Swimmer’s Ear (Otitis Externa)

Swimmer’s ear, also known as otitis externa, is an infection of the outer ear canal. It’s usually caused by water that stays in the ear and creates a moist environment that helps bacteria grow.

Inserting fingers, cotton swabs, or other objects into the ears can also damage the thin layer of skin lining the ear canal, resulting in swimmer’s ear.

Signs / Symptoms

What's common signs of swimmer's ear?

Otalgia
Hearing loss
Ear fullness or pressure
Redness, puffiness, and narrowing of the external auditory canal
Tinnitus
Fever
Itching
Severe deep pain
Purulent and foul-smelling discharge
History of exposure to or activities in water (frequently) (e.g., swimming, surfing)
History of preceding ear trauma (e.g., forceful ear cleaning, water in the ear canal)

Common causes

What's common causes of swimmer's ear?

Swimmer’s ear is an infection usually caused by bacteria. It’s less common for a fungus or virus to cause swimmer’s ear.

Departments & Emergency

It is recommended to go to a General Practitioner or an Otolaryngology or Infectious Disease and Clinical Microbiology specialist in the near days.

Diagnosis

It is based on clinical assessment and physical examination.

Examining ear canal
Looking at eardrum (tympanic membrane)
If infection doesn’t respond to treatment sampling of discharge

Treatment

Proper ear hygiene
Cleaning the ear canal
Treating inflammation and infection with medications
Pain control
Antiseptics and acidifying solutions
Keeping ears dry
Avoiding putting foreign objects into the ear

FAQ

Will the swimmer’s ear go away by itself?
Often heal on their own or by taking ear drops. The best way is to keep ears as dry as possible.

How long does a swimmer’s ear last?
If it is treated with ear drops usually cured within 7 to 10 days. The pain should lessen within a few days of treatment.

References:

Charles PS Hui, Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Acute otitis externa, Paediatrics & Child Health, Volume 18, Issue 2, February 2013, Pages 96–98, https://doi.org/10.1093/pch/18.2.96
Schaefer, P., & Baugh, R. F. (2012). Acute otitis externa: an update. American family physician, 86(11), 1055–1061.
Otitis externa: Practice essentials, background, anatomy. (2020, March 9). Diseases & Conditions – Medscape Reference. Retrieved May 1, 2021, from https://emedicine.medscape.com/article/994550-overview
Swimmer’s ear – Symptoms and causes. (2019, June 28). Mayo Clinic. Retrieved May 1, 2021, from https://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/syc-20351682
Bowman, J. (2019, March 8). Outer ear infection (Swimmer’s ear). Healthline. Retrieved May 1, 2021, from https://www.healthline.com/health/otitis-externa
Patient education: External otitis (including swimmer’s ear) (Beyond the Basics). (2021, March). UpToDate. Retrieved May 1, 2021, from https://www.uptodate.com/contents/external-otitis-including-swimmers-ear-beyond-the-basics
External otitis: Treatment. (2021, March). UpToDate. Retrieved May 1, 2021, from https://www.uptodate.com/contents/external-otitis-treatment
Swimmer’s Ear (External Otitis). (2016, March). Nemours KidsHealth – the Web’s most visited site about children’s health. Retrieved May 1, 2021, from https://kidshealth.org/en/teens/swimmers-ear.html