What Is Swimmer’s Ear? Causes, Symptoms, and Treatment
Key takeaways:
Swimmer’s ear is a bacterial infection of the outer part of the ear that can lead to pain, redness, and difficulty hearing.
You can help decrease your chances of getting swimmer’s ear by fully drying out your ears after they get wet. Also, avoid placing objects in your ears (including Q-tips).
The best swimmer’s ear treatment is a topical ear drop (not oral antibiotics).
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Table of contents
Swimming can be tons of fun, and it’s great exercise too. But, for some people, it comes with an added risk: pain and redness of the ear, a condition known as swimmer’s ear. About 1 in 10 people will experience swimmer’s ear at some point in their lives. Knowing how to prevent and treat this condition can help you enjoy the water without prolonged ear pain.
What is swimmer’s ear?
Swimmer’s ear (acute otitis externa) is an infection of the ear canal. The ear canal is the area from the outside opening of the ear to the eardrum. When that area develops inflammation and infection, it’s called swimmer’s ear.
What causes swimmer’s ear?
Swimmer’s ear is usually caused by bacteria that grow in the ear canal. Anything that causes water to remain in the ear canal makes it more likely that bacteria will grow. Swimming or spending time in a water-based play area (like a pool or waterpark) is one of the most common triggers, hence the name. However, swimming isn’t the only way to get it.
Swimmer’s ear is more likely to develop in humid environments and in people who:
Have narrow ear canals
Use hearing aids
Scratch inside their ears or use Q-tips
Have chronic dry skin, such as eczema or psoriasis
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What are the symptoms of swimmer’s ear?
Swimmer’s ear can appear in a variety of ways. Common symptoms include:
Pain (especially when tugging on the earlobe or pushing on the ear)
Redness
Itching
Dry, scaly skin in the ear canal
Drainage of clear fluid
Redness or swelling of the outer ear
Muffled or decreased hearing
How is swimmer’s ear diagnosed?
To diagnose swimmer’s ear, a healthcare professional will perform a physical exam and ask you about your symptoms. They’ll look inside your ear to make sure you don’t have a middle ear infection.
They likely won’t take a sample culture (to identify the specific bacteria) unless you:
Have severe symptoms
Experience recurring ear infections
Are immunocompromised
Had ear surgery recently
Didn’t respond to initial treatment
Common swimmer’s ear treatments
Fortunately, there’s a cure for swimmer’s ear. It’s not recommended to use oral antibiotics for treating a simple swimmer’s ear infection. Instead, treatments with ear drops applied directly to the ear canal are preferred. These seem to be more effective at getting rid of swimmer’s ear. And they lead to fewer side effects.
Best ear infection treatments: Check out our list of the best antibiotics for ear infections, so you can get fast relief.
Adult ear infections: It’s not just an issue for kids. Find out what to do if you’re an adult with an ear infection.
Ear infection medications: Learn more about the best over-the-counter treatment options for ear infections.
Here are common ways of treating swimmer’s ear.
Ear drops
Ear drops with the following ingredients can be used for swimmer’s ear:
Antibiotics: ofloxacin (Floxin)
Antibiotics plus steroids: ciprofloxacin / dexamethasone (Ciprodex) or colistin / hydrocortisone / neomycin / thonzonium (Cortisporin)
Sterilizing ingredient: acetic acid
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Medications
Other medications that may be used to treat swimmer’s ear include:
Over-the-counter (OTC) pain medications: Some options of these are acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
Oral antibiotics: In some cases, a healthcare professional may prescribe oral antibiotics. An example is if you have an underlying condition that makes you more prone to serious infections. Another is if it’s too difficult for you to use ear drops due to another medical problem. The oral antibiotics will prevent a more severe infection from developing.
Other tips
Here are some basic home remedies for swimmer’s ear to keep in mind while you’re recovering:
Take a break from swimming. While treating swimmer’s ear, do your best to keep your ears dry. Avoid swimming for 7 to 10 days.
