Otomycosis

Otomycosis is a fungal infection of the ear canal. Normally, bacteria and fungi live on the skin all over the body including the ear canal.

These microorganisms, called normal flora, exist in harmony and help keep each other “in check” so neither grows out of control. In addition, earwax is an oily substance produced by glands in the ear canal and the dead skin on the surface of the canal. It has antibacterial and antifungal abilities to protect against infections. The acidic nature of earwax also helps prevent the growth of fungi and bacteria. Fungal infections of the ear canal can be mistaken for bacterial infection, and they can also occur together. These infections occur most commonly in the summer swimming season when heat, humidity, and water exposure is more prevalent.

What Are the Symptoms of Otomycosis?

Symptoms of otomycosis typically include:

Pain in the ear
Itching of the ear
Plugging of the ear with decreased hearing
Drainage from the ear
Symptoms occurring at the same time

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What Causes Otomycosis?

Removing earwax with cotton-tipped swabs can increase the possibility of an ear canal infection because the natural protectant of the skin is gone. Excess moisture can also foster fungal infections of the ear canal in some patients. Otomycosis occurs when there is moisture, injury to skin, and a lack of earwax to protect the ear.

Fungi that live on the skin in the ear canal or are introduced externally need a warm, moist environment to grow. The nature and shape of the ear canal allows water to remain there for a long period of time, letting humidity build up quickly when the ear canal is plugged. Sometimes, fungal infections of the ear canal occur as a result of using antibiotics. Antibiotic eardrops suppress the growth of bacteria but not the growth of fungi. When the bacteria die, the fungus has nothing to keep it “in check,” so it can grow and lead to an ear canal infection, or otomycosis.

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What Are the Treatment Options?

Treatment for otomycosis involves preventing the growth of the fungus by removing the dead skin and fungal elements. This is best accomplished by a thorough cleaning of your ear canal performed by an ENT (ear, nose, and throat) specialist, and the application of an antifungal agent. Commonly, your physician may ask you to use a combination of alcohol and vinegar to wash your ear. Removing the dead skin and creating a dry, slightly acidic environment prevents the growth of fungi.

If you have a hole in your eardrum, the options for treating otomycosis are limited. Your physician may prescribe a topical antifungal called clotrimazole or a topical antifungal powder, which helps dry the ear and kill the fungus. Some physicians use an antifungal medication called gentian violet, which some patients refer to as “the purple stuff” due to its deep purple color. One last option is an antifungal cream placed in the ear canal and left for a few days. Your physician may fill the entire ear canal with the cream, which will gradually melt and come out.

It is important to protect your ears If you have repeated fungal or bacterial infections. For instance, you may need to keep water out of your ears when bathing, showering, or swimming. Keeping your ears dry and avoiding excessive use of cotton-tipped swabs will help get rid of the problem.

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What Questions Should I Ask My Doctor?

How can I protect my ear when showering or exposed to water?
What should I do to keep my ear clean and free of debris?
When should I follow up with you?
How do I prevent further infections?
I am immunosuppressed; is there anything special I need to worry about?
What should I be concerned about that would make me call your office?

Last reviewed July 2023.

Other Ear Conditions

Hearing and balance are critical to how we conduct our daily lives. ENT specialists treat conditions such as ear infection, hearing loss, dizziness, ringing in the ears (called tinnitus), ear, face, or neck pain, and more.