What Are Symptoms of Swimmer's Ear?

Swimmer's ear, or otitis externa, is an infection of the outer ear that is caused by getting contaminated water in the ear. It can occur from swimming in contaminated (dirty) water but also just by getting water in your ear while bathing or showering.

Swimmer's ear is more likely to occur if the water stays inside the ear for a prolonged period of time as this creates a moist environment for bacteria or fungi to grow and thrive in. Swimmer's ear is a common condition that can occur in individuals of all ages but may be more common in children and teenagers than adults.

Swimmer's ear may occur more frequently in individuals with underlying conditions such as eczema or excessive ear wax. The shape of some people's ears may also make it more likely for water to become trapped in the ear.

You should not confuse otitis externa with otitis media, which is a middle ear infection. Otitis is Latin for inflammation of the ear. Media or externa refers to where the inflammation is occurring, which is in the middle ear (behind the eardrum) and outer ear canal respectively. 

Swimmer's ear (otitis externa) is not the same thing as a middle ear infection (otitis media), which is inside of the ear and experienced by almost all children. In swimmer's ear, many of the signs and symptoms may be visible because they are occurring on the outside of the ear. While swimmer's ear is common among children, anyone can get swimmer's ear.

Symptoms of swimmer's ear may include a combination of one or more of the following:

• itchy ears
• red, irritated ears
• dry, flaky skin around the outer ear
• swelling
• ear pain
• hearing loss
• ear drainage which may be clear, pussy, or have a foul odor
• occasionally swimmer's ear can cause a ruptured eardrum

Rarely swimmer's ear can spread to parts of the body other than the outer ear canal. This rare but very serious condition is called malignant otitis externa. Malignant otitis externa causes additional symptoms of swimmer's ear including:

• fever
• pain around the bones and tissues at the base of the skull 

If you are not sure whether your condition is a middle ear infection or swimmer's ear, there are a few key differences. Swimmer's ear is very painful to the outer ear — so if you touch the cartilage portion of the outer ear and experience pain, you may have swimmer's ear.

A middle ear infection will not cause visible swelling, itchiness, or pain to the outer portion of the ear (the cartilage portion of the ear, which can be easily seen and felt), although it may cause symptoms such as pain, ear drainage or a ruptured eardrum.

Certain risk factors make it more likely that you will develop symptoms of swimmer's ear. These include:

• unnecessary removal of ear wax (cerumen)
• putting any foreign object into the ear, even a q-tip
• scratching your ear (this damages the skin and makes it easier for germs to get in)
• swimming in contaminated water such as rivers or lakes and including commercial swimming pools and hot tubs

It is important to see a doctor if you have symptoms of swimmer's ear so that you can get antibiotics, (usually given in the form of ear drops), to treat the infection.

Untreated swimmer's ear may cause so much swelling that tissues may block access to the ear canal. If this happens your doctor will insert a wick into your ear which will allow antibiotic ear drops to be administered.

Use these tips to prevent swimmer's ear:

• gently blow dry your ears on a cool setting after swimming or bathing
• use a drop of olive oil or baby oil in each ear daily, as long as you have not had surgery (ventilation tubes), or might have an impaired eardrum
• use earplugs while bathing or swimming
• tip your head from side to side to let any extra water drain out of your ears after bathing or swimming
• use a drop of alcohol in each ear after bathing or swimming (again, only if you have not had ear surgery or might have a ruptured eardrum)