Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, August 15, 1995 TAG: 9508150028
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: LINELL SMITH THE BALTIMORE SUN
DATELINE: LENGTH: Long
``It was like nerve-racking,'' he says.
Shortly afterward, his sister Casey, age 6 1/2, discovered she had a weird white bump - ``like a little white ball or a cavity or something'' - on her foot. It turned out to be a plantar wart.
And their mother, Laurie Kelly, received another lesson in the flip side of summer fun. Although living pool-side can bring relief from the sweltering heat, it can also introduce families to such health woes as swimmer's ear, plantar warts and impetigo.
Between Brennan's ear, Casey's wart and 10-year-old Tyler's painful ingrown toenail, Kelly spent an entire week ``schlepping to the doctor's office and spending half the day there worried and uptight,'' she says. ``When it rains, it pours.''
The good news is that pool-related earaches, warts and skin infections are easily treated. Here are descriptions of these common conditions, how they are treated and how they can be prevented:
SWIMMER'S EAR
Some people have difficulty getting water out of their ears after they swim because of the shape of their ear canals or excessive ear wax. Residual water can provide the perfect breeding ground for bacteria or fungus, which cause the ear to feel blocked, then to itch and then to hurt - real bad.
And scratching the ear or sticking objects into it - Q-Tips, hairpins - to relieve the itching and blocked sensation only makes matters worse: Bacteria and fungi love to establish a ``beachhead'' in broken skin.
``Just a little bit of water in an ear is remarkably irritating,'' says otolaryngologist Dr. John Ruth of Union Memorial Hospital in Baltimore . ``You feel you can't hear and your sense of balance is off. But the skin in the ear canal is not used to being touched. What you think would be a gentle manipulation could be a skin breakdown.''
Once the infection is under way, you must visit a physician for prescription ear drops and usually stay out of the water for a couple of days. The average infection tends to last from three to seven days.
Sometimes an ear is so swollen, as it was in Brennan Kelly's case, that the doctor will insert a wick in it to keep the ear canal open enough to allow the drops in.
In rare instances, an outer ear infection becomes life-threatening: in some elderly people, diabetics and people whose immune systems are compromised by chemotherapy or such conditions as AIDS, the physicians say. In these cases the infection can penetrate the bone which surrounds the ear canal and requires aggressive therapy such as antibiotics administered intravenously.
Children who suffer from middle ear infections are no more likely to get swimmer's ear than those who don't, says otolaryngologist Karl Diehn of the Greater Baltimore Medical Center. However, those children who have had tubes inserted into their ears need to take special precautions against getting water into their ears.
To prevent swimmer's ear, try using such over-the-counter products as Swim-Ear, made from a solution of boric acid and alcohol, to draw out the water after you swim, Diehn says. Some swimmers find that ear plugs and/or swim caps help keep their ears drier.
People are no more likely to get swimmer's ear at an indoor pool than an outdoor pool, Ruth says. However, infection is more likely from any water that is not treated with chlorine - such as ponds or lakes - and from private pools that are not carefully monitored. Toddlers can pick up infections from playing in plastic baby pools where the water is not regularly changed.
Even those people who wouldn't be caught dead at a pool can get swimmer's ear. Heavy sweating during hot, humid weather, long sessions in a hot tub and showering can also cause water to get trapped in the ears.
And doctors caution against overzealous ear cleaning.
``The most common reason for infection is the use of Q-tips or bobby pins [to clean the ears], which traumatizes the skin and allows an infection to start,'' Ruth says.
``People talk about chemicals in the pool, but the reality is that a lot of external otitis is caused by germs which people already have on their own skin,'' says Diehn. ``If you get moisture in the ear, then it provides culture medium so the bacteria grow.''
WARTS
Swimming pool pavements - and locker rooms - are known for accommodating the viruses that cause plantar warts and the fungi that cause athlete's foot.
The most common way to get plantar warts, those often painful warts on the soles of your feet, is to walk around barefooted at a swimming pool, gym or locker room, says podiatrist Marc Lenet, chief of podiatry at Liberty Medical Center and the University of Maryland Medical Center, both in Baltimore. The virus that causes warts can exist on the ground.
``The foot is made up of concave surfaces - like the arch - and convex surfaces like the heel and the ball.
``The pores of the skin dilate and contract so that when you're walking with that kind of foot surface, you get a suctioning effect and can pick up all kinds of organisms on the ground that will embed in the skin cells.''
Because of the force of the body's weight, plantar warts on the feet embed into the skin while warts on other parts of the body remain more elevated.
Podiatrists and dermatologists can remove plantar warts by using chemicals to burn them off, by surgically removing them or by using a laser treatment.
Lenet tends to treat more children than adults for these warts - ``There's a certain resistancy an adult may have over a child'' - but says that adult cases can be more difficult to eliminate and that they have a higher degree of recurrence.
Lenet describes the customary plantar wart as a discreet, painful area that will sometimes show little dots within the lesion and is usually well-circumscribed.''
The ``mosaic'' type of wart, on the other hand, is a group of multiple warts that are interlinked like chains. Treating this type can prove lengthy and difficult. There is a higher incidence of recurrence with this type of wart.
There is also the risk that other susceptible family members can contract the wart virus from someone else in the family by walking around barefoot in the bathroom, Lenet says.
To avoid getting plantar warts, wear shoes or sandals in high-risk places.
IMPETIGO
Impetigo is a contagious bacterial skin infection. Commonly seen in summer when children are playing together outdoors, it resembles a scab with a kind of honey-colored crust. Sometimes, it looks like a cluster of scabs and can itch. It is often picked up when a child brushes against the infected skin of another child in the sandbox or the pool. The bacteria is especially likely to lodge in a break in the skin, say a mosquito bite that has been scratched.
Parents should keep children with impetigo out of the water and away from other children until the condition is treated, says pediatrician Lauren Bogue.
And as far as prevention? Everyone has bacteria on their skin, Bogue points out. The best way to guard against such infection is maintaining good hygiene - children should wash their hands regularly - and keeping kids' fingernails short so that they can't scratch insect bites into open sores.
by CNB