Swimmer’s Ear: Causes, Symptoms & Treatment

Have you ever emerged from a swimming pool and had the feeling that your ear was filled with water?

You jump, shake your head, and stick your finger in your ear … but it just won’t go away! Water in your ear (or sometimes wax, or other foreign objects) can cause an outer ear infection known as otitis externa, also referred to as swimmer’s ear. 

Outer ear infections can be uncomfortable, but proper diagnosis and treatment can improve symptoms quickly.

There are also a number of ways to prevent swimmer’s ear.

In this article, I’ll explain what swimmer’s ear is, what causes it, and outline its symptoms. I’ll outline how it’s diagnosed, and list some treatment options you can get from your healthcare provider or try at home.

Finally, I’ll go through some risk factors and potential complications, and talk about how you can prevent swimmer’s ear.

What is Swimmer’s Ear?

Otitis externa, or swimmer’s ear, is an outer ear infection that’s often caused by water that stays in your ears after swimming.

Bacteria can grow in the moist environment. Swimming isn’t the only way you can develop this type of infection, though.

You can also get otitis externa by putting cotton swabs, fingers, or other objects in your ear, injuring the outer ear, or if wax blocks the ear canal.

Ear infection vs. swimmer’s ear

An ear infection is an infection or inflammation of the outer ear canal, inner ear, or middle ear.

When one talks about an “ear infection,” they often mean an infection in the middle ear, the space behind the eardrum that holds the ear’s vibrating bones.

Middle ear infections are often caused by viruses, but sometimes bacteria, and are extremely common in younger children. 

Swimmer’s ear is an infection of the outer ear in your ear canal, the tube that runs from the hole of your ear to your eardrum.

Unlike the common middle ear infection, swimmer’s ear is more often caused by bacteria. 

What Causes Swimmer’s Ear?

• Moisture in your ear: Heavy perspiration, humid weather, or leftover water in your ear after swimming can create an optimal environment for bacteria to thrive.

• Scratches in your ear canal: Cleaning your ear with a cotton swab or a hairpin can scratch the inside of your ear or rub away protective ear wax, causing small breaks in the skin that allow bacteria to grow.

• Sensitivity reactions: Jewelry or hair products, like hairspray, can cause allergies. Existing skin conditions, like eczema, dermatitis, and psoriasis can also promote infection.

• Foreign objects in your ear canal: The use of hearing aids or ear buds can also promote infection. 

• Age: Children are more prone to swimmer’s ear due to their small, narrow ear canals. 

Symptoms

Symptoms of swimmer’s ear can include:

• Itching
• Redness inside the ear
• Discomfort
• More severe ear pain

You may notice pain when pulling on the outer ear or earlobe.

One might also notice clear or odorless fluid coming from the infected site, intense itching, increased pain, feeling of fullness, and muffled hearing. In severe cases, a person with swimmer’s ear might experience a fever, redness of the external ear, swollen lymph nodes near the ear, or total blockage of the ear canal.

Diagnosis 

You should speak to a healthcare provider to properly diagnose swimmer’s ear.

During the visit, the doctor will discuss your symptoms, look at the outer ear, and may use an otoscope to examine the ear canal and look at the eardrum. 

Treatment Options

Cleaning

Cleaning the outer canal will help ear drops flow into the infected area.

You should never attempt this at home, as using q-tips can push ear wax further into the ear canal or cause injuries, especially if the ear is already inflamed.

A healthcare provider may use suction, saline rinses, or a curette to clean away discharge or excess skin of the ear canal. 

Ear Drops

Oral antibiotics are rarely needed to treat swimmer’s ear.

Ear drops are the most effective treatment. Depending on the type of infection you’re experiencing, a patient may require drops that are an acidic solution, steroid ear drops, antibiotic ear drops, or antifungal drops.

A combination of a steroid and an antibiotic is commonly used for swimmer’s ear.

Medications

If you’re experiencing severe pain, over-the-counter pain relievers like acetaminophen or ibuprofen can help ease discomfort.

OTC swimmer’s ear drops can also help dry up any extra fluid and improve pain.

Steroid ear drops that are commonly prescribed for these infections help with pain as well, so speak with a healthcare provider if you are still having pain despite over-the-counter treatments.

Swimmer’s Ear Home Remedies

Some studies show that certain at-home remedies can help relieve mild swimmer’s ear or prevent it from occurring after swimming.

This includes a solution of half rubbing alcohol and half white vinegar that can be applied in the ear. The alcohol helps evaporate and remove water in the ear, while the acidity of the vinegar keeps bacteria from growing.

Hydrogen peroxide may also be used after swimming to remove excess fluid. Some people also use garlic oil drops, which may have natural antibacterial properties, but have not been proven to treat ear infections in quality scientific studies.

Over-the-counter swimmer’s ear drops work similarly to help dry the inner ear and prevent bacteria from growing.

For pain and discomfort, hot and cold compresses help.

It’s also recommended that you avoid water exposure while you have swimmer’s ear symptoms.

You can protect the ear canal from water by using a cotton ball dipped in petroleum jelly in the ear before showering or by using waterproof ear plugs.

You should avoid swimming or immersing the ears in water until the infection has gone away. 

Risk Factors

One of the greatest risk factors for swimmer’s ear is narrow ear canals—water can get stuck inside and bacteria can grow.

This is why these ear infections are more common in children and teens.

Cuts in the ear and contact with unclean water or hot tub water can also increase your risk of these infections.

Those who swim for long periods of time or every day will also have higher risk since their ear canal is wet more frequently. Using watertight ear plugs can help prevent infection for those who swim regularly.

Complications 

Swimmer’s ear can result in uncomfortable or serious complications.

If left untreated, or if you have an underlying condition such as diabetes or weakened immune system, you can develop chronic otitis externa that is harder to treat, and can be caused by bacterial or fungal infections. 

There is also a small risk of the infection spreading to other parts of the body, like the skull, nerves, or brain—this is more common in those with a suppressed immune system.

While rare, this can be serious and potentially life-threatening.

Swimmer’s ear can also occasionally cause hearing loss due to inflammation. Seek medical advice and treatment if you think you might have swimmer’s ear. 

When to Call a Healthcare Provider

Contact your health care provider if you have pain with or without a fever, decreased hearing, or abnormal discharge from your ear after swimming, water exposure, or an injury to the ear canal.

If you have recurring infections or infections that do not get better with standard treatment, you may need to see an ENT or ear specialist.

Prevention Tips

The key to preventing swimmer’s ear is a dry ear.

In seasons when you’re swimming more often, try to use water-resistant ear plugs.

The CDC recommends using a hair dryer after getting out of the water to dry out the earlobe and ear canal. Make sure to put the dryer on the lowest setting and hold it at least a foot away from your ear.

You can make a remedy of preventative ear drops made with one drop of white vinegar and one drop of rubbing alcohol.

You can also use hydrogen peroxide or OTC swimmer’s ear drying drops, which will promote the drying process.

Avoid putting foreign objects like hair pins, paperclips, or cotton swabs in your ear that might scratch or disturb the wax and canal. For excessive ear wax, it is safer to use ear wax drops, then let the ear wax safely drain out on its own.

How K Health Can Help

Ear infections can be painful, but if you’re suffering from one, a healthcare provider can help improve your symptoms and cure the infection quickly.

Did you know you can get affordable primary care with the K Health app?

Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.