Ear health (Shutterstock)
Article 19 July

How to keep your ears healthy on your travels

From travel sickness to ‘swimmer’s ear’, looking after your lugholes can be the difference between a trip to remember and one to forget, advises Dr Jane Wilson-Howarth

Pardon?

It is always a good plan to sort any niggling symptoms before each trip. If you aren’t hearing too well, it is worth asking your GP if your ear canals are full of wax. If they are, the treatment is to put a drop of olive oil in each ear every night for two weeks then book in to see the practice nurse for syringing.

If time is short, over-the-counter treatments such as Waxsol (docusate sodium BP 0.5%) makes the wax softer and less likely to trap water within the ear when swimming. It can save pain later, and the alternative of digging with cotton buds is never a good idea.

Pressure drop

The ear comprises three compartments: the drum lies at the end of the ear canal; beyond that is the middle ear; and deeper still is the inner ear where the organs of balance sit. If the pressure within the middle ear is different to that of the outside world, the drum will be stretched and can become painful. Swallowing, chewing, drinking, yawning and moving the jaw momentarily opens the eustachian tube connecting the ear with the throat and allows pressure equalisation.


Flying with or soon after a heavy cold or ear infection can be very painful. If flying while congested, chewing on gum will help your ears to remain comfortable and mentholated gum probably works best.


Similarly, if you have sinus congestion this can cause great pain on take-off and landing, and people have described the pain as being similar to someone sticking a screwdriver through your cheekbone. Frequent (hourly, for just 30 seconds or so) steam inhalations before a flight will help clear the mucous and make the trip more comfortable. Some may need to resort to a single dose of a decongestant such as Sudafed, which in the short term solves the pressure problem but in my clinical experience seems to predispose users to sinus infection if repeated doses are taken.

Dry your ears after swimming in the sea as trapped water leads to infections (Dreamstime)
Dry your ears after swimming in the sea as trapped water leads to infections (Dreamstime)

In the water

Any trip that allows you to spend a lot of time swimming increases the risk of external ear infection (or “swimmers’ ear”). This is when the outer ear becomes infected, and because the external canal is encased within the skull, even a little swelling causes a disproportionate amount of pain.


This problem’s more common in people who clean their ears with cotton buds, as they remove the protective wax. The usual treatment is to put drops into the ear canal that contain antibiotics and steroids; often these can be bought over the counter in a pharmacy. The Dutch commonly use aluminium acetate drops, which are effective.


Surfers and swimmers enjoying the waves can often get sand and debris in their outer ear. If left in situ, this will cause irritation and infection may follow. However, it should be possible to flush out most of the debris while showering.


Flushing is most effective if the top of the ear is pulled towards the crown of the head while allowing water to play around the ear. After the shower, it is best to drain out any excess water by tipping the ear towards the ground and again moving the flap of the ear around to shake any remaining drops loose.

Middle-ear infections

Bacterial infection of the middle ear was common in children until the Hib immunisation reduced the risk. Although less common now, it can strike and cause a great deal of pain, and misery. If both ears are painful, however, this suggests a pressure problem that should clear with lots of jaw movements. But if the pain affects only one ear, it is likely to need a doctor’s assessment to see if oral antibiotics or drops are required.

Ear examining with an otoscope (Shutterstock)
Ear examining with an otoscope (Shutterstock)

Labyrinthitis

The inner ear detects the position of the body by sensing the movement of tiny grains of chalk that float within semi-circular canals. If signals from the inner ear are contradicted by what the eyes are telling the brain, then motion sickness can result. This means that closing the eyes can improve nausea symptoms when on a turbulent plane or bucking boat, and music can distract the sensations arising in the ear too. Those prone to travel sickness might ensure a supply of good, soothing music and eye masks.


The semi-circular canals of the inner ear can also be upset by viral infections, and when this happens you can feel seasick while still on land. At its worst it causes vomiting and such bad dizziness that the sufferer is confined to bed. There are sometimes outbreaks of this infection in people who have bathed in the Mediterranean. The dizziness can persist for many days but prochlorperazine seasickness pills usually help.

Ear care

The ears are common places for sun damage and skin cancer, so report to your doctor if you notice flaking and persisting lumps on the ears or elsewhere on sun-exposed parts of the skin. So-called sun spots or solar keratoses are most common in those who have been sunburned excessively or often, and they can need excision.

Dr Jane’s own experience

We’d been on a short trek in Nepal and our five-year-old son had been complaining about his ear. I’m ashamed to say that I didn’t take much notice but my husband took a look and said: “I think there is something moving in there!”


A small tick had crawled inside his ear and dined so well that it was trapped between the folds of his outer ear. The blood-bloated tick fell out when we waggled the ear, and when my boy saw his parasite he took great delight in jumping on it.


The lymph nodes on one side of his neck subsequently became a bit inflamed but he escaped infection. Ticks can often spread a variety of nasty infections, so seek medical help if bitten.


Dr Jane Wilson-Howarth lived in remote corners of Asia for 11 years but now works in Cambridge as a GP. Read about her writing at www.wilson-howarth.com


Main Image: Ear health (Shutterstock)