How is Swimmer's Ear Treated?

Girl being assessed for ear problems.
Girl being assessed for ear problems. BURGER/PHANIE/Getty Images

Swimmer's ear, also called otitis externa by medical professionals, is a fairly common infection that needs to be treated by a doctor. Swimmer's ear is caused by contaminated water entering the ear. It is an infection of the outer ear, unlike otitis media (middle ear infections), the ear infections that are so common in children. The infection is generally caused by a bacteria or fungus, and treatment often depends on the severity of the infection but frequently involves the administration of special ear drops.

As the name implies swimmer's ear is common among swimmers but can be caused by any activity that causes water to become trapped in the outer ear canal including bathing or soaking in a hot tub. 

Symptoms of Swimmer's Ear

Symptoms of swimmer's ear may include:

  • pain in the ear 
  • flaky skin in the outer ear canal
  • redness
  • itching

Diagnosis

Swimmer's ear can usually be diagnosed by your doctor just by preforming a simple examination of your ear and reviewing your medical history and current symptoms.

Preparing the Ear for Treatment

In order to give you proper treatment for your swimmer's ear, the outer ear canal must be cleared. Your doctor can do this in the office. He or she will remove any debris that might be blocking the ear canal, (such as ear wax), and if swelling is making the ear canal difficult to access, the doctor can insert a wick so that medicated drops can get inside of the ear.

Do not use ear candles or other methods to try to remove the debris yourself before seeing your doctor, as you can damage the eardrum or introduce new germs into the ear. Cotton swabs are notorious for pushing wax further into the ear canal and causing blockages.

Antibiotic Ear Drops

Most cases of swimmer's ear are treated with antibiotic ear drops. The American Academy of Otolaryngology - Head and Neck Surgery recommends that all uncomplicated cases of swimmer's ear be initially treated with antibiotic ear drops. This limits side effects and the possibility of creating antibiotic-resistant bacteria. Examples of common antibiotics include ciprofloxacin, neomycin, and finafloxacin.

Oral Antibiotics

If your swimmer's ear does not respond to antibiotic ear drops or if the infection has spread to areas other than your ears, your doctor may choose to give you oral antibiotics.

Antifungal Medication

Although it is much more rare than a bacterial cause, swimmer's ear can be caused by a fungus. Is this case, it needs to be treated with a medication that kills fungus. Examples include nystatin drops or oral drugs like Diflucan (fluconazole).

Steroids

Your doctor may choose to treat the swelling from swimmer's ear with steroid ear drops, such as hydrocortisone or dexamethasone. For convenience, there are also ear drops that contain both an antibiotic and steroid. However, depending on your insurance (or lack thereof), combination products tend to be more expensive than buying the medications separately so your doctor may choose to give you a couple different prescriptions instead. Keeping your head elevated can also reduce swelling.

Treating the Pain of Swimmer's Ear

Swimmer's ear can be a painful condition. You can treat your pain with things at home, such as a heat pack and over-the-counter pain relievers like acetaminophen and ibuprofen. Or if necessary your doctor can give you a prescription for something to reduce the pain. Ear drops that contain a local anesthetic, similar to what you get at the dentist's office, are available. In severe cases, your doctor may have to prescribe a narcotic pain medication.

Keep Your Ears Clean and Dry

It is important to keep your ears dry while undergoing treatment for swimmer's ear. Try using a hair dryer on the lowest setting after you get out of the shower to thoroughly dry the ear canal, (be careful not to burn yourself). If possible, you should avoid swimming or getting in a hot tub until you are finished taking antibiotics (usually seven to 10 days, depending on the antibiotic).

Swimmer's ear is curable, but some infections may take longer than others to clear up. Even mild cases of swimmer's ear can be recurring for many people. It's important to take measures to prevent swimmer's ear in the future.

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