Swimmer's Ear

Insight into Causes, Prevention, and When to See a Doctor

Don't let swimmer's ear ruin water play; learn more about prevention and treatment.

As the weather starts to get warmer and people flock to the pools, oceans, and lakes for fun and sport, otitis externa (commonly called "swimmer's ear") incidence rises. This painful condition can be prevented and treated effectively.

Otitis externa is an infection of the outer ear structures. It typically occurs in swimmers, but since the cause of the infection is water trapped in the ear canal, water from bathing or showering may also cause this common infection.

When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection and irritation of the ear canal. If the infection progresses it may involve the outer ear.

Treatment for the early stages of otitis externa includes careful cleaning of the ear canal and eardrops that inhibit bacterial growth. Mild acid solutions such as boric or acetic acid are effective for early infections.

For more severe infections, if you do not have a perforated eardrum, ear cleaning may be helped by antibiotics. If the ear canal is swollen shut, a sponge or wick may be placed in the ear canal so that the antibiotic drops will be effective. Pain medication may also be prescribed.

Follow-up appointments are very important to monitor progress of the infection, to repeat ear cleaning, and to replace the ear wick as needed.

Your otolaryngologist has specialized equipment and expertise to effectively clean the ear canal and treat swimmer's ear.

The most common symptoms of swimmer's ear are mild to moderate pain that is aggravated by tugging on the outer ear and an itchy ear. Other symptoms may include any of the following:

  • Sensation that the ear is blocked or full
  • Drainage
  • Fever
  • Decreased hearing
  • Swollen lymph nodes
  • Intense pain that may radiate to the neck, face, or side of the head
  • The outer ear may appear to be pushed forward or away from the skull

An itchy ear is a maddening symptom. Sometimes it is caused by a fungus or allergy, but more often it is a chronic dermatitis (skin inflammation) of the ear canal. One type is seborrheia dermatitis, a condition similar to dandruff in the scalp; the wax is dry, flaky, and abundant. Some patients with this problem will do well to decrease their intake of foods that aggravate it, such as greasy foods, carbohydrates (sugar and starches), and chocolate. Doctors often prescribe a cortisone eardrop at bedtime when the ears itch. There is no long-term cure, but it can be kept controlled.

A dry ear is unlikely to become infected, so it is important to keep the ears free of moisture after swimming or bathing. Q-tips should not be used for this purpose, because they may pack material deeper into the ear canal, remove protective earwax, and irritate the thin skin of the ear canal creating the perfect environment for an infection.  The safest way to dry your ears is with a hair blow-dryer.

  If you do not have a perforated eardrum, rubbing alcohol or a 50:50 mixture alcohol and vinegar used as eardrops will evaporate excess water and keep your ears dry.  Before using any drops in the ear, it is important to verify that you do not have a perforated eardrum. Check with your otolaryngologist or audiologist if you have ever had a perforated, punctured, or injured eardrum, or if you have had ear surgery.

People with itchy ears, flaky or scaly ears, or extensive earwax are more likely to develop swimmer's ear. If so, it may be helpful to have your ears cleaned periodically by an otolaryngologist. Custom earplugs for swimmers are available from your audiologist. 


Swimmer's Ear/ Recreational Water (n.d.) Centers for Disease Control. Accessed 3/23/2015 from http://www.cdc.gov/healthywater/swimming/rwi/illnesses/swimmers-ear.html.

Swimmer's Ear (n.d.). The American Academy of Otolaryngology Head and Neck Surgery. Accessed 3/23/2015 from http://www.entnet.org/content/swimmers-ear. 

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