Swimmer's Ear (Otitis Externa)

January 16, 2018

Swimmer's ear (otitis externa) is an inflammation, irritation, or infection of the outer ear canal. This is the channel leading from the outer ear to the ear drum. Water that stays trapped in the ear canal (such as when swimming) may:

  • Provide a source for the growth of bacteria and fungi
  • Soften the skin and let infectious organisms get into the skin
  • Wash away the ear wax which acts as a natural guard against infection

It is more common in children but can also happen in adults. Many factors can raise the chance of getting swimmer's ear. One of the factors is too much wetness. This can occur with frequent swimming, but it can also happen for other reasons. Other possible causes include:

  • Being in warm, damp places
  • Harsh cleaning of the ear canal
  • Injury to the ear canal
  • Dry ear canal skin
  • Foreign body in the ear canal
  • Too much ear wax
  • Eczema and other inflammatory skin conditions

You are at a higher risk for swimmer’s ear if your outer ear is exposed to conditions that may harm the skin. This lets bacteria get into the skin. Devices that are routinely worn within the ear canal can cause damage and irritation. This includes hearing aids, headphones, or ear plugs.

If you are exposed to conditions that remove the protective layers from the skin, you are more likely to get infected with bacteria or fungus. For example, if you swim often, the moisture removes the protective layer of ear wax and softens underlying skin.

Symptoms of swimmer’s ear include:

  • Redness of the outer ear
  • Itching inside the ear
  • Pain, especially when touching or wiggling the ear lobe (pain may spread to the head, neck, or side of the face)
  • Drainage from the ear
  • Swollen glands in the upper neck or around the ear
  • Swollen ear canal
  • Muffled hearing or hearing loss
  • Full or plugged-up feeling in the ear
  • Fever

The symptoms of swimmer’s ear may look like other health conditions or problems. Always check with your healthcare provider for a diagnosis.

Swimmer’s ear may be diagnosed with a medical history and physical exam. Your provider may also use a special lighted tool called an otoscope. This helps to view inside the ear. This will help your provider see if you also have a middle ear infection (otitis media).

Your healthcare provider may also take a culture of the drainage from your ear. For a culture, a sample of the draining fluid is treated in a lab to see what bacteria or fungi grow. The results can help guide treatment.

With proper treatment, swimmer's ear often clears up within 7 to 10 days. Your healthcare provider will figure out the best treatment plan for you based on:

  • How old you are
  • Your overall health and medical history
  • How sick you are
  • How well you can handle certain medicines, treatments, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment may include

  • Antibiotic or antifungal ear drops
  • Corticosteroid ear drops to help decrease the swelling
  • Pain medicine
  • Keeping the ear dry, as directed by your healthcare provider

To help prevent swimmer’s ear:

  • Use ear plugs for swimming or bathing to prevent constant moisture inside the ear.
  • Don’t aggressively clean your ear canal.
  • Avoid handling your outer ear canal.
  • Use the coolest setting on a hairdryer to dry the outer canal after swimming or when moist.
  • Swimmer’s ear is an irritation or infection of the outer part of the ear canal. It’s usually caused by infection.
  • It is linked to frequent swimming.
  • It can be caused by certain health problems that lower the skin protection in the ear canal or cause injury or irritation.
  • Avoiding the cause (moisture, irritation) can prevent swimmer’s ear.
  • Your healthcare provider may prescribe medicines to help ease symptoms.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.


January 16, 2018


External otitis: Pathogenesis, clinical features, and diagnosis. UpToDate., External otitis: Treatment. UpToDate., Shaefer, Paul, MD, PhD. Acute Otitis Externa: An Update. American Family Physician. 2012: Issue 86, 11th ed., pages 1055-1061.

Reviewed By:  

Kacker, Ashutosh, MD , Dozier, Tennille, RN, BSN, RDMS