What is swimmer's ear?

Otitis externa, also known as swimmer's ear, is an infection of the outer ear canal. This type of infection is common and usually occurs in summer when you are more likely to go swimming. Swimmer's ear affects all age groups but is most common in children. It usually gets better quickly with treatment.

What are the symptoms of swimmer's ear?

The symptoms of swimmer's ear usually appear within 2 days and can include:

• pain in the outer part of the ear — this may range from slightly uncomfortable to severe
• pain that feels worse when you chew
• itchiness of your ear
• a feeling of fullness in your ear
• muffled hearing
• red skin around your ear

You might also have discharge. This is liquid that comes from in your ear. It can be clear and watery or it can look like pus.

What causes swimmer's ear?

Swimmer's ear is usually caused by a bacterial infection.

You're more likely to get swimmer's ear if you get water in your ear that doesn't come out. This can happen when you go swimming or wash your hair.

The stuck water allows bacteria to build up in your ear which can cause an infection. An infection is more likely to happen in a warm or wet climate.

Damage or irritation to your ear canal can also increase your chance of getting an ear infection. This can happen when:

• you clean the ear canal with a cotton bud or other objects
• chemicals such as shampoo irritate the skin in your ear
• eczema or dermatitis cause a break in your skin
• you have a middle ear infection
• you often wear hearing aids or headphones

You are more likely to get swimmer's ear if you have a weakened immune system or diabetes.

When should I see my doctor?

You should see your doctor if you have:

• ear pain
• itchiness
• discharge coming from your ear
• difficulty hearing

It's important to start treatment early so the infection doesn't get worse or spread.

If your symptoms haven't improved after 3 days of treatment, go back to your doctor for a review.

When to seek urgent care?

Swimmer's ear can be a sign of a serious infection. You should get urgent care if you have symptoms of swimmer's ear, as well as:

• a fever (high temperature)
• swelling around the ear
• weakness
• drooping on one side of your face

You should also get urgent care if you've had a significant head or ear injury.

How is swimmer's ear diagnosed?

If you think you might have swimmer's ear you should see your doctor. Your doctor will ask you about your symptoms. They will use a device called an otoscope to look inside both of your ears for damage and swelling. They may also check your temperature or feel your lymph nodes (glands).

How is swimmer's ear treated?

Your doctor will prescribe ear drops to fight the infection in your ear canal.

While you are using the ear drops, you should also:

• avoid getting your ear canal wet — check with your doctor before swimming
• wear a shower cap or soft ear plugs while in the shower
• not put anything into your ear canal including cotton buds
• avoid scratching or touching your ear

If you have severe swelling in your ear canal, you can insert a small sponge into the ear canal. This is called a wick, and it helps to make sure the ear drops get inside your ear canal.

Your doctor may also clean your ear canal. This can be done through swabs or a gentle suction technique called microsuction.

In most cases, your symptoms will start to improve after 3 days. If your symptoms have not improved at all after 3 days, see your doctor.

Most people will have few or no symptoms after the first week of treatment.

Medicines for swimmer's ear

If you have pain, you can use medicines such as paracetamol or ibuprofen. If you have a weakened immune system your doctor might also prescribe you antibiotics.

Speak to your doctor or pharmacist before taking medicines for swimmer's ear.

What are the complications of swimmer's ear?

Complications from swimmer's ear are rare.

Swimmer's ear can cause cellulitis (skin infection) around the ear.

If it's left untreated, swimmer's ear can cause necrotising otitis externa. This is a severe infection of the ear canal which can be life threatening.

Can swimmer's ear be prevented?

There are ways you can help prevent swimmer's ear. You can:

• use earplugs while swimming
• avoid swimming in dirty water
• tilt your head after swimming to remove water from your ear canals
• avoid putting cotton buds or other objects into your ears
• regularly take out hearing aids or headphones

You can also use ear drops after you have been exposed to unclean water. Ask your pharmacist about how to protect your ears from getting infected.

Resources and support

The Emergency Care Institute offers information about different types of ear infections.

Learn more about ear infections in babies and young children with the Aboriginal Ear Health program Healthy Ears, Happy Kids.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.