Summer is upon us and now, more than ever, we’re looking forward to enjoying outdoor activities — particularly water sports! Unfortunately, with water sports, we also see an increase in swimmer’s ear.  

What is swimmer’s ear? 

Swimmer’s ear is an infection found in the outer ear canal, the area that extends from the outer ear (pinna) to the eardrum (tympanic membrane). The medical term for swimmer’s ear is otitis externa. Swimmer’s ear occurs when moisture gets trapped in the outer ear space, creating the perfect breeding ground for bacterial growth, which can invade the skin of the ear canal.

What causes swimmer’s ear?

Not surprisingly, a swimmer’s ear is most often caused by moisture or debris retained in the ear canal from swimming. But showering, bathing or other moist environments can also be the source of retained moisture. Swimmer’s ear should be taken seriously and should be treated to prevent any negative effects it may have on your hearing and to prevent further infection.

Other factors can contribute to swimmer’s ear, including:

• Exposure to excessive bacteria, often found in hot tubs or polluted water
• Excessive cleaning of the ear canal with cotton swabs (or any other tool that can damage the skin)
• Cuts or skin conditions in the ear canal (eczema, seborrhea, etc.) that create an opening for bacteria to penetrate the skin
• Contact with chemicals such as hair spray or hair dye that migrate into the ear canal

What are the symptoms of swimmer’s ear?

Mild cases of swimmer’s ear will likely begin with itching and irritation in the ear canal and pain that worsens when you tug on the outer ear (pinna). The ear may feel swollen or blocked. A clear, odorless discharge may be present as well. 

Advanced cases of swimmer’s ear may involve: 

• Fever
• Decreased hearing
• Intense pain that spreads to the neck, face, or head
• Drainage or discharge that has an odor 

Swimmer’s ear is not typically considered to be a dangerous condition and can clear up quickly following treatment. However, if untreated, the swimmer’s ear can become extremely painful and potentially dangerous, especially for those who are diabetic or have problems with their immune system, including the elderly.

Can swimmer’s ear lead to complications?

Left untreated, swimmer’s ear can lead to:

• Hearing loss
• Recurring ear infections (chronic otitis externa): without treatment, the infection can persist
• Bone and cartilage damage: untreated infections can spread to the base of the skull, brain, or cranial nerves (diabetics and the elderly are at higher risk for this sort of complication)

What is the treatment for swimmer’s ear?

Swimmer’s ear is best treated by a physician.  

The physician will perform an otoscopic examination to confirm there is no eardrum perforation, which would allow moisture to invade the middle ear space. The physician may be able to easily clean the infected area to relieve irritation and pain. Antibiotic ear drops are necessary to clear the infection and will be prescribed by the physician. 

For a more advanced infection, oral antibiotics or pain medication may be prescribed as well. If the infection does not improve within 3-4 days, the physician may consider different medications.

It is important to keep the infected ear(s) dry during the healing process. 

Are there ways to help prevent swimmer’s ear?

It’s wise to take preventative measures to protect your ears and stay in the swim of things this summer.  Some recommendations to avoid swimmer’s ear include: 

• Dry the ears following water exposure, especially swimming. Tip your head to one side to let the water drain out, then repeat on the other side. Never use cotton swabs to dry the ear! A dry towel or tissue can be used as well.
• Keep water out of the ear. This may be accomplished by using a barrier such as earplugs. These can be found as over-the-counter products but are most effective when custom molded by a hearing professional for the patients’ ears.
• Maintain proper earwax hygiene. Earwax or cerumen plays an important role in protecting the outer ear canal. Too much or too little cerumen can be an issue. Improper ear cleaning methods such as cotton swabs or ear candling can lead to ear canal damage that can lead to infection.
• Maintain proper skin health. The skin in the ear canal plays a big role in the prevention of swimmer’s ear. Dry, cracked skin (often the result of health conditions) can be an open invitation to infection. 
• Protect your ears from chemicals. Keep chemicals from hair spray and dye out of the ear canal with cotton balls or earplugs.
• Consider ear drops. There are over-the-counter ear drops designed to help prevent swimmer’s ear. It is important that you DO NOT put anything in your ear canal if there is any risk of you having a perforation of the eardrum. Seeing a physician verify the integrity of the eardrum is strongly advised. 

It’s important to be aware of swimmer's ear and be on the lookout for symptoms. Schedule an appointment today for a hearing consultation.