Earplugs or heated pools, it's your call

After years of surfing I started getting lots of ear infections. My GP said it's because my ear canal is narrowing. What can I do to stop it getting worse?
- K.P.
Exostosis is the term for narrowing of the ear canal because of bony ingrowths. Surfers are at highest risk, but ocean swimmers, scuba divers, or anyone repeatedly exposed to very cold water over the years can also develop these.
Usually they become problematic in the third and fourth decade of life. It's as though the body is trying to protect itself from further insult by closing off the ear canal.
If you stop the cold exposure, it shouldn't progress. You can do this by swimming in pools, or using tight latex swim caps, neoprene hoods, or silicone ear plugs. You can also use a warm hairdryer to gently dry out your ear canal after showers.
The goal is to eliminate stagnant moisture in the canal, which forms a breeding ground for bacteria that cause external ear infections, or otitis externa. To eliminate this moisture, you can also mix white vinegar half-and-half with isopropyl/rubbing alcohol and use three drops in the affected ear after swimming or surfing to help dry it out, or even as a treatment for very mild cases of otitis externa.
Over-the-counter ear preparations are also available that do the same thing. Use these only after your GP has established your diagnosis and ruled out a perforated eardrum. With time, some surfers with exostosis may end up with frequent ear infections that don't clear (despite treatment) or even deafness.
As a last resort, an ear, nose and throat surgeon can remove the bony growths with drills or micro-chisels, but the operation is not a trivial one because of the ear canal being so narrow, deep, and close to the delicate eardrum. Better to just prevent it in the first instance.
A surfer's rule of thumb: If it's cold enough for you to need a wetsuit, your ears need plugs.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)