Understanding Swimmer’s Ear

Swimmer’s ear peaks in the summer months, when people are more likely to go swimming, but you can get it without ever going in the water.

Each year, millions of people in the United States see a doctor or another health care provider to get treatment for a painful ear infection called acute otitis externa. You probably know it by its more popular name: swimmer’s ear.

This common condition happens to 10 percent of people at some point. Here’s what to know.

You Don’t Have to Swim to Get Swimmer’s Ear

The infection is usually caused by one of two types of bacteria, Pseudomonas aeruginosa or Staphylococcus aureus. Water left in the ear canal after swimming provides an environment that is favorable for these bacteria to grow, but there are other ways for the germs to take root in the ear, says Christine DeMason, MD, an ear, nose and throat physician at UNC Medical Center in Chapel Hill.

Any water, sand or other debris that gets into the ear canal and stays there can cause the infection.

“Lots of people who get swimmer’s ear don’t go near the water,” Dr. DeMason says.

“Sometimes people try to clean their ears with cotton swabs. This can cause damage or irritation to the lining of the ear canal, and that gives bacteria a way to get in and cause an infection.”

That’s why doctors recommend that you never put any foreign objects, including cotton swabs or your fingers, inside your ears.

People who wear hearing aids are at risk of developing swimmer’s ear because hearing aids can break down the natural protective barrier of the skin and trap moisture. That doesn’t mean people who need hearing aids shouldn’t wear them, Dr. DeMason says; she simply recommends that people take them off when they aren’t using them, such as at night.

Signs, Symptoms and Treatment of Swimmer’s Ear

Some of the more common signs and symptoms of swimmer’s ear include:

  • Itching inside the ear
  • Pain inside the ear that gets worse when you tug on the outer ear
  • Sensation that the ear is blocked or full
  • Drainage from the ear
  • Decreased hearing

In most cases, swimmer’s ear can be treated with a careful cleaning of the ear canal (which should be done by a health care professional) and prescription eardrops that inhibit bacterial or fungal growth and reduce inflammation. These drops often contain antibiotics and steroids. You may also be prescribed medication to reduce pain.

If your ear canal is swollen, your doctor might place an ear wick in the ear canal to help the drops reach their target. In rare cases, patients may also be given IV antibiotics if eardrops aren’t enough to clear the infection by themselves.

If left untreated, swimmer’s ear can lead to more serious problems, such as a deep tissue infection called cellulitis, or to bone and cartilage damage. That’s why you should always see your health care provider if you think you might have swimmer’s ear, Dr. DeMason says.

How to Reduce Your Risk

To reduce your risk of swimmer’s ear, the Centers for Disease Control and Prevention recommends that you keep your ears as dry as possible when swimming by wearing a bathing cap, earplugs or custom-fitted swim molds. You should also dry your ears thoroughly after swimming or showering. However, you should not try to use cotton swabs, or anything else, to remove your earwax, because earwax helps protect your ear against infection.

Your risk of swimmer’s ear is higher when you swim in natural bodies of water, such as rivers, lakes or the ocean, compared with swimming in a chlorinated swimming pool, Dr. DeMason adds. That’s because natural bodies of water are more likely to have higher levels of bacteria.

That doesn’t mean you should never swim in a natural body of water, she says, but if you want to reduce your risk of swimmer’s ear, a swimming pool is the safer option.

You can also use over-the-counter eardrops to help dry out your ears after swimming. They’re often called drying eardrops or swimming eardrops. But Dr. DeMason recommends that people make their own: Mix one part rubbing alcohol with one part white vinegar. Add a few drops to the ear when it’s wet.

For people with eczema, who are also prone to swimmer’s ear, the problem is the opposite: The skin is too dry, which can lead to infection in the ear canal. For these people, Dr. DeMason recommends mineral oil, which lubricates without water.

If you are experiencing symptoms that may be swimmer’s ear, call your primary care doctor or visit an urgent care location. If you have a persistent problem with swimmer’s ear, talk to your doctor about seeing an ENT specialist or a pediatric ENT specialist. Need a doctor? Find one near you.