Otitis Externa (Swimmer’s Ear)

Last Updated November 2020 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

What is swimmer’s ear?

Swimmer’s ear is an irritation, swelling, or infection in your ear. It’s often caused by swimming a lot or swimming in unclean water. It can occur suddenly. It’s common in children and young adults but can happen to anybody. The medical name for swimmer’s ear is otitis externa.

Swimmer’s ear infects the outer ear or ear canal. Because those areas are dark and warm, bacteria and fungus can grow there to create an infection. Note this type of infection is different than an inner ear infection.

Symptoms of swimmer’s ear

There are many symptoms of swimmer’s ear.

  • Pain and/or itching in the affected ear. The pain gets worse when you chew or move your ear.
  • A plugged-up feeling in the affected ear
  • Some hearing loss
  • Clear or pus-like drainage
  • Swelling inside the ear and painful to the touch

In serious cases, swimmer’s ear can spread to other areas of the ear. This includes the skull bone. The infection can become severe in older people and people who have diabetes.

What causes swimmer’s ear?

Several things can cause swimmer’s ear, including:

  • Swimming in unclean water.
  • Swimming and showering too much. Water can accumulate in the ear canal, which allows germs to grow.
  • Excessive cleaning of your ears. Earwax helps to flush germs from the ear. Removing too much may allow germs to spread and start an infection.
  • Injuring the skin in the ear canal. This can happen by putting your finger or an object (such as a cotton swab) in your ear.
  • Some skin conditions. If you have conditions such as eczema and psoriasis in other places on your body, they can occur in the ear canal, too. This can cause an infection.
  • Bacteria from products used in your hair, such as hairspray or hair dye. These products can get trapped in your ear canal.

How is swimmer’s ear diagnosed?

Your doctor will look inside your ears. As they do, touching or moving it may hurt. The infected ear will appear red and swollen. It also may look scaly. Your doctor will check your eardrum for infection or a hole. They may not be able to see the eardrum due to swelling.

Your doctor may take a sample of fluid from the ear to send to a lab. The lab is checking for bacteria or fungus.

Can swimmer’s ear be prevented or avoided?

Follow these tips to prevent swimmer’s ear:

  • Never put anything in the ear canal. This includes cotton swabs, your finger, liquids, sprays, etc. If your ears itch, see your doctor.
  • Don’t remove earwax on your own. If you think your earwax affects your hearing, see your doctor.
  • Take steps while in the water. When swimming, wear a bathing cap or wet suit hood. Special earplugs can keep water out of your ears.
  • Keep your ears dry. Use a towel to dry your ears after swimming or showering. Let the water run out of your ears. Turn your head to each side and pull the earlobe in different directions to let the water drain out. You also can use a hair dryer set on the low heat to dry your ears. Hold the dryer several inches from your ear.
  • Try to avoid bacteria. To help prevent bacteria from growing in your ear, mix one drop of rubbing alcohol with one drop of white vinegar. Place the drops of the mixture into the ears after they get wet.

Swimmer’s ear treatment

Your doctor will clean the drainage or pus from your ear. They will likely prescribe antibiotic ear drops to make your infection go away and may prescribe oral antibiotics if your case is severe. They may also prescribe other medicine to help with itching. Over-the-counter medicine can relieve pain. Ask your doctor what type you should take.

After your diagnosis, keep your ear as dry as possible for 7 to 10 days. Take baths instead of showers. Put a cotton ball in each ear to keep the water out. And don’t swim during that time. Your symptoms should be better in 3 days. They should go away in 10 days.

Living with swimmer’s ear

Swimmer’s ear can be short-term or long-term. Your ears will likely hurt the most before you start taking antibiotics.

Questions to ask your doctor

  • Can I get swimmer’s ear from chlorinated pool water?
  • How much swimming is too much swimming?
  • Am I more likely to get swimmer’s ear if I have small eustachian tubes?
  • Should my baby wear ear plugs in the bath and in pools? Are those safe?
  • Can repeated infections cause serious hearing loss?
  • Can I get swimmer’s ear from taking showers?