Swimmer’s Ear

If you’ve been at the pool recently and your kiddo starts to complain of ear pain, there’s a good chance the cause is swimmer’s ear. This painful outer ear infection can happen anytime but is commonly associated with summer months when more people are swimming regularly.

What Is Swimmer's Ear?

Swimmer’s ear (otitis externa) is an outer ear infection that affects the ear canal and outer portion of the ear. It happens when water and moisture get “stuck” in the ear canal. Bacteria thrive in this relatively dark, warm and moist environment.

Otitis externa is more common during the summer, but you don’t have to go swimming to get this infection. Common causes include

• Swimming
• Bathing—showers or baths
• Scratches or cuts in the ear canal
• Cleaning the ear canal with cotton swabs

Symptoms and Diagnosis

Otitis externa symptoms are usually single-sided, but it’s also possible for the infection to develop in both ears simultaneously. Your child may complain about

• Pain
• Itchiness
• Swelling
• Redness
• Tenderness
• Drainage
• Difficulty hearing

Often, the ear is so tender that children resist letting you touch or move the affected ear. Ear drainage color and consistency may vary. If present, the drainage could be clear and watery or yellow-green and thick.

Swimmer’s ear symptoms usually do NOT include

• Fever
• Congestion
• Cold-like symptoms
• Sore throat

A painful ear with a recent swimming history is a good bet that the diagnosis will be swimmer’s ear. However, your doctor will rule out a middle ear infection or other potential causes.

Swimmer’s Ear Treatment

Antibiotic ear drops are the most common treatment for otitis externa. They’re relatively easy to use, but most are given three to four times a day. Just as with oral antibiotics, completing the prescribed treatment course is essential. Your provider may also prescribe ear drops that help control the swelling and pain.

Sometimes, the ear canal is so swollen that your provider will insert a cotton wick during the appointment. You’ll then put the antibiotic drops on the end of the wick, and the medication will seep into the ear canal where it’s needed.

You can give acetaminophen (Tylenol) and ibuprofen (Motrin) at age- and weight-appropriate doses. Warm compresses may also provide comfort.

Your swimmer must stay out of the pool and avoid putting their head underwater for seven to 10 days. Regular showers and bathing are fine.

Prevention

You can reduce your chances of getting swimmer’s ear with a few simple tricks:

• Wear earplugs or a swimming cap while swimming.
• Dry your ears after swimming or bathing—towel dry or use a hair dryer on low heat, several inches away from the ear.
• Use ear drops that dry up any moisture. Ready-to-use options include Debrox Swimmer’s Ear or other drying aids. (Use as directed.)
• Make your own drying solution by mixing 1 part white vinegar with 1 part rubbing alcohol. Pour a teaspoon into the ear canal and let it drain back out.

Note: Don’t use any drops if your child has ear tubes or a hole in their ear drum without talking to their doctor.

• Don’t stick anything in your ears! Cotton swabs, bobby pins or other items can create cuts or abrasions that lead to infection.

Don’t let swimmer’s ear put a damper on summer fun. Prioritize ear drying after swimming or bathing to prevent the pain and misery of this infection. No one likes being told they have to avoid the pool for seven to 10 days during the summer!

Joleen Sams is a family nurse practitioner who lives in Shawnee with her family.

As always, please consult your health care provider with any questions or concerns.

Resources

• CDC. Ear Infections
• Mayo Clinic. Swimmer’s Ear