Swimmer’s Ear (Otitis Externa)

Overview

What is swimmer’s ear?

Swimmer’s ear (also called otitis externa) is an ear infection in your ear canal, the pathway between your outer ear and your middle ear. Swimmer’s ear may be a bacterial infection or fungal infection.

It’s called swimmer’s ear because many avid swimmers develop the condition at some point in their lives. But even people who rarely dunk their head in the pool, lake or ocean may develop swimmer’s ear. For example, skin conditions like psoriasis increase your risk of swimmer’s ear.

Left untreated, swimmer’s ear may affect your hearing, including causing hearing loss. Most of the time, treatment solves any hearing issues caused by swimmer’s ear. Healthcare providers treat swimmer’s ear with eardrops that eliminate the infection.

Will swimmer’s ear go away by itself?

No, it won’t. Swimmer’s ear is an infection in your ear canal that won’t go away unless it’s treated. Left untreated, a swimmer’s ear infection may spread to the base of your skull, your brain or your cranial nerves.

Symptoms and Causes

What are the symptoms? 

Swimmer’s ear symptoms can be mild or severe, depending the infection in your ear. Symptoms may include:

  • Ear pain: You may have an earache or notice ear pain if you pull or tug on your ear. Ear pain often gets worse if the underlying infection isn’t treated. Sometimes, the pain may spread from your ear to the side of your face. 
  • Itchiness inside of your ear.
  • Drainage from your ear: This may be bad-smelling pus or yellow or yellow/green pus oozing from your ear.
  • Blocked ear. This feels like something is in your ear or a sense of fullness in your ear.
  • Redness and swelling in your outer ear.
  • Temporary hearing loss or decreased hearing.
  • Slight fever.
  • Swollen lymph nodes around your ear or upper neck.

What causes swimmer’s ear?

Many things may cause swimmer’s ear, but the most common cause is activity that traps water in your ear canal. As bacteria and fungi thrive in warm, moist places, water pooling in your ear canal is the perfect environment for bacteria and fungi settle in, start multiplying and eventually cause infection.

Other causes include:

  • Losing earwax: Earwax protects your ear canal from bacteria and fungi. You may lose earwax because there’s too much water in your ear or because you accidentally remove too much earwax when you clean your ears, irritating your ear canal’s delicate skin. 
  • Injuring your ear: You can damage your ear canal by sticking objects in your ear to try to remove earwax. (Think cotton swabs, pens, bobby pins or paper clips.) Probing your ear may push earwax and dirt even deeper into your ear canal 
  • Swimming in fresh water: You can develop swimmer’s ear from swimming in pools. But fresh water swimming — swimming in lakes, ponds, rivers, streams and oceans — increases your risk because fresh water may be polluted and contain more bacteria than you’d find in a pool. 
  • Skin conditions: Eczema or psoriasis in your ear canal increases your risk of developing swimmer’s ear. 
  • Chemicals: Chemicals in hairspray and hair dye that get into your ear canal may damage your ear and increase your risk of infection.
  • Using earbuds or hearing aids: Hearing aids or earbuds that have been contaminated by dirt or other substances may cause an ear infection.

Diagnosis and Tests

How do healthcare providers diagnose swimmers ear?

A provider will examine your ears for redness, swelling or other signs of damage. If your ears are draining, providers may take a sample of the drainage to determine what caused the infection. Bacterial infections and fungal infections require different treatment.

Management and Treatment

How do healthcare providers treat swimmer’s ear?

Providers may prescribe eardrops that contain antibiotics and corticosteroids. They typically recommend over-the-counter pain medication to ease pain.

Prevention

Can I prevent swimmers ear?

Yes, there are things you can do to prevent swimmer’s ear. Keeping your ears dry is the most effective way to prevent swimmer’s ear.

