Swimmer’s Ear – Symptoms and Causes

Overview

Swimmer’s ear occurs when the outer ear canal becomes infected. The outer ear canal is the path from your eardrum to the outside of your head.

This condition often develops when water stays in your ear after swimming or bathing. This creates a damp environment where bacteria can grow easily.

However, you don’t need to be a swimmer to get this infection.

Damaging the delicate skin that lines your ear canal can also cause swimmer’s ear. This can happen when you put objects like fingers, cotton swabs, or other items into your ears.

Medical professionals call this condition otitis externa. Most cases can be treated effectively with prescription eardrops. Getting treatment quickly is important to prevent the infection from spreading or becoming more serious.

Common symptoms of swimmer’s ear include:

• Redness inside the ear canal
• Pain that may get worse when touching the ear
• Fluid drainage from the ear
• Discharge of pus

Without proper treatment, the infection might spread beyond the ear canal to nearby tissues and even bone. Most doctors recommend antibiotic ear drops as the first treatment. In more severe cases, oral antibiotics or other medications might be needed.

Signs and Symptoms

Swimmer’s ear typically begins with mild symptoms. You might notice some itching inside your ear canal and slight redness.

Pulling on your outer ear or pressing the small bump in front of your ear (tragus) causes mild discomfort. Clear fluid without odor may drain from the ear.

Middle Stage Problems

Without treatment, symptoms can worsen. Itching becomes more intense, and pain increases. The redness inside your ear spreads further. You might experience:

• Increased fluid drainage
• Feeling of fullness in your ear
• Partial ear canal blockage due to swelling, fluid, and debris
• Hearing loss or muffled sounds

Severe Complications

In advanced cases, swimmer’s ear can cause extreme discomfort. Pain may spread to your face, neck, or side of your head. The ear canal can become completely blocked.

The outer ear may turn red or swell. Lymph nodes in your neck might become swollen, and fever can develop.

When to See a Doctor

Reach out to your doctor if you notice any symptoms of swimmer’s ear, even mild ones.

Seek immediate medical attention if you experience:

• Severe pain
• Fever

These symptoms may indicate a more serious infection that needs prompt treatment.

Why Swimmer’s Ear Happens

Your outer ear has built-in ways to protect itself from infection. A thin, water-resistant film lines your ear canal. This film is slightly acidic, which helps stop bacteria from growing.

Earwax is made from this film plus dead skin cells and other materials. It moves toward the ear opening to keep the canal clean. The shape of your outer ear also helps keep harmful things out of your ear canal.

How Infections Start

Swimmer’s ear happens when these natural defenses can’t do their job anymore. Three main things can lead to an infection:

1. Moisture in the ear canal – When water stays in your ear, it creates a perfect place for bacteria to grow.
2. Contact with dirty water – Swimming in water that has bacteria can bring those germs into your ear.
3. Damaged ear canal skin – Scratches or cuts in your ear canal give bacteria an easy way to enter and cause infection.

When these factors come together, the natural protection system in your ear gets overwhelmed, and an infection can develop.

Risk Factors

Several factors may raise your chances of getting swimmer’s ear:

• Moisture buildup can result from sweating, humid weather, or water left in ears after swimming.
• Swimming in bacteria-filled water, like lakes or poorly maintained pools.
• Ear canal damage from cleaning with cotton swabs, fingernails, or other objects.
• Using ear devices such as earbuds or hearing aids can create small skin breaks.

These conditions create an environment where bacteria can grow and cause infection.

Complications

Swimmer’s ear can lead to several problems when not treated quickly. While most cases clear up with proper care, some issues may occur.

Hearing may become muffled temporarily during an infection. This usually improves once the ear heals.

When symptoms last longer than three months, the condition becomes chronic otitis externa. This happens more often with:

• Unusual bacteria types
• Allergic reactions to the skin or antibiotic drops
• Skin conditions like dermatitis or psoriasis
• Combined bacterial and fungal infections

In rare cases, the infection can spread deeper into the skin tissues, causing cellulitis.

More serious complications include damage to bone and cartilage, known as early skull base osteomyelitis. This happens when the infection spreads to the ear cartilage and lower skull bones, causing severe pain. People at higher risk include:

• Older adults
• Those with diabetes
• Individuals with weakened immune systems

The most serious but rare complication occurs when the infection spreads beyond the ear, potentially affecting the brain or nearby nerves. This widespread infection can be life-threatening.

Preventing Swimmer’s Ear

Keep your ears healthy and dry to prevent infection. These simple steps can help you avoid painful ear problems.

Keeping Ears Dry and Protected

After swimming or bathing, tilt your head to each side to help water drain out. Gently dry your outer ear with a soft towel.

You can use a blow-dryer on the lowest setting, keeping it at least 12 inches away from your ear.

Make a simple protective solution by mixing equal parts white vinegar and rubbing alcohol. Put 1 teaspoon in each ear before and after swimming, then let it drain out.

This helps dry your ears and stops bacteria and fungi from growing. You can find similar products at drugstores.

Wear earplugs or a swimming cap to keep water out of your ears while swimming. Avoid swimming in lakes or rivers when bacterial warnings are posted.

Protect your ears from irritants by putting cotton balls in them when using hair products like sprays and dyes.

If you’ve recently had an ear infection or ear surgery, talk to your doctor before swimming to avoid complications.

What to do about earwax

Earwax naturally moves to your outer ear, where you can wipe it away with a damp cloth. It’s best to let earwax do its job protecting your ears.

Never put objects in your ear canal. These include cotton swabs, paper clips, hairpins, and any other small objects. These items can push earwax deeper, irritate the delicate skin, or cause scratches or breaks in the skin.

Safe ways to handle excess earwax:

1. See your doctor for professional removal
2. Try these at-home cleaning steps:

Steps	Instructions
Soften the wax	Use an eyedropper to apply a few drops of baby oil, mineral oil, glycerin, or diluted hydrogen peroxide
Wait	Let the drops work for 1-2 days to soften the wax
Rinse gently	Use a rubber-bulb syringe with warm water while tilting your head
Position correctly	Pull your outer ear up and back to straighten the ear canal
Drain	Tip your head to let water flow out
Dry thoroughly	Gently dry your outer ear with a towel or blow-dryer