Mayuri Bhakta, FNP-BC
Swimmer’s ear affects more than just swimmers. Otitis externa, commonly known as “swimmer’s ear,” is a condition that results in about 2.4 million healthcare visits each year in the United States.
What is Otitis Externa?
Otitis externa is an infection of the outer ear canal (whereas otitis media is an infection of the middle ear). Otitis externa can lead to swelling and drainage from the ear canal.
Otitis externa can occur at any age, but it is more common in children. It occurs more frequently when water remains in your ear after swimming—which is why it has been termed “swimmer’s ear.” Excess water in the ear canal can lead to a moist environment where bacteria and other organisms can grow and cause infection. Putting objects into the ear canal can cause damage to the lining of the ear canal, which can also increase the risk of infection.
Factors that increase your risk of developing otitis externa include:
- Increased moisture in the ear canal from swimming, perspiration, or high humidity.
- Removal of ear wax, also known as cerumen. Ear wax helps to protect the ear canal from infection.
- Inserting objects into the ear canal such as cotton swabs, fingernails, hearing aids, or ear plugs.
What are Symptoms of Otitis Externa?
Symptoms of otitis externa include:
- Itching inside the ear
- Redness and swelling of the ear
- Pain with pressure on the ear
- Pain with tugging on the ear
- Drainage from the ear
- Difficulty hearing from the affected ear or muffled hearing
How Is Otitis Externa Treated?
If you think you have symptoms of otitis externa, you should contact your healthcare provider. Most people with otitis externa are treated successfully at home with medications. Your healthcare provider may suggest over the counter medications to help with the pain and may prescribe ear drops to help with swelling and infection. Your healthcare provider may suggest that you avoid getting the inside of your ears wet during treatment and that you avoid using hearing aids, ear plugs, or in-ear headphones until your symptoms improve.
How Do I Prevent Otitis Externa?
The following can help reduce your risk of otitis externa:
- Keep your ears as dry as possible by using swimming caps, ear plugs, or swim molds when swimming.
- Dry your ears thoroughly after swimming or showering by:
- Using a towel to dry your ears well.
- Tilting your head to each side to allow water to drain out of the ear canals.
- Drying the ears using a hair dryer on a low setting and holding the hair dryer 12 inches away from the ear.
- Check your pool and/or hot tub to make sure there are adequate levels of disinfectant and pH levels.
- Avoid putting objects such as cotton swabs or fingernails into the ear canals.
- Avoid cleaning out your ear wax.
- If you are a swimmer, your healthcare provider may recommend the use of ear drops before and/or after swimming as long as you do not have punctured ear drums.
Centers for Disease Control and Prevention, “Hygiene-related Diseases: ‘Swimmer’s Ear’ (Otitis Externa),” August 2, 2016, https://www.cdc.gov/healthywater/hygiene/disease/swimmers_ear.html
Robert Sander, “Otitis Externa: A Practical Guide to Treatment and Prevention,” American Family Physician 63, no. 5 (2001): https://www.aafp.org/afp/2001/0301/p927.html
Laura A. Goguen, “External otitis: Pathogenesis, clinical features, and diagnosis,” UpToDate, July 29, 2020.
Mayo Clinic, “Swimmer’s ear,” June 28, 2019, https://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/syc-20351682
Ariel A. Waitzman, “Otitis Externa,” Medscape, March 9, 2020, https://emedicine.medscape.com/article/994550-overview#a8
Laura A. Goguen, “External otitis: Treatment,” UpToDate, June 14, 2019.