Swimmer’s ear is a type of infection that affects the outer ear and the ear canal, it is also known as otitis externa.
The word otitis means inflammation of the ear, and externa relates to where in the ear the infection is.
Swimmer’s ear is usually caused by water trapped in the ear.
What happens when water gets stuck in your ear?
Getting water in your ear is a common occurrence, whether it’s from bathing or showering, swimming, sweating or being in a humid environment. In most cases, the water makes its way out of the ear on its own, but sometimes water can get stuck in the ear.
Trapped water, coupled with the warm conditions of the ear, makes it an ideal environment for bacteria to grow and cause an infection, specifically an ear canal infection (otitis externa). This type of ear infection is common in regular swimmers, which is why it also goes by the name of swimmer’s ear.
The infection might also be caused by a scratch in the ear canal that allows bacteria into the break in the skin, or if you have an allergic reaction to certain products or jewellery.
What is swimmer’s ear?
If you submerge your head when swimming, it’s inevitable that water will go into your ears if they aren’t protected by ear plugs. In most cases it will come out, but if the water gets trapped in your ear, it risks growing bacteria which can then cause an infection.
Signs you have water trapped in your ear:
- Muffled hearing
- Feeling of fullness in the ear canal
- Tickly feeling in the ear
What is otitis externa?
The word otitis means inflammation of the ear, and externa relates to where in the ear the infection is. In this case, it’s found in the ear canal – the tube that connects the outer part of the ear to the eardrum.
Most cases of ear canal infections are caused by bacteria or fungus. This can happen if there’s an excessive amount of liquid in your ear canal (from swimming, sweating, or humid environments) which provides ideal conditions for bacterial growth. That’s why swimmers often get this type of ear infection. It's usually simple to treat and will clear after a few days. However, some cases may last longer.
Otitis externa vs otitis media
Although both are ear infections, otitis externa and otitis media affect different parts of the ear and are quite different in their symptoms. Otitis externa, or ear canal infection, affects the outer part of the ear, and doesn’t go any further than the eardrum. Otitis media, or middle ear infection, affects the area behind the eardrum and before the inner ear. Both conditions, however, can be caused by putting things into the ear that either damage the skin of the ear canal, or the eardrum itself — leading to infection.
What is acute otitis media?
Acute otitis media is the name for inflammation and infection of the middle ear.
The condition starts quite suddenly. It usually occurs in children and can follow a cold or flu.
The symptoms include earache, fever, irritability and hearing loss.
Symptoms of swimmer’s ear
Symptoms can be mild to begin with but can get worse over time, particularly without treatment.
- Itchy ears
- Redness inside the ear
- Swelling in the ear canal or outer ear
- Discomfort or pain (particularly if you pull on your ear)
- Feeling of fullness in the ear
- Discharge from the ear
- Discomfort, pain or tenderness when you move your jaw, or while you’re eating
- Muffled hearing in the affected ear
- Dry or flaky skin around the outer ear and ear canal
- Some temporary hearing loss in the affected ear
Will water come out of my ear naturally?
Most of the time, any water in your ears will trickle out on its own after a few minutes or hours.
Sometimes it can get trapped due to a narrow ear canal, or if earwax is blocking its way out.
How to prevent an ear canal infection
Although it’s not possible to completely prevent getting an ear infection, there are a few things you can do to reduce your chances of developing swimmer’s ear and limit water getting stuck in the ear in the future.
These include things like:
- Wearing ear plugs designed for swimming to keep any water out of your ear canal
- If you’re not sure how clean the water is (in lakes and rivers, for example) – steer clear
- After you’ve been swimming, tip your head to the side to let any excess water out
- Use a clean towel to dry the outside of your ears after a shower, bath, or swimming
- Never try to get earwax out yourself with your finger, cotton buds, or hairpins
- Wear a swimming cap if you’re a regular swimmer or you could talk to an audiologist about custom ear protection to prevent water from getting into the ear.
- Avoid getting anything in your ears like shampoo or hair spray that could irritate the skin
Risk factors for swimmer’s ear
Swimmer’s ear can happen to anyone, but you might be at a greater risk of developing it if you:
- Are a regular swimmer
- Scratch or scrape the ear canal with your finger or with a cotton bud
- Have an existing skin condition like eczema or psoriasis
- Have excess earwax, wear hearing aids, or use a swimming cap (this can trap water in the ear)
Swimmer’s ear treatment
Swimmer’s ear drops
Prescription ear drops are the most common treatment for swimmer’s ear. They contain medication that will help to fight the infection and calm down any swelling you have. You’ll probably need to use these a few times a day for a few days, and it’s important that you finish the bottle – even if your ear is feeling better.
Medical treatment for swimmer’s ear
Depending on the extent of your symptoms, your GP might need to clean out your ears, or try a different method in order to properly access the ear for treatment. They’ll also check on the health of your eardrum as this might affect the type of treatment they recommend. Rarely, some people may require a stay in hospital for treatment.
Treating the condition from home
After you’ve started treatment, it’ll usually take a few days for your symptoms to clear.
But while you’re waiting for treatment to kick in, there are a few things you can do to make your symptoms feel a little better.
This might include taking paracetamol or ibuprofen to manage any pain you have, avoiding using earphones or hearing aids for a few days, and keeping your ear dry and away from anything that could irritate it (like hairspray or shampoo).