Swimmer's Ear (Otitis Externa)

What is swimmer's ear?

Swimmer's ear (otitis externa) is an inflammation, irritation, or infection of the outer ear canal. This is the channel leading from the outer ear to the ear drum. Water that stays trapped in the ear canal (such as when swimming) may:

  • Provide a source for the growth of bacteria and fungi
  • Soften the skin and let infectious organisms get into the skin
  • Wash away the earwax that acts as a natural guard against infection

What causes swimmer's ear?

It is more common in children but can also happen in adults. Many factors can raise the chance of getting swimmer's ear. One of these is too much wetness. This can occur with frequent swimming. But it can also happen for other reasons such as:

  • Being in warm, damp places
  • Harsh cleaning of the ear canal with cotton swabs or other objects
  • Injury to the ear canal
  • Dry ear canal skin
  • Foreign body in the ear canal
  • Too much ear wax
  • Eczema and other inflammatory skin conditions
  • Allergies
  • Irritants such as hair dye or hair spray

Who is at risk for swimmer’s ear?

It happens to people of all ages. But you are at a higher risk for swimmer’s ear if your outer ear is exposed to conditions that may harm the skin. This lets bacteria get into the skin. Devices that are routinely worn in the ear canal can cause damage and irritation. This includes hearing aids, headphones, or earplugs.

If you are exposed to conditions that remove the protective layers from the skin, you are more likely to get infected with bacteria or fungus. For example, if you swim often, the moisture removes the protective layer of earwax and softens underlying skin.

What are the symptoms of swimmer's ear?

Symptoms of swimmer’s ear include:

  • Redness of the outer ear
  • Itching inside the ear
  • Pain, especially when touching or wiggling the earlobe (pain may spread to the head, neck, or side of the face)
  • Drainage from the ear
  • Swollen glands in the upper neck or around the ear
  • Swollen ear canal
  • Muffled hearing or hearing loss
  • Full or plugged-up feeling in the ear
  • Fever

The symptoms of swimmer’s ear may look like other health conditions or problems. Always check with your healthcare provider for a diagnosis.

How is swimmer's ear diagnosed?

Swimmer’s ear may be diagnosed with a health history and physical exam. Your provider may also use a special lighted tool called an otoscope. This helps to view inside the ear. This will help your provider see if you also have a middle ear infection (otitis media).

Your healthcare provider may also take a culture of the drainage from your ear. For a culture, a sample of the draining fluid is treated in a lab to see what bacteria or fungi grow. The results can help guide treatment.

How is swimmer's ear treated?

With correct treatment, swimmer's ear often clears up in 7 to 10 days.

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

Treatment starts with cleaning the external ear canal. This speeds up healing and allows the medicated eardrops to reach the infection site.

Treatment may include:

  • Antibiotic or antifungal eardrops
  • Corticosteroid eardrops to help reduce the swelling
  • Pain medicine
  • Keeping the ear dry, as directed by your healthcare provider

What can I do to prevent swimmer's ear?

To help prevent swimmer’s ear:

  • Use earplugs for swimming or bathing to prevent constant moisture inside the ear.
  • Don’t aggressively clean your ear canal or use cotton swabs and other objects in your ear canal.
  • Don't handle your outer ear canal.
  • Use the coolest setting on a hairdryer to dry the outer canal after swimming or when moist.

Key points about swimmer's ear

  • Swimmer’s ear is an irritation or infection of the outer part of the ear canal. It’s often caused by infection.
  • It is linked to frequent swimming.
  • It can be caused by certain health problems that lower the skin protection in the ear canal or cause injury or irritation.
  • Staying away from the cause (moisture, irritation) can prevent swimmer’s ear.
  • Your healthcare provider may prescribe medicines to help ease symptoms.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • 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 provider 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 instructions your provider 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 do not 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 provider if you have questions.
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