Swimmer's ear

Definition

Swimmer's ear is inflammation, irritation, or infection of the outer ear and ear canal. The medical term for swimmer's ear is otitis externa.

Swimmer's ear may be sudden and short-term (acute) or long-term (chronic).

Alternative Names

Ear infection - outer ear - acute; Otitis externa - acute; Chronic swimmer's ear; Otitis externa - chronic; Ear infection - outer ear - chronic

Causes

Swimmer's ear is more common among children in their teens and young adults. It may occur with a middle ear infection or a respiratory infection such as a cold.

Swimming in unclean water can lead to swimmer's ear. Bacteria commonly often found in water can cause ear infections. Rarely, the infection may be caused by a fungus.

Other causes of swimmer's ear include:

Trying to clean (wax from the ear canal) with cotton swabs or small objects can also damage the skin.

Long-term (chronic) swimmer's ear may be due to:

Symptoms

Symptoms of swimmer's ear include:

Exams and Tests

The health care provider will look inside your ears. The ear canal area will look red and swollen. The skin inside the ear canal may be scaly or shedding.

Touching or moving the outer ear will increase the pain. The eardrum may be hard to see because of a swelling in the outer ear. The eardrum may have a hole in it. This is called a perforation.

A sample of fluid may be removed from the ear and sent to a lab to look for bacteria or fungus.

Treatment

In most cases, you will need to use antibiotic ear drops for 10 to 14 days. If the ear canal is very swollen, a wick may be put into the ear. The wick will allow the drops to travel to the end of the canal. Your provider can show you how to do this.

Other treatments may include:

People with chronic swimmer's ear may need long-term or repeated treatment. This will avoid complications.

Placing something warm against the ear may reduce pain.

Outlook (Prognosis)

Swimmer's ear most often gets better with the proper treatment.

Possible Complications

The infection may spread to other areas around the ear, including the skull bone. In older people or those who have diabetes or a condition that weakens the immune system, the infection may become severe. This condition is called malignant otitis externa. This condition is treated with high-dose antibiotics given through a vein.

When to Contact a Medical Professional

Contact your provider if:

Prevention

These steps can help protect your ears from further damage:

References

American Speech-Language Hearing Association website. Swimmer's ear (otitis externa). www.asha.org/public/hearing/Swimmers-Ear/. Accessed October 25, 2022.

Haddad J, Dodhia SN. External otitis (otitis externa). In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 657.

Naples JG, Brant JA, Ruckenstein MJ. Infections of the external ear. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 138.


Review Date: 7/28/2022
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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