Sal asked
My doctor prescribed hydrocortisone and Acetic acid otic solution for my ear and I am to use it three times a day and five drops the solution feels like it's just sitting there in my ear I even laid down and fell asleep and about three hours later it was still pooled in my ear am I doing something wrong should it be absorbing or does it not get absorbed or end up going down in the canal?
Answer
Hydrocortisone, acetic acid ear drops are used to treat an infection and the symptoms of infection in the external ear canal (the part of the ear starting at the opening and ending at the ear drum). Acetic acid has antibacterial properties while the hydrocortisone is a steroid that is used for both inflammation and itching.
It is important to use ear drops correctly for them to work well.
Many ear drops can be tough to administer because they do have a tendency to leak out, especially ones that are used in the external ear canal. Ear drops do not absorb very well and really aren't intended to. They are used to treat a local infection via direct contact, unlike an antibiotic you take by mouth.
In fact, the actual absorption of the ear drops is almost none, it's the direct contact we are looking for. The 5 prescribed drops are usual because the intent is to coat the whole external ear for therapy. Most likely, your doctor told you to do it 3-4 times a day. It's this frequency that allows the drops to be effective.
How To Administer Ear Drops To Prevent Pooling
Now, it is GENERALLY recommended for the first day or two to use a cotton ball to keep the liquid in. This usually isn't necessary but it does tend to make the infection go away quicker that it would without it. This is how I counsel patients on administration of ear drops:
- Try to remove some earwax if you can. If it is painful to touch your ear and remove the earwax, it is fine to skip this step. It may just shorten therapy duration.
- Warm up the bottle of ear drops by holding it in your hands for about a minute. Cold ear drops can sometimes cause discomfort.
- Lie on your side or tilt your head to side and insert the 5 drops into the ear canal. Try to stay in this position for at least a few minutes to facilitate the contact of the drops to the infected parts of your ear.
- Try not to touch the dropper to your ear.
- For the first day, saturate a cotton ball or cotton wick with ear drop solution and gently place it in the ear. No need to stuff it in, just put it in enough for it to hold by itself. This helps the solution you just administered to stay in direct contact with the infected areas of the ear.
A general rule of thumb is that once the infection noticeably goes away, continue treating for 2-3 days. This helps to prevent a reinfection. Your symptoms will hopefully start to get better within a couple of days. If there is no symptom improvement in 3-4 days, be sure to contact your doctor as they may need to try something else.