Dry your ears

Swimmer’s ear happens when there’s water trapped in your ear canal, creating a place for bacteria and fungi to multiply. Ways to dry your ears include:

  • Wear clean earplugs when you swim or spend time in the water.
  • Wear a shower cap when you shower.
  • When you wash your hair, put cotton balls in your ears to reduce the amount of water in your ears.
  • Use a dry towel to dry your ears after bathing, swimming or being in the water.
  • Drain water from your ears by tipping your head from side to side and pulling your earlobe in different directions. The combination of tilting and pulling will help water drain from your ear canal.
  • Use a hairdryer to dry out water in your ears. Use the lowest possible settings for the fan speed and heat level and hold the nozzle of the dryer several inches from your ears. That way, you won’t run the risk of burning your ear.

Protect your ears

  • Ask a provider about drops to dry your ear canal after swimming or bathing. Ask if they recommend a homemade solution of vinegar and rubbing alcohol.
  • Don’t stick anything into your ear canal.
  • Don’t swim in polluted water.
  • If you use earbuds or wear hearing aids, be sure to clean them before you put them in your ears. If you use hearing aids, ask your audiologist how to keep your hearing aids clean.

Outlook / Prognosis

What can I expect if I have swimmers ear?

Most people with mild swimmer’s ear feel better within seven to 10 days after starting treatment. If you have severe swimmer’s ear, it make take more time for medication to get rid of the infection.

Living With

How do I take care of myself?

Swimmer’s ear is an infection in your ear canal. If you’re receiving treatment for swimmer’s ear, you can take care of yourself by:

  • Completing your treatment. If your provider prescribes antibiotics or antifungal medication, follow your provider’s directions about medication use.
  • Keeping water away from your ears. Wear a cap when you shower and avoid swimming until your infection is gone.
  • Protecting your ears. Don’t poke at your ears with your fingers or use objects like paper clips, pencils and pens, or bobby pins to clean your ears.
  • Drying your ears.

How do you treat swimmers ear at home?

Sometimes, people confuse the term “swimmer’s ear,” which is an infection, and the experience of having water in their ear. You need treatment to eliminate an infection. But if you have water in your ear, you can and should dry your ear canal as much as possible so you don’t develop an infection. You can dry out your ear canal by:

  • Carefully and gently drying your ears.
  • Using eardrops that dry out your ear canal.

When should I see my healthcare provider?

You should see your healthcare provider if:

  • You’re receiving treatment for a bacterial or fungal infection and it hasn’t gone away 10 to 14 days after you started treatment.
  • Your ear pain gets worse.
  • You lose your hearing.
  • You have pus draining from your ears.

What questions should I ask a healthcare provider?

If you have swimmer’s ear, you may want to ask your provider the following questions:

  • What treatment do you recommend?
  • How soon will I feel better?
  • Can I swim or take a shower with swimmer’s ear?
  • Does swimmer’s ear come back?

A note from Cleveland Clinic

Swimmer’s ear is an infection in your ear canal. Typically, it affects people who spend a lot of time in the water. But you can develop swimmer’s ear when you shower, by using earbuds or hearing aids, or because you have certain skin conditions. Swimmer’s ear isn’t a serious condition but it’s an infection that left untreated may cause serious medical issues. If your ears hurt or feel itchy, talk to a healthcare provider.

Last reviewed by a Cleveland Clinic medical professional on 11/15/2022.

References

  • American Academy of Otolaryngology. Swimmer’s ear. (https://www.entnet.org/content/swimmers-ear) Accessed 11/15/2022.
  • Association of Family Physicians. Acute Otitis Externa: An Update. (https://www.aafp.org/pubs/afp/issues/2012/1201/p1055.html) Accessed 11/15/2022.
  • Centers for Disease Control and Prevention. Swimmer’s ear (otitis externa). (https://www.cdc.gov/healthywater/swimming/swimmers/rwi/ear-infections.html) Accessed 11/15/2022.
  • Merck Manual. Ear Canal Infection (Swimmers Ear) – Ear, Nose and Throat Disorders. (https://www.merckmanuals.com/home/ear,-nose,-and-throat-disorders/outer-ear-disorders/ear-canal-infection-swimmers-ear?query=swimmer%27s%20ear) Accessed 11/15/2022.

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