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Now hear this: All about swimmer’s ear

June 16, 2016 | UCI Health
Child's ear with pool water

One of the joys of summer is enjoying the cool waters of the ocean or the nearest swimming pool. But the fun can quickly fade if you happen to bring home some of that water — trapped in the delicate structure of your ear canal.

Swimmer's ear is a common malady of summer, especially among children and teens, although anyone can develop it. The infection is officially known as acute otitis externa, and it can produce one heck of an earache, along with:

Infection can develop if not treated 

Untreated, the infection can progress beyond the ear canal.

The infection can develop when water gets trapped in the ear canal. The water eventually weakens the skin, damaging the protective barrier.

"It's simply water sitting in the ear canal for a period of time and bacteria are able to grow in it and invade into the skin," says Dr. Harrison W. Lin, a UCI Health ear, nose and throat specialist with the UCI Health Department of Otolaryngology — Head and Neck Surgery.

"Some people may be more prone to the condition if the ear canals angle in such a way so that water is more easily trapped. But anyone can get swimmer's ear."

Here are Lin's tips for recognizing, treating and preventing swimmer's ear.

Symptoms of swimmer's ear

The symptoms of swimmer's ear include:

  • Pain and tenderness of the ear and surrounding area
  • Drainage (usually yellow and pus-like) and swelling are common
  • Sound is muffled

If you think you have a mild ear infection, you may be able to treat it at home by keeping the ear dry.

"Don't go swimming," Lin advises. "Use a hair dryer with the heating setting off and blow air into the ear." But, he adds: "Most people with swimmer's ear will likely benefit from a trip to the doctor."

Treating the infection

Treatment for swimmer's ear involves several steps.

  • Canal cleaning. The doctor will likely clean out the ear canal, removing the fluid, bacteria and dead skin cells. The patient then typically uses prescription ear drops for about two weeks to kill the infection. Sometimes other treatments are needed, such as oral antibiotics or pain medication. Occasionally, the infection is fungal, not bacterial, which requires a different medication, Lin says.
  • Take ear drops. To administer ear drops, lie down with the ear facing upwards. (It's easier if someone else puts the drops in for you.) Remain lying down for a few minutes after receiving the drops so the medicine can be absorbed.
  • Avoid water. During treatment, it's important to keep the ear dry and avoid swimming or getting the ear wet in the shower or bathtub. Coat a cotton ball with Vaseline and plug the ears during a shower or use ear plugs, Lin says. "I usually tell people to stay out of the water for one week as long as they are getting better. Swimmer's ear can relapse. But the vast majority of people — after having the ear cleaned out and using ear drops twice daily — feel better in 24 to 48 hours."
  • When to seek medical attention. People who have diabetes or a weakened immune system (for example, due to cancer treatment or an autoimmune condition) should seek medical attention immediately if they suspect they have swimmer's ear, Lin says. "They need to be particularly careful because their immune system is weakened, and a simple ear infection like this can lead to severe infections that can go into the brain."

Preventing swimmer's ear

  • Block the water. Wear ear plugs when you swim.
  • Keep ears dry. Use a hair dryer with the heat setting off to blow air into the ears after swimming or a shower.
  • Avoid prescription ear drops. However, you can make your own ear-drop solution at home to help prevent infection, Lin says. Mix up a solution that is 50 percent rubbing alcohol and 50 percent white vinegar. With an ear dropper, put four or five drops of the solution in each ear after swimming or a shower. "The solution reduces the acidity of ear canal and dries out the ear, making the ear canal environment more hostile to bacteria." Lin says.
  • Don't use cotton swabs or Q-tips. "Nothing good comes from putting a Q-tip in your ear," Lin says. "The skin gets abraded by the Q-tip. The keratin, which is a protective layer of skin, gets knocked off and that opens the door to an infection."
  • Live with your ear wax. "People who don't make enough ear wax or make too much ear wax are at increased susceptibility to swimmer's ear," he adds. "Ear wax is generally good. It reduces the acidity of the ear canal, and has antibacterial properties. If you make the right amount, and most of us do, it tends to protect the ear." Too much ear wax can trap water, however. Talk to your doctor about excessive ear wax.

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