can accumulate in the boil, which cannot drain naturally even with successful antibiotic treatment. The bacteria living in the pus can then lead to recurrence, which is the development of a new ear furuncle.
Outlook and prognosis
Under normal circumstances, the prognosis for an ear furuncle is favorable. It is usually a temporary health impairment that resolves completely. It is associated with pain, hearing limitations, and swelling. If the present inflammation can be cured by the administration of medication, there is a regression of all existing health irregularities.In most cases, medications are administered to help the body’s defense system prevent the pathogens from reproducing and to kill them. Within a few days, a significant alleviation of symptoms can be expected. Recovery is achieved within a few weeks. Without adequate medical care, the inflammation may spread in the organism. The pathogens reach other regions in the body via the blood system and can also trigger diseases there. Therefore, people with a weakened immune system or high-risk patients in particular should not refrain from seeking medical treatment. In basically healthy people with a stable endogenous immune system, spontaneous healing can also be observed. They do not necessarily require medical care for relief of symptoms. Nevertheless, they should be attended by a physician for observation so that immediate action can be taken if their health deteriorates.
Prevention
Ear boils cannot be prevented entirely because of the wide distribution of staphylococci. Although vaccinations are not possible, this is not further required. After all, it is a painful disease, but not life-threatening. In this respect, the general recommendations remain to strengthen one’s immune system as well as the natural skin flora as the most effective protective mechanisms. This also includes refraining from excessive hygiene. The outer ear canal needs the natural sebum; removing it does more harm than good. That’s why medical professionals advise against cotton swabs and instead recommend cleaning the external ear canal with a gentle stream of water from the shower spray while showering, rather than using cotton swabs or surfactant-containing soaps and shower gels. Provided that the natural environment of the ear canal is not affected, pathogens that eventually lead to ear boils usually cannot spread.
Aftercare
An ear boil usually does not require long-term follow-up care. After the boil has receded, a few short-term wound checks by the doctor are required. Likewise, blood counts are measured to detect inflammation in the body. Finally, a comprehensive medical history is taken, during which open questions are clarified. If no abnormalities are found and the patient has no further questions, the treatment can be completed. The intake of any painkillers and anti-inflammatory drugs should be phased out slowly. The responsible physician should be consulted about this. Follow-up care also includes checking whether the trigger for the ear furuncle has been eliminated. If necessary, the physician can indicate further measures to cure causative conditions such as susceptibility to infection. Follow-up care on this point is based on the patient’s individual symptoms. The follow-up care of an ear furuncle is carried out by the physician who has already taken over the actual treatment of the furuncle. The ear specialist or an internist is responsible if the inflammation has spread to other parts of the body. In case of complications, another specialist may have to be consulted. Treatment of the ear furuncle must be resumed.
What you can do yourself
Regular cleaning of the ear is an integral part of personal hygiene. Foreign bodies, the formation of cerumen or other dirt must be removed so that no abnormalities or changes in the appearance of the skin develop. Bacteria or other germs can reside in the outer as well as the inner ear and become triggers of complaints. To ensure that the infestation of pathogens does not lead to further illnesses or worsening of an ear furuncle, thorough checks and cleaning of the ear should be carried out, especially when a diagnosis is made. If the affected person feels insecure or insufficiently able to perform a competent cleaning, it is advisable to hire another person to remove impurities. When cleaning the ear, care should be taken not to inadvertently push existing debris deeper into the ear. This often happens when cotton swabs are used to remove earwax or foreign objects. These can be used to push easily picked up particles deeper into the ear canals by twisting and turning. Irrigation of the ear is more optimal for improvement.They help to clean thoroughly, remove secretions of the ear furuncle and prevent possible new diseases in the ear canal. So that the skin flora is not affected, ph-neutral washing and skin care products should be used.