Swimmer's Ear (External Otitis)

What Is Swimmer's Ear?

Swimmer's ear is an infection of the ear canal, the tubular opening that carries sounds from the outside of the body to the eardrum. It can be caused by different types of bacteria or fungi.

What Causes Swimmer's Ear?

Swimmer's ear — or otitis externa — usually develops in ears that are exposed to moisture. People who get it often have been diving or swimming a lot, which can bring the germs directly into the ear canal. Swimmer's ear often happens during the summer months, when lots of us are enjoying water activities.

People who don't swim can also develop it by scratching their ear canals when they try to clean their ears. This is especially true if they use cotton swabs or dangerously sharp small objects, like hair clips or bobby pins.

Sometimes, in a person with a middle ear infection (otitis media), pus collected in the middle ear can drain into the ear canal through a hole in the eardrum, casuing otitis externa.

What Are the Signs of Swimmer's Ear?

The main sign is severe ear pain that gets worse when the outside part of the ear is pulled or pressed on. Sometimes there is itching in the ear canal before the pain begins.

The outer ear might get red or swollen, and lymph nodes around the ear may get enlarged and tender. Sometimes, there's a greenish-yellow discharge of pus from the ear opening. It can be hard to hear in the affected ear if pus or swelling of the canal begins to block passage of sound into the ear.

How Long Does Swimmer's Ear Last?

If it's treated with prescription ear drops, swimmer's ear is usually cured within 7 to 10 days. The pain should lessen within a few days of treatment.

External otitis is not contagious, so you don't have to limit your contact with friends as long as you're feeling well enough to socialize.

When Should I Call My Doctor?

Call your doctor if you have any of these problems: 

• pain in an ear with or without fever
• lasting itching of the ear or in the ear canal
• loss of hearing or decreased hearing in one or both ears
• discharge from an ear, especially if it's thick, discolored, bloody, or bad-smelling

Getting treatment is the fastest way to relieve the ear pain and to prevent the spread of infection.

How Is Swimmer's Ear Treated?

Your doctor's treatment for swimmer's ear will depend on how severe the pain and the infection are. For most outer ear infections, your doctor may prescribe ear drops containing antibiotics possibly mixed with medicine to help improve swelling and inflammation. These will help fight the infection and ease swelling of the ear canal. Ear drops are usually given several times a day for 7 to 10 days.

If the opening into your ear is narrowed by swelling, your doctor may clean your ear and insert a wick into your ear canal to help carry ear drops into the ear more effectively. For a severe infection, you might also get antibiotic liquid or pills to take. Your doctor may send some of the fluid draining from your ear to a lab to help identify what type of germ is causing the infection.

What Can I Do to Feel Better?

At home, follow your doctor's directions for using ear drops and take all doses of antibiotic medicine as prescribed. Keep taking these for all days of treatment, even if you are starting to feel better. If you stop too soon, the infection could come back.

You can try acetaminophen or ibuprofen for ear pain. If they don't help, your doctor might prescribe a stronger pain reliever. You'll use this only for a short time — until the ear drops and antibiotics begin to work.

To protect your ear while it heals, your doctor will probably tell you to keep your head out of water for several days or weeks — even while showering or shampooing! This can be tough, but your doctor can give you suggestions on how to do this, such as using a cotton ball as an earplug.

Can Swimmer's Ear Be Prevented?

You may be able to prevent swimmer's ear by using over-the-counter acetic acid drops after you've finished swimming for the day. (But don't use these drops if you have ear tubes or a hole in your eardrum.) Dry your ears well with a clean towel after swimming, bathing, or showering.

Keep all objects out of your ear canals — including cotton swabs — unless your doctor has told you it's OK to use them.