Surfer’s Ear: All the Latest and FAQs
By Corky Carroll
It’s that time of year when the water and air are getting cold and more and more surfers turn up with ear issues. Each year at this time I ask Doctor Carol Jackson, the world’s leader in “surfersear” treatment and the developer of the latest surgery techniquesto weigh in on the latest information that might enlighten local surfers on how to deal with those unwanted ear problems. The following just came in from Dr. Jackson.
“Having treated Orange County surfers and water enthusiasts for over twenty-five years, I’ve seen thousands with ear problems from frequent water exposure and unrelated conditions made worse by water activities. One consequence of years of frequent surfing is exostosis, known as “surfer’s ear.” 
That’s when bumps develop in the outer ear canal to protect the ear drum from the pounding trauma of cold water that occurs with forceful falls into waves. Exostoses enlarge over time and don’t shrink even when surfing is discontinued. When they block over 80% of the ear opening diameter, they trap sand and water leading to fungal and bacterial infections “swimmer’s ear”, which compounds blockage due to swelling in addition to exostosis.
Signs of exostosis are plugging, reduced hearing and discomfort. As the bone growths enlarge, frequent plugging, drainage and hearing reduction occur. When exostosis occludes over 90 % of the external ear canal, acute severe pain can occur. That’s because dead skin and germs become trapped between exostoses and set up painful swelling and infection debris.
Unfortunately, over the counter ear cleaning agents often worsen the problem by chemical irritation or drying. Home rubbing alcohol or vinegar may help prevent infections when used weekly or less, yet when used more often can contribute to infections known as “swimmer’s ear” by excessive drying and cracked canal skin. They should be avoided for those in water daily such as lifeguards, swimmers and water polo players. The drying opens the door to water borne and airborne germs..
Fortunately, minimally invasive outpatient laser-assisted removal is the latest best way to achieve complete, permanent and safe exostosis removal with quicker healing and less discomfort. There are no external incisions. With this technique, exostoses are gone for good. There’s no need for future repeat surgical excision. When patients come to us for revisions performed elsewhere, a recently developedcommercial graft material is helpful for lining the canal and grafting the ear drum when the patient’s own tissues are scarred and donor graft material is limited from prior surgery.
With this trans-canal laser-assisted technique there is little discomfort. Most patients require no postoperative paint medication or take Tylenol or a nonsteroidal anti-inflammatory drug such as Advil. Prior risks of long-ago surgical removals such as facial nerve weakness, new tinnitus or hearing loss; simply no longer occur due to advanced nerve monitoring during general anesthesia and greater precision with micro-instruments and laser.
Frequently Asked Questions:
“How long must I stay out of water after laser-assisted transcanal exostosis removal? Usually 4 to 6 weeks, returning with plugs and ear drops.
When can I return to work? Usually 2 days after the procedure while keeping the ear clean and dry.
Does removal make more grow back? No, not at all.
Does insurance cover this? Yes, according to your policy’s deductibles and co-payments.
To prevent exostosis or to halt the progression, the latest custom vented or membrane ear plugs are effective and popular. They allow sound to be heard through them, come in bright colors or on a lanyard and are rarely lost. Plugs halt the growth of exostoses; however, exostoses don’t shrink and cannot be dissolved. Ear plugs work by blocking the forceful rush of cold water against the ear drum when active surfers wipe out. Today’s plugs are comfortable and stay in place.
Ears do not need to be cleaned. Do not put Qtips or other objects in the ear to attempt to remove wax. Ears are self-cleaning when healthy. Ear wax is not dirt! It’s a protective water-repellent coating on external canal skin; like the wax you use on a surfboard. Q tips, alcohol and over the counter ear cleaning agents should be avoided. They remove helpful skin oils causing skin cracking leading irritated skin, debris, and dry wax which contribute to blocking the canal. Worse, occasionally a user will be allergic to chemicals in commercial ear was removal drops causing painful ear blistering.
In surfers over age 60, occasionally permanent partial hearing loss from surf trauma or board injury adds to damage of unprotected loud music, firearms and noise; plus natural aging of the inner ear. Advanced technology hearing aids can help. When properly fit, they improve conversational hearing clarity, brain health and ease of conversations with less fatigue. Many are barely visible. Nowadays most hearing devices are rechargeable and Bluetooth link to TVs and cell phones.
When water is retained in the ear, evaporate it with a standard hair dryer for three minutes or surfer’s ear dryer for use on the go. They’re available on the internet and plug into vehicle power ports or run on batteries. Without water in the dark warm ear canal, germs cannot grow. 
If you surf and experience ear plugging, reduced hearing, dizziness or imbalance your cou4ld have severe surfer’s ear or another ear condition that needs treatment. Best to get it evaluated. Early detection of ear disorders is important to reduce impairment to your hearing and balance. If you have any of these warning symptoms or signs, see an ear doctor with an office microscope. Have a hearing test in a sound booth by an audiologist or hearing professional. “You only have one pair of hears. Take good care of them””
You can reach Dr. Jackson at (949) 577 7744, her office in near Fashion Island in Newport Beach. Or for more information go to www.myeardoctors.com