Early Swimmer's Ear Infection Symptoms, Home Remedies & Prevention

4/22/2018 Early Swimmer's Ear Infection Symptoms, Home Remedies & Prevention
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De nition and Facts about Swimmer's Ear 

HOME EAR, NOSE & THROAT CONDITIONS CENTER TOPIC GUIDE

Swimmer's Ear (Symptoms,

Treatment, Natural
Remedies, Prevention)
Medical Author: John P. Cunha, DO, FACOEP
Medical Author: Melissa Conrad Stöppler, MD, Chief Medical Editor
https://www.emedicinehealth.com/swimmers_ear/article_em.htm 1/25
De nitionDe
and Facts
nition andabout Swimmer's Ear
Facts about 
Swimmer's Ear
The de nition of swimmer's ear is an
infection, in ammation, or pain in the ear
caused by water trapped in the ear canal.
This condition frequently occurs in
swimmers, which is why it's known as
swimmer's ear but it can occur in anyone,
even from showering.
The main cause of swimmer's ear is a
break in the skin lining of the outer ear or
ear canal that allows bacteria or fungi to
invade the outer ear. A break in the skin
may be caused by scratching the ear
area, skin conditions such as seborrheic
dermatitis and psoriasis, improperly
cleaning your ears with cotton-tipped
swabs or other objects inserted in the ear,
using devices inserted into the ear (ear
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In Ear
Treatment for Ringing
in the Ears
3. Decongestants For Ears
Symptoms of swimmer's ear include

How to Get Rid of Ear 4. Ringing In Your Ears
pain,
itching,
redness, FEATURED SLIDESHOWS
swelling, ADHD in Children

Better Parenting
draining uid or pus,
di culty hearing, Atrial Fibrillation (AFib)
De nition and Facts about Swimmer's Ear

ringing in the ear,

Heart Symptoms, Diagnosis, and
Treatment
dizziness, or

vertigo. 
Breast Cancer
 Symptoms, Diagnosis and
Swimmer's ear is diagnosed with a history Treatment
and physical examination of the inside of
the ear. Any drainage may be examined
under a microscope to determine the
type of infection.
Home remedies to treat and cure
swimmer's ear include avoiding water
exposure (including avoiding swimming),
applying heat to the a ected ear to
control pain, and over-the-counter (OTC)
pain relievers.
Medical treatment for swimmer's ear
includes medications prescribed for
symptom relief, cleaning the a ected ear,
antibiotics, topical ear remedies, or
acidifying, antiseptic, or anti-in ammatory
agents.
Swimmer's ear may be prevented by
using ear plugs when swimming, use of
ear drops after swimming to help dry the
ear canal, avoiding placing objects in the 

ear that can scratch the skin of the ear
canal and lead to infection, not using
cotton swabs to remove earwax from the
ears, and drying ears thoroughly after
swimming or showering.
The prognosis for swimmer's ear is good.
De nition and Facts

Pain from about
swimmer's ear usuallySwimmer's
goes Ear 
away within 24 hours after medical
treatment begins, and the infection
typically clears up within a week.


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What Is Swimmer's Ear

(Otitis Externa)?
Swimmer's ear (also called otitis externa) is a


painful condition of the visible or outer portion
of the ear and ear canal (outer ear). The ear
canal is a cylinder-shaped structure that
extends from the outer part of the ear, above
the ear lobe, all the way to the eardrum
(tympanic membrane). The typical size of the
canal is about 2.5 centimeters in length and 7-9
millimeters in width.
The main function of the ear canal is to protect

the middle ear from infection and entry of
De nitionforeign
and Facts
objects. about
This function Swimmer's Ear
is accomplished 
by the length of the canal, making it di cult for
objects to enter. In addition, the outer portion of
the canal produces ear wax (cerumen) that

helps trap debris entering the ear. It also
produces an acidic environment that may be

harmful to bacteria entering the ear. There is
also hair in the ear canal which provides an 
additional barrier against debris entering the ear.
Males and females of all ages are a ected by

otitis externa equally, but children and
teenagers most frequently develop this type of
ear infection. It is estimated that swimmer's ear
is responsible for 2.4 million doctor visits in the
U.S. Children are most often a ected as they
routinely spend more time in the water
swimming, etc. during vacation periods than
adults. However, competitive swimmers and
adults that are frequent swimmers are
disproportionally a ected as well.
Swimmer's Ear vs. Ear

