What Is Swimmer's Ear?
Swimmer’s ear, medically known as otitis externa, is an inflammation or infection of the outer ear canal—the passage leading from the outer ear to the eardrum. It commonly occurs when water remains in the ear after swimming, creating a moist environment that facilitates bacterial or fungal growth. While it’s often associated with swimming, swimmer’s ear can develop from any activity that allows water or moisture to enter the ear canal.
What Causes Swimmer's Ear?
Under normal conditions, waxy, water-repellent secretions from sebaceous and apocrine glands protect your ears. However, when these usual barriers are lost, the skin becomes inflamed and macerated, increasing the risk of bacterial or fungal invasion.
A common cause of the breakdown of this barrier happens when water enters the ear canal and doesn’t drain out, such as when you go swimming or wash your hair.
The skin becomes soft and soggy when the ear canal is wet for an extended period. This makes ears more susceptible to injury and creates an ideal environment for bacteria or fungi to flourish and cause an infection.
Other causes and contributing conditions may include:
- Cleaning inside the ear canal with cotton buds, hair clips or other sharp objects.
- Shampoos, hairsprays and hair dyes that may irritate and emaciate your skin.
- Eczema or dermatitis causes the skin to break and no longer acts as a protective barrier.
- Insufficient (cerumen) earwax production to protect your ear canal.
CNX OpenStax, CC BY 4.0, via Wikimedia Commons.
Risk Factors
Certain factors increase the likelihood of developing swimmer’s ear:
- Swimming: Especially in lakes or rivers with high bacterial levels.
- Hot and Humid Climates: Promote bacterial growth and moisture retention.
- Narrow Ear Canals: This can make it harder for the ear canals to dry out effectively.
- Ear Devices: Frequent use of earbuds, earplugs, or hearing aids.
- Chronic Skin Conditions: Such as eczema or seborrheic dermatitis.
- Excessive Ear Cleaning: Removes protective earwax and can injure the skin.
- Exostoses or Surfer’s Ear: Narrows the ear canal and can trap water inside.
8 Symptoms of Swimmer's Ear
Ear pain is the most common complaint about swimmer’s ear or otitis externa. With enough swelling and discharge, conductive hearing loss is also common.
- Ear Pain: Ranging from mild discomfort to severe pain that may worsen when touching or pulling the earlobe.
- Itching: Inside the ear canal.
- Redness and Swelling: Of the outer ear and ear canal.
- Discharge: Clear, odourless fluid or pus draining from the ear.
- Feeling of Fullness: In the ear, sometimes with decreased or muffled hearing.
- Fever: In advanced infections.
- Swollen Lymph Nodes: Around the ear or upper neck.
- Difficulty Moving the Jaw: Pain when chewing or talking.
Treatment for Swimmer’s Ear
Treatment is aimed at cleaning the ear canal and keeping it dry.
In mild cases, a healthcare practitioner may clean the outer ear canal using a light suction device called microsuction. A doctor may also prescribe an ointment or ear drops for you to use at home.
A test swab might be taken and sent to a pathology lab to identify a bacterial or fungal infection.
Sometimes antibiotics are needed for severe bacterial infections. Take the entire course as your doctor prescribes, even if you feel better after a day or two.
How to Prevent Swimmer’s Ear
Earplugs or cotton wool coated in Vaseline to keep water out of your ear canal are good options when swimming or bathing.
When washing your hair, tip your head forward, and your ears will act as umbrellas. This will minimise the amount of water entering your ear canals.
It would be best to avoid any water activities, such as swimming, surfing, and diving, for the duration of the infection and at least one week afterwards.
Tips to reduce the risk of swimmer’s ear include:
Keep Ears Dry
Dry Ears After Water Exposure: Gently towel dry the outer ear. Tilt your head to allow water to drain.
Use Ear Drops: Over-the-counter acetic acid or alcohol-based drops can help dry the ear canal (consult a healthcare provider first).
Use Ear Protection
Earplugs: Wear swim moulds or earplugs when swimming.
Shower Caps or Ear Guards: To prevent water entry during bathing.
Avoid Inserting Objects
No Cotton Swabs: Do not use them to clean the ear canal.
Professional Cleaning: Seek help if you suspect excess earwax.
Protect Ears from Irritants
Hair Products: Avoid spraying near the ears.
Allergen Awareness: Be cautious if you have sensitive skin or allergies.
Manage Skin Conditions:
Manage Skin Conditions
Treatment: Address eczema or psoriasis affecting the ear canal with a healthcare provider’s guidance.
When to Contact a Healthcare Professional
Persistent Symptoms: If symptoms worsen or do not improve within 48 to 72 hours.
Severe Pain or Fever: May indicate a more serious infection.
Hearing Loss: Sudden or significant changes in hearing.
Spread of Infection: Signs of infection spreading beyond the ear.