Apply heat for relief. Try putting a heating pad or a warm compress around the ear for 10 to 15 minutes at a time. This can help relieve swelling and pain from swimmer’s ear.
How can you prevent swimmer’s ear?
There’s no guaranteed way to prevent external ear infections. However, here are some tips to help decrease your chances of developing one:
Wear a bathing cap or ear plugs when swimming.
Dry your ears well after swimming or showering.
Don’t try to remove earwax. Earwax helps prevent bacteria from growing.
Don’t put objects in your ears (including cotton swabs or your fingers).
Make sure your pool has been appropriately treated to prevent bacterial overgrowth.
Avoid swimming in freshwater lakes, if you’re prone to swimmer’s ear.
If you’re prone to swimmer’s ear, it may help to dry out the ears after swimming or showering using OTC rubbing alcohol (70% isopropyl alcohol) or a homemade remedy. But talk to a healthcare professional first and make sure ear drops are safe for you to use.
To make the homemade remedy:
Mix equal parts rubbing alcohol and vinegar.
Use an eyedropper to place about 5 mL in your ear.
Let it drain out.
What’s the difference between swimmer’s ear and a regular ear infection?
A swimmer’s ear infection involves the outer part of the ear (the ear canal). A typical ear infection, on the other hand, refers to inflammation that occurs more internally, just behind the eardrum in the middle ear. Both types of ear infection involve ear pain. But there are some common ways in which they’re different.
Middle ear infection
A middle ear infection is more likely to:
Be triggered by a viral upper respiratory infection like a cold or the flu
Occur along with a fever
Cause pain that worsens when lying down
Need oral antibiotics to get better
Affect younger children
External ear infection (swimmer’s ear)
An external ear infection is more likely to:
Be associated with pain when pulling on the outside part of the ear
Have ear discharge
Happen after swimming
Have visible redness and swelling to the outside part of the ear
Get better without oral antibiotics
Can swimmer’s ear go away on its own?
Sometimes, swimmer’s ear can resolve on its own. But this can take weeks. And it can occasionally lead to long-term scarring and hearing loss. In rare cases, it can lead to necrotizing otitis externa, a severe infection of the surrounding bones. This mostly occurs in people with a weakened immune system or older people with diabetes.
If you think you might have swimmer’s ear, you should contact a healthcare professional for treatment.
Frequently asked questions
It’s rare for showering or taking a bath to lead to swimmer’s ear. But anything that creates moisture in the ear canal can cause swimmer’s ear. So, it’s possible. If you often aggressively remove ear wax or have eczema that irritates the skin on your outer ear canal, you may be more prone to developing swimmer’s ear from daily activities.
Some activities may make it more likely for you to get swimmer’s ear, including:
Swimming in freshwater lakes: This is often due to the presence of a bacteria called Pseudomonas aeruginosa that can be present in freshwater lakes.
Swimming in unclean pools: Improperly treated pools can allow bacteria to develop, leading to increased risk for infection.
Water sports: Anything that involves more time spent in the water can lead to swimmer’s ear. A typical example is water sports (such as water polo or competitive swimming).
The bottom line
Swimmer’s ear is a common and treatable infection of the external canal of the ear. You can decrease your chances of developing it by keeping your ear dry, avoiding activities that irritate the skin lining the ear canal, and avoiding pools or lakes, which are more likely to be contaminated by bacteria. If you get diagnosed with swimmer’s ear, a variety of ear drops may be used for treatment.
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References
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Harmes, K. M., et al. (2013). Otitis media: Diagnosis and treatment. American Family Physician.
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Nationwide Children’s. (2014). Otitis externa (swimmer's ear).
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van Asperen, I. A., et al. (1995). Risk of otitis externa after swimming in recreational freshwater lakes containing pseudomonas aeruginosa. The BMJ.
Wiegand, S., et al. (2019). Otitis externa: Investigation and evidence-based treatment. Deutsches Ärzteblatt International.
