Swimmer’s ear is the familiar name for a condition more scientifically known as otitis externa. It’s a bacterial infection of the outer ear canal (the passageway that leads to the eardrum). Some people are more susceptible than others, and this type of infection is more common in children than adults. It’s not the same as typical childhood ear infections, though, which generally occur deeper in the ear structure, in the middle ear, often in conjunction with a cold or other illness.
This painful condition can put a real damper on things for people who love swimming. However, with some good information, it can usually be prevented or quickly and easily treated if it occurs.
Risk Factors for Developing Swimmer’s Ear
Swimmer’s ear results from bacterial growth in the ear canal when water gets trapped there. Dark, damp conditions are prime breeding grounds for bacteria. So, people with narrower ear canals—which includes kids—are more likely to have water trapped and to develop otitis externa.
Even minor abrasions in the ear canal greatly increase the chances of developing swimmer’s ear. People who use earbuds or hearing aids, for example, may develop small breaks in the ear canal’s skin. Aggressive wax removal or wax removal using a pointed object can cause small cuts, too. Also, allergic reactions to earrings or personal care products can cause breaks in the skin.
Swimming in water with elevated bacteria levels is a big risk factor as well. This might include natural bodies of water or a poorly maintained pool.
Symptoms and Complications of Swimmer’s Ear
This infection usually starts out mild, but it can progress quickly without treatment. Itching, redness, and swelling in the ear canal are common initial signs, as is some drainage of clear fluid. There’s usually also some discomfort or pain, particularly when the outside of the ear is pulled, bumped, or even just touched.
These symptoms usually become worse over time, and pus may also start leaking out of the ear canal. Hearing may become dulled or muffled, and there may be a full or clogged sensation in the ear.
When swimmer’s ear becomes advanced, the pain is often intense and radiates to the face, neck, and/or side of the head. The outside of the ear sometimes swells, as can the lymph nodes in the neck, the ear canal may become blocked, and hearing is more severely affected. There may also be a fever.
Left unchecked, complications of swimmer’s ear can include partial or complete but usually temporary hearing loss, deeper and more dangerous infections like cellulitis, and bone or cartilage damage.
Diagnosing and Treating Swimmer’s Ear
If you or your child experiences pain in the ear or any of the above symptoms, schedule a doctor’s appointment promptly. The doctor or pediatrician will ask about the symptoms, examine the ear with an otoscope, and remove any excess wax or other obstructions with an ear curette or small suction device.
Antibacterial ear drops treat swimmer’s ear. Sometimes, topical products also containing an antifungal agent or anti-inflammatory agent like steroids are prescribed. If the infection is particularly painful, a painkiller may be recommended, too.
During treatment, stay out of the water and use a cotton ball or cap to keep the inside of the affected ear dry during showers or baths. Also, refrain from using ear plugs, earbuds, or other items inserted in the ear. This all generally holds for seven to 10 days, but check with the doctor for personalized advice.
If the infection doesn’t clear up, the doctor may take a culture to determine the type of bacteria so that a more targeted antibiotic can be prescribed. If there are signs of concerning complications, there may be a referral to an ear, nose, and throat (ENT) specialist.
Preventing Swimmer’s Ear
There are several ways to reduce the risk of developing otitis externa, and it’s a good idea to use them if you’ve found you’re prone to these ear infections. One of the simplest things to do is to help your ears dry efficiently after swimming; tip your head to each side and hold it for 10 seconds to encourage draining. Then gently dry your outer ear with a clean towel (but don’t stick anything into your ear canal, as that can cause breaks in the skin or damage your ear drum).
Be gentle when cleaning your ears, don’t use hair pins or other pointed objects to dig out wax, and refrain from putting items like earbuds in. In fact, ear wax helps protect your ears, so consider leaving it in. Also, if you tend to suffer irritation from hair dyes or hair styling products, put cotton balls in your ears before applying them.
Swim in properly maintained pools and keep up with elevated bacteria count alerts if you swim in natural bodies of water. Well-fitted ear plugs made for swimmers are also good at keeping water and bacteria out of the ear canal (but ear plugs made to dampen sound are useless in this respect).