External Otitis (Swimmer's Ear)
Infection of the outer ear canal
Quick Facts
- Type: Ear infection
- Also called: Swimmer's ear
- Common trigger: Trapped water, scratching the canal
- Main treatment: Medicated ear drops
Overview
External otitis, often called swimmer's ear, is inflammation or infection of the outer ear canal, the tube that runs from the opening of the ear to the eardrum. It is different from a middle ear infection, which sits behind the eardrum.
The canal has a protective layer of wax and a slightly acidic environment that resists germs. When this protection is disrupted, often by trapped water, scratching, or excessive cleaning, bacteria or fungi can grow and cause infection. External otitis is common in swimmers and in humid climates and usually responds well to ear drops, though it can be quite painful.
Anyone can develop external otitis, but it is especially common in people who swim frequently or live in warm, humid places where moisture lingers in the ear. People who wear hearing aids or earbuds for long periods, or who clean their ears with cotton swabs, are also more prone to it because these habits can trap moisture or injure the canal.
Symptoms
- Ear pain that worsens when the outer ear is tugged or pressed
- Itching inside the ear canal
- Redness and swelling of the canal
- Clear, white, or yellowish discharge
- A feeling of fullness or blockage
- Muffled hearing if the canal becomes swollen or blocked
Spreading redness and swelling of the outer ear, fever, or severe pain may signal a more serious infection that needs prompt medical care.
The discomfort can range from mild itching to significant pain, and the ear may feel blocked if swelling narrows the canal. Some people also notice a foul smell from the discharge in more pronounced infections.
Causes
External otitis develops when the protective barrier of the ear canal breaks down, allowing germs to grow.
- Trapped moisture: Water left in the canal after swimming or bathing softens the skin and encourages bacteria.
- Injury to the canal: Scratching with cotton swabs, fingernails, or objects damages the skin.
- Skin conditions: Eczema or psoriasis can inflame the canal.
- Fungal growth: Especially in warm, humid conditions or after prolonged antibiotic drop use.
Risk Factors
- Frequent swimming, especially in warm or untreated water
- Using cotton swabs or objects to clean the ears
- Humid or hot climates
- Narrow ear canals or excess earwax
- Skin conditions such as eczema
- Hearing aids or earbuds that trap moisture
Diagnosis
A doctor usually diagnoses external otitis by examining the ear:
- Otoscopy: Looking into the canal, which appears red, swollen, and may contain debris or discharge.
- Gentle manipulation: Pain when the outer ear is moved supports the diagnosis.
- Swab: Occasionally a sample of discharge is tested if the infection is severe or not improving.
Treatment
Most cases clear with proper ear drops and care.
- Medicated ear drops: Drops containing antibiotics, antifungals, or anti-inflammatory medicine, sometimes with a steroid to reduce swelling.
- Cleaning the canal: A clinician may gently clear debris so the drops can reach the infection.
- Pain relief: Over-the-counter pain medicine and warm compresses.
- Keeping the ear dry: Avoiding water and swimming while it heals.
If the canal is very swollen, a small wick may be placed to help drops penetrate. People with diabetes or weakened immunity need prompt care, as infections can become more serious.
It is important to use the full course of ear drops even if symptoms improve quickly, so the infection clears completely. Keeping the affected ear dry while it heals, for example by avoiding swimming and protecting the ear during showers, helps the medicine work and prevents the problem from returning.
Prevention
- Dry your ears gently after swimming or bathing, tilting the head to drain water
- Avoid putting cotton swabs, fingers, or objects in the ear canal
- Consider swim earplugs if you are prone to swimmer's ear
- Treat skin conditions affecting the ears
- Do not over-clean the ears, which removes protective wax
When to See a Doctor
See a doctor if you have ear pain, itching, or discharge that does not improve, especially after swimming. Seek prompt care for:
- Severe pain or swelling spreading to the outer ear or face
- Fever
- Hearing loss or a fully blocked ear
- Diabetes or a weakened immune system with ear infection symptoms
Frequently Asked Questions
What is swimmer's ear?
Swimmer's ear is an infection of the outer ear canal, often after water gets trapped and softens the protective skin. It causes pain, itching, and sometimes discharge, and usually responds well to medicated ear drops.
How long does external otitis take to heal?
With proper ear drops, most cases improve within a few days and clear within one to two weeks. Keeping the ear dry and finishing the full course of drops helps it heal.
Can I prevent swimmer's ear?
Yes. Dry your ears after swimming, avoid cotton swabs, and consider earplugs if you swim often. Keeping the protective wax intact and the canal dry lowers the risk of infection.
Why does pulling on my ear hurt with this infection?
Tugging or pressing the outer ear moves the inflamed, infected skin of the canal, which causes pain. This is a typical feature that helps tell external otitis from a middle ear infection.
When is swimmer's ear serious?
It can become serious if redness and swelling spread, if you have a fever, or if you have diabetes or a weakened immune system. These situations need prompt medical care to prevent a deeper infection.
References
- Centers for Disease Control and Prevention (CDC). Swimmer's Ear (Otitis Externa).
- Mayo Clinic. Swimmer's ear — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Ear infection — outer ear.
- American Academy of Otolaryngology–Head and Neck Surgery. Swimmer's Ear.