Otitis Externa (Swimmer’s Ear)

Overview

What is swimmer’s ear?

Swimmer’s ear (also called otitis externa) is a type of ear infection that involves the ear canal. Because the canal is dark and warm, it can easily get infected with bacteria and fungus. Swimmer’s ear is different from the kind of infection you get in the middle ear that causes a bulging painful eardrum. That kind of infection is called otitis media.

Symptoms

What does swimmer’s ear feel like?

Symptoms of swimmer’s ear include:

If left untreated, the affected ear can become swollen and very painful to the touch. The fluid may become more pus-like and the muffled of decreased hearing may become worse.

  • Pain or itching in the outer part of the ear (the pain is often worse when the ear moves, such as when you are chewing)
  • A stuffy or plugged-up feeling in the affected ear
  • Fluid draining from the affected ear
  • Decreased or muffled hearing

Causes & Risk Factors

What causes swimmer’s ear?

Several things can make swimmer’s ear more likely, including the following:

  • If you swim or shower a lot, too much water can get into your ears. Water removes the protective earwax, which makes it easier for germs and fungus to grow.
  • Cleaning your ears can remove the protective wax layer and lead to infection.
  • If you injure the skin in the ear canal by putting your finger or some object (such as a cotton swab or a pencil) in your ear, an infection can develop in the canal.
  • Skin conditions (such as psoriasis) that occur in other parts of the body can also occur in the ear canal and cause an infection.
  • Bacteria from products you use in your hair (such as hairspray or hair dye) can get trapped in the ear canal and cause an infection.

Treatment

How is swimmer’s ear treated?

Your doctor will look in your ear canal and remove any drainage or pus. Your doctor will check your eardrum to make sure there’s no other infection. Most swimmer’s ear infections can be treated with ear drops that contain antibiotics to fight infection and medicine to reduce itching and swelling. You can also take an over-the-counter pain medicine to relieve pain, such as ibuprofen (some brands: Advil, Motrin).

What else can I do for swimmer’s ear?

Follow your doctor’s directions carefully and use all of your medicine(s). Swimmer’s ear can be hard to treat. Here are some things that will help you get better:

Symptoms are usually much better in 3 days. They should be completely gone in 10 days. If you’re not better by then, call your doctor.

  • Keep your ear as dry as possible for 7 to 10 days. Take baths instead of showers. Try to keep water out of your ears when you wash your hair. Use a cotton ball to protect your ear from water while bathing (but don’t stuff the cotton into the ear canal). Don’t swim or play other water sports. If you’re on a swim team, ask your doctor before you return to swimming.
  • Don’t put anything except the prescribed medicine in your ears. Scratching and rubbing will only make swimmer’s ear worse.

Bibliography

Prevention

How can I prevent swimmer’s ear?

The best way to prevent swimmer’s ear is to keep the ear canal’s natural defenses against infection working well. Follow these tips:

  • Never put anything in the ear canal (cotton swabs, your finger, paper clips, liquids or sprays). This can damage or irritate the skin. If your ears itch a lot, see your doctor.
  • Leave earwax alone. If you think your earwax affects your hearing, see your doctor to be sure there’s no other cause.
  • Keep your ears as dry as possible. Use a towel to dry your ears well after swimming or showering. Help the water run out of your ears by turning your head to each side and pulling the earlobe in different directions. A hair dryer set on the lowest heat and speed can also help to dry ears. Be sure to hold it several inches from your ear. If you swim or surf, use a bathing cap or wet suit hood to keep water out of your ears. There are also special earplugs designed to keep water out of your ears while you are swimming.

Citations

  • Acute otitis externa: an update. by Schaefer P, Baugh RF.(American Family Physician 12/01/12, http://www.aafp.org/afp/2012/1201/p1055.html)