What advice should I provide to patients to prevent recurrence of otitis externa after treatment?

Advice to prevent recurrence of otitis externa after treatment:

• Avoid inserting cotton buds or other objects into the ear canal to prevent damage and further infection.
• Keep the ears clean and dry; avoid swimming and water sports for at least 7–10 days during treatment.
• Use ear plugs and/or a tight-fitting cap when swimming to protect the ear from water exposure.
• Keep shampoo, soap, and water out of the ear when bathing or showering by using ear plugs or cotton wool coated with petroleum jelly.
• Consider using a hair dryer on the lowest heat setting to dry the ear canal after hair washing, bathing, or swimming.
• For people aged 12 years and older, consider using over-the-counter acetic acid 2% ear drops or spray morning, evening, and after water exposure for up to 7 days to reduce bacterial growth and promote healing.
• Manage any underlying causes or risk factors, including associated skin conditions, to reduce recurrence risk.
• If allergic or sensitive to certain ear drops or devices (e.g., neomycin, ear plugs, hearing aids, earrings), avoid these or use hypoallergenic alternatives.
• Ensure correct technique when administering ear drops to improve treatment efficacy and reduce failure risk.

These measures help maintain a healthy skin barrier in the ear canal, reduce moisture retention, and prevent damage that predisposes to recurrent infection.