What is swimmer's ear (otitis externa)?
Swimmer's ear (also called otitis externa) is a type of ear infection. The infection occurs in the ear canal. Because the ear canal is dark, warm, and can hold water, it makes a perfect environment for water-loving bacteria and fungus to grow.
Why is this ear infection called "swimmer's ear"?
Otitis externa was given the nickname swimmer's ear because it most commonly affects individuals who spend a lot of time in water, such as swimmers.
Symptoms and Causes
What conditions cause swimmer's ear (otitis externa)?
Conditions that can lead to swimmer's ear include:
- Water that gets trapped in the ear canal, for example from swimming or showering often
- Loss of ear wax – a natural protectant – due to too much water entering the ear canal or removing too much wax when cleaning ears
- Injury to ear caused by putting objects into the ear, such as fingers, pen/pencils, paper clips, hair clips
- Swimming in polluted water
- Other skin conditions that affect the ear canal, such as eczema or psoriasis
What are the symptoms of swimmer's ear?
- Ear pain: pain that often gets worse when the outer ear is tugged or pressed on; pain can become intense and spread across the side of the face of the affected ear
- Itching inside the ear canal
- Bad-smelling or colored (yellow, yellow/green) pus oozing from the ear
- Blocked ear
- Redness and swelling in the outer ear
- Temporary hearing loss or decreased hearing
- Slight fever
Management and Treatment
How is swimmer's ear (otitis externa) treated?
First, the ear canal is examined and is cleared of any pus or drainage. Ear drops that contain an antibiotic are prescribed. Sometimes the ear canal is too narrowed or blocked to deliver ear drops by simply placing drops in the ear. When this happens, a thin gauze or "wick" is placed inside the ear, which helps the ear drops pass through the blockage and reach the infection. Ear drops are typically used for 7 to 14 days. Oral antibiotics are rarely used for swimmer's ear.
An over-the-counter pain medicine, such as ibuprofen (Advil®, Motrin®) can be taken to relieve pain and swelling. Corticosteroids may be prescribed to reduce itching and inflammation. Sometimes oral antibiotics are prescribed if the infection has spread beyond the ear canal.
What can happen if swimmer's ear continues to reoccur?
The infection, which starts in the inner ear, can spread to cartilage and bone of the ear canal. This condition is called malignant external otitis. Facial nerve paralysis is rare, but can occur when the infection advances this far.
What can I do to prevent swimmer's ear (otitis externa)?
- Keep ears as dry as possible. Place a shower cap over your head to help prevent water or hair shampoo from getting into your ears. Place a cotton ball in the ear but do not push it in far. Use a dry towel to dry your ears after bathing or swimming. Use ear plugs if you play water sports or are frequently in water.
- Turn your head from side to side after getting out of water. This helps water drain from your ears.
- Don't stick anything into your ear canal. This includes pens/pencils, fingers, bobby clips or cotton-tipped swabs. (Swabs should only be used to dry the outer ear.)
- Don't swim in polluted water.
- Do not swallow the water you swim in.
- Use a simple, homemade solution to help prevent bacteria from growing inside the ear. Mix one drop of vinegar with one drop of isopropyl (rubbing) alcohol and put one drop in each ear after bathing or swimming. Be sure to check with your doctor first before making and using this homemade solution.
When should I see a specialist to treat swimmer's ear (otitis externa)?
If your ear infection has not gone away 10 to 14 days after treatment with antibiotic eardrops, you have lost your hearing, you see pus or other yellow/green matter oozing from your ear, or experience a worsening of any of the symptoms of swimmer's ear, you should be seen by an ear specialist (an otolaryngologist).