What is swimmer’s ear?

Swimmer's ear, also called otitis externa, is an infection of the ear canal. The ear canal is the passage that carries sounds from the outside of the body to the eardrum (tympanic membrane).

Water can get trapped in the ear canal when you swim. The water may cause problems. For example:

• It can help germs (bacteria and fungi) grow.

• It can soften the skin. This can let germs into the skin.

• It can wash away earwax. The wax acts as a natural guard against infection.

Swimmer's ear is a painful condition that often happens to children. But it can happen to people of all ages. It doesn't spread from person to person.

What causes swimmer's ear?

One of the main causes of swimmer’s ear is too much wetness in the ear. This can happen when you swim. But it can also happen for other reasons. These include:

• Being in warm, humid, or damp places.

• Cleaning or scratching your ear canal using your fingers, cotton swabs, or other objects.

• An injury to the ear canal.

• Dry ear canal skin.

• An object (foreign body) in the ear canal.

• Too much earwax.

• Eczema or other inflammatory skin conditions.

Who is at risk for swimmer's ear?

Children have a higher risk of getting swimmer's ear. But it can also happen in adults. It's more likely if you do things that remove the protection from the skin of the ear canal. Losing this protection lets germs into the skin. For instance, if you swim often, the water removes earwax and softens the skin in the ear.

You can also harm the skin in the ear by wearing hearing aids, ear buds, or earplugs.

Other things that put you at greater risk for swimmer's ear include:

• Coming into contact with germs in hot tubs or unclean pool water.

• Having a cut in the skin of your ear canal.

• Hurting your ear canal by putting cotton swabs, fingers, or other objects inside your ears.

• Using earphones or hearing aids.

• Having a skin condition, such as eczema.

What are the symptoms of swimmer's ear?

Each person’s symptoms may vary. Common symptoms of swimmer's ear include:

• Redness of the outer ear.

• Itching inside the ear.

• Pain, often when touching or wiggling your earlobe. The pain may spread to your head, neck, or side of the face.

• Pus draining from your ear. This may be yellow or yellowish-green, and it may smell bad.

• Swollen glands in your upper neck or around the ear.

• A swollen ear canal.

• Muffled hearing or loss of hearing.

• A full or plugged-up feeling in the ear.

• A fever.

The symptoms of swimmer's ear may look like other health problems. Always see your doctor for a diagnosis.

How is swimmer's ear diagnosed?

Your doctor will ask about your past health and any symptoms you have now. They'll give you a physical exam. Your doctor will look into both of your ears.

Your doctor may check your ears using a lighted tool (otoscope). The tool helps your doctor see inside your ear. This will also help to see if you also have an infection in your middle ear (otitis media). Some people may have both types of infections (otitis externa and otitis media).

If you have pus or drainage from your ear, your doctor may take a sample of the pus or drainage for testing. This is called an ear drainage culture. A cotton swab is placed gently in your ear canal to get a sample. The sample is sent to a lab to find out what is causing the ear infection. The results can help guide your treatment.

How is swimmer's ear treated?

With correct treatment from a doctor, swimmer’s ear often clears up in 10 days.

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Using ear drops to kill bacteria (antibiotic ear drops) or fungus (antifungal ear drops).

• Using ear drops to help reduce swelling (corticosteroid ear drops).

• Taking pain medicine.

• Keeping the ear dry, as directed by your doctor.

Your doctor will advise you on how to use ear drops. Follow the directions to make sure you get the right dose of medicine. Antibiotic pills may be prescribed in case of a severe infection.

What are the possible complications of swimmer's ear?

If left untreated, swimmer's ear may cause other problems, such as:

• Hearing loss from a swollen and inflamed ear canal. Hearing often returns to normal when the infection clears up.

• Ear infections that keep coming back.

• Bone and cartilage damage.

• Infection spreading to nearby tissue, the skull, the brain, or the nerves that start directly in the brain (cranial nerves).

What can I do to prevent swimmer's ear?

To help prevent swimmer's ear, try these tips:

• Keep your ears as dry as you can.

• Use earplugs when you swim or shower. This prevents constant moisture inside the ear.

• Don’t scratch or clean your ear canal with cotton swabs, your fingers, or other objects.

• Don't be rough when cleaning your ear canal. Treat it gently.

To dry your ears well after you swim or shower, try these tips:

• Tilt your head to each side to help drain water out of your ears.

• With your ear facing down, pull your earlobe in different directions. This will help drain water out.

• Gently dry your ears with the edge of a towel.

• Use a hair dryer on the lowest or coolest setting to gently dry your ears. Hold the dryer at least 12 inches from your head. Wave the dryer slowly back and forth. Don't hold it still.

Your doctor may advise drops to help dry your ears.

Key points about swimmer's ear

• Swimmer's ear, also called otitis externa, is an infection of the ear canal.

• When water stays in the ear canal, germs can grow. This causes an infection.

• It's a painful condition that often affects children and people of all ages who swim often.

• With correct treatment, it often clears up in 10 days. Prescription medicines can help ease symptoms.

• Preventing moisture and irritation can prevent swimmer's ear.

Next steps

Here are some tips to help you get the most from a visit to your doctor:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your doctor tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also, write down any new directions your doctor gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also, know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you don't take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your doctor if you have questions.