Swimmer's Ear (Otitis Externa)

Swimmer’s ear is a painful condition that affects the outer ear and ear canal. Symptoms often occur after water gets trapped in the ear, especially if the water has bacteria or fungal organisms in it. Because this condition commonly affects swimmers, it is known as swimmer’s ear.

Swimmer’s ear is an infection caused by increased moisture trapped in the ear canal. Swimmer’s ear needs to be treated to reduce pain, prevent the spread of infection and eliminate any effect it may have on hearing.

Other factors that may contribute to swimmer’s ear:

• Contact with bacteria that may be present in hot tubs or polluted water.
• Excessive cleaning of the ear canal with cotton swabs or other objects causing damage to the skin in the ear canal.
• Contact with certain chemicals such as hair spray or hair dye.
• A cut in the skin of the ear canal.
• Other skin conditions affecting the ear canal, such as eczema or seborrhea.
• Ill-fitting hearing aids, contaminated earbuds, earphones or other ear devices.

Common signs of swimmer’s ear include:

• Itching inside the ear
• Pain inside the ear that gets worse when you tug on the outer ear
• Feeling that the ear is blocked or full
• Drainage from the ear
• Fever
• Decreased hearing
• Intense pain that may spread to the neck, face or side of the head
• Swollen lymph nodes around the ear or in the upper neck
• Redness or swelling of the skin around the ear

If swimmer’s ear is left untreated, hearing loss could occur. When the infection heals, hearing usually returns to normal. Recurring ear infections (chronic otitis externa) are also possible. Without treatment, infections can continue to occur or persist.

Bone and cartilage damage (malignant otitis externa) are also possible due to untreated swimmer’s ear. If left untreated, ear infections can spread to the base of your skull, brain or cranial nerves. People with diabetes, older adults and those with conditions that weaken the immune system are at higher risk for such dangerous complications.

To evaluate for swimmer’s ear, your doctor will look for redness and swelling in your ear canal and ask if you are experiencing any pain. Your doctor may also take a sample of any abnormal fluid or discharge in your ear to test for the presence of bacteria or fungus if you have recurrent or severe infections.

Treatment for the early stages of swimmer’s ear includes careful cleaning of the ear canal and use of eardrops that inhibit bacterial or fungal growth and reduce inflammation. For more severe infections, your doctor may prescribe antibiotics to be applied directly to the ear.

If you have tubes in your eardrum, a non-ototoxic (do not damage your hearing) topical treatment should be used. Topical antibiotics are effective for infection limited to the ear canal.

A dry ear is unlikely to become infected, so it is important to keep ears free of moisture during swimming or bathing.

Prevention tips include:

• Use ear plugs when swimming.
• Use a dry towel or hair dryer (from a distance) to dry your ears.
• Have your ears cleaned periodically by an ENT specialist if you have itchy, flaky or scaly ears, or extensive earwax.
• Do not use cotton swabs to remove ear wax.