What is Swimmer's Ear?

Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Swimmer's ear is an infection of the outer part of the ear canal and the external ear. It occurs most commonly following extended exposure to water. Because the infection causes inflammation of the external ear, it is medically known as otitis externa.

The infected ear may be red, swollen, and painful. Movement of the head (such as chewing) and even touching the earlobe may cause severe pain. Sometimes itching precedes the onset of pain. You may also notice discharge from an affected ear. This discharge may be clear or may contain pus.

Otitis externa (or swimmer's ear) is different from the usual middle ear infection that children get, which is called otitis media. If the ear can be wiggled or pulled without discomfort or pain, then the ear infection is probably otitis media and not otitis externa.

The name swimmer's ear comes from the fact that the condition often occurs after spending time in the water. The water can break down the skin lining the ear canal, allowing it to become infected. Sticking foreign objects such as a finger in the ear or cleaning the ear canal with cotton swabs can also make the area more vulnerable to swimmer's ear.

While the condition may result from infection with a variety of bacteria and fungi found in contaminated water, the most common cause is the bacterium Pseudomonas aeruginosa. This type of bacteria is common in water, soil and on plants.

Otitis externa is not contagious to other people, but it should be treated with antibiotics to prevent spread to the deeper structures and bones around the ear. Ear drops containing antibiotics are usually prescribed, sometimes with a corticosteroid to decrease swelling and inflammation. If the ear is very swollen, a wick may be used to deliver medications into the ear canal. In severe cases, oral antibiotics are also prescribed. Your doctor may also recommend over-the-counter pain relievers. With appropriate treatment, swimmer's ear (otitis externa) is cured within seven to ten days.

If you or your child has had otitis externa, you can take some preventive measures to decrease the chance of future infection:

1. After swimming, always dry the ears well, tilting the head to both sides to allow water to drain from the ear canal.
2. Over-the-counter ear drops containing a dilute solution of acetic acid or alcohol can help prevent infection, but should only be used if the ear drums are intact.
3. Children should not put any objects into their ears or attempt to clean their own ears with cotton-tipped swabs. Ear swabs should always be used gently.
4. Pools and hot tubs should be monitored often for appropriate chlorine content and pH.
5. Do not swim in contaminated water (that may or may not be posted with a warning sign)

Swimmer's ear may sound like a harmless annoyance but it can be very painful and, sometimes, serious. If you suspect swimmer's ear, get it checked out and treated. Safe swimming!