Infection
There are many types of ear infections, and

swimmer's ear can be one type of ear infection
caused by bacteria or fungus that gets trapped
in the ear canal. Swimmer's ear can also refer to
just in ammation and pain in the ear that occurs
after water gets trapped in the ear canal. The
most common bacteria responsible for
swimmer's ear infections are Staphylococcus
aureus and Pseudomonas aeruginosa. In fewer
than 10% of cases a fungus causes swimmer's
ear 
Swimmer's Ear and

Other Ear Infection
Symptoms
Swimmer's Ear and Other Ear Infection

Symptoms
An infection of the ear canal (the outer
ear) is sometimes referred to as
swimmer's ear. Signs of an outer ear
infection include: 
Itching or soreness of the ear when 

touched
Ear pain 
Hearing loss
Discharge from the ear
Nausea
Vomiting
Learn more about ear infection symptoms and

causes »
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
What Are the Symptoms of
Swimmer's Ear?
 Readers Comments 4
 Share Your Story
Early symptoms of swimmer's ear

The most common symptom of
swimmer's ear is ear pain or earache. Pain
gradually begins over a day or two. The


ear pain almost always involves only one 
ear. The pain is especially intense when

the ear is touched or pulled, or when
chewing.
The ear canal may itch.
The outer ear may be red.
In severe cases the ear canal may be
swollen shut.
The ear may drain uid or pus. This
drainage may be clear, white, yellow, or
sometimes bloody and foul smelling.
Some uid may crust at the opening of
the ear canal.
With severe swelling or drainage, the
person may have trouble hearing.
Ringing in the ear (tinnitus) and dizziness
or spinning sensation (vertigo) may also
be present.
Fever is generally not present. If there is a
fever, it is not usually high.


Other symptoms of swimmer's ear include:
A feeling of fullness in the ear.
In severe cases, pain that extends to the
side of the face or neck.
Swollen lymph nodes if infection is

present.
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
What Causes Swimmer's
Ear?
The skin lining the ear canal and outer ear

serves as a barrier against infection from
De nitionbacteria
and andFacts about
fungi. The ear Swimmer's
is protected against Ear 
infection because the lining is slightly acidic.
The lining is also a physical barrier that protects
against excessive moisture.

Any break in the skin lining can lead to infection,
allowing bacteria or fungi to invade the outer 
ear.

The barrier can become broken and lead to an
infection in the following ways:
When you attempt to clean your ears with
cotton-tipped swabs or other objects
inserted in the ear, the skin lining of the
ear canal may break. This can also
remove the protective ear wax from the
ear canal. The break in the skin allows an
infection to start.
Excessive moisture in the ear canal from
showering or swimming alters the acidic
environment of the ear canal, and allows
for the invasion of bacteria or fungi. This is
the reason this condition happens mainly
in the summer months, and is called
swimmer's ear. This is especially
important when exchanging ear buds with
other people. If a person has an ear
infection it can be transmitted through ear
buds.
Ear plugs, hearing aids, headphones, and 

other devices that may be inserted into
the ear canal may increase the risk of
swimmer's ear.
Chemicals such as hair dyes, bleaches,
and shampoos may irritate the ear canal
and alter its protective properties. An
De nition and Facts

infection about Swimmer's Ear
can result.

Skin conditions, such as seborrheic
dermatitis and psoriasis can cause cracks 

in the skin that allow bacteria or fungus to

enter.

Generally, any in ammation of the outer ear
canal, such as infections, allergies, or skin
conditions, can lead to swimmer's ear.
The most common bacteria responsible for

outer ear infection are Staphylococcus aureus
and Pseudomonas aeruginosa. Other bacteria
are less common. In less than 10% of cases
fungus causes of swimmer's ear.
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Can You Swim with

Swimmer's Ear?
You should not swim if you have swimmer's ear.

Even if you wear earplugs, they do not have a
De nitiontightand
enoughFacts about
seal to completely keepSwimmer's
water out, Ear 
and your ears need to stay dry to heal. Scuba
diving and other water activities also should be
avoided.


Which Types of Doctors
Treat Swimmer's Ear?
A family practitioner, internist, or pediatrician

may initially diagnose and treat swimmer's ear.
In an emergency department you would see an
emergency medicine specialist. If the condition
is severe patients may be referred to an
otolaryngologist (an ear, nose, and throat
specialist, also called an ENT) to treat
swimmer's ear.
When Should I See a

Doctor for Swimmer's Ear?
Call a health-care professional immediately in

any of these situations:
Pain is not controlled with over-the-
counter medicines that are taken as
recommended on the label. Any pressure
on the outer ear may cause great pain, so
it is often di cult to lie down with the
a ected side against a pillow. Many 

people with swimmer's ear have trouble
sleeping until they get medical attention.
The person feels dizzy.
The person has any signs of facial
weakness or double vision.
The person has diabetes or some other
De nition and Facts

condition about
that prevents Swimmer's Ear
the immune

system from functioning normally.
If there is associated redness or swelling 

that extends down the neck or along the

face from the ear, immediate medical
attention should be sought. 
If the swimmer's ear does not improve
after one week of medical treatment.
The symptoms of swimmer's ear worsen.
Swimmer's ear, in general, is not an emergency.

However, a person should go to an emergency
department at the hospital if they are
experiencing symptoms of swimmer's ear and
have diabetes, a compromised immune system,
are running a fever, are experiencing dizziness
or facial weakness, or have a history of prior ear
surgery.
How Is Swimmer's Ear

Diagnosed?
The doctor can easily make a diagnosis of

swimmer's ear after taking a brief history and
performing a limited physical examination. Pain
produced by gently pulling on the ear as the
doctor attempts to examine the ear canal is a
likely sign of swimmer's ear.

The doctor may look at the ear canal with
a lighted scope called an otoscope. With
this, if swimmer's ear is present the doctor
can see if the ear canal is swollen, red, or
sometimes coated with a whitish material
called an exudate.
The doctor may examine the drainage
De nition and Facts

from the ear underabout Swimmer's
a microscope to Ear 
determine if bacteria or fungi are causing
the infection. This allows the doctor to


prescribe either an antibacterial or an
antifungal medicine. 
X-rays and blood tests are rarely needed. 
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How Do You Get Rid of

De nitionSwimmer's
and Facts about Swimmer's Ear
Ear? 
Treatment for swimmer's ear includes home
remedies such as avoiding water exposure 
(such as swimming), applying heat to the
a ected ear to control pain, and over-the- 
counter (OTC) pain relievers such as aspirin,
ibuprofen, or acetaminophen. 
Medical treatment for swimmer's ear include

medications prescribed for symptom relief;
cleaning the a ected ear; and at times,
antibiotics, topical ear remedies, or acidifying,
antiseptic, or anti-in ammatory agents.
What Home Remedies

Treat Ear Pain and Other
Symptoms?
Home care for swimmer's ear can be used to

control pain temporarily. However, because OTC
ear drops are not strong enough to cure the
infection, a visit to a health-care professional for
speci c medications is needed. Swimmer's ear
is usually not an emergency situation in most
cases, so call your doctor for an appointment
and use a home remedy to relieve symptoms in
the meantime.
Avoid any further trauma to the ear. Do
not attempt to remove visible debris or


drainage from the ear.
Stop swimming or exposure to water until
the condition improves.
Apply heat to the ear to control the pain at
home. Warmth from a heating pad may
provide some relief. Fold a towel in half
De nition and Facts

and place about
it between Swimmer's
the heating pad and Ear 
the ear. Limit the use of the heating pad to
short periods. The folded towel should


help prevent accidental burning of the ear
if the heating pad is too hot. 
A white vinegar rinse may be used in mild 

cases of swimmer's ear to help restore
the ear canal's natural pH and reduce
swelling. Dilute white vinegar with equal
parts water or rubbing alcohol. Do not use
undiluted vinegar as it is too acidic and
could cause further irritation. Lie down
with the a ected ear upward and ll the
ear canal (ideally someone else will do
this for you). Leave the solution of vinegar
diluted with water or alcohol in for 5
minutes, then turn your head to the side
and move the ear to drain the solution.
Note: Do NOT do this if there is a hole in
the eardrum or if you have ear tubes that
have been inserted.
The American Academy of
Otolaryngology does not recommend use
of ear candles as a home remedy for
swimmer's ear, as they may cause more
injury to the ear.
What OTC Medications

Help Ear Pain?
OTC pain medicines such as aspirin,
ibuprofen (such as Advil), or
De nition and Facts(such

acetaminophen about Swimmer's
as Tylenol) may be Ear 
used for pain relief of swimmer's ear.
Nonprescription ear drops are not usually 

strong enough treatment to cure

swimmer's ear. Such drops are useful only
for prevention of episodes after water 

exposure. Ear drops used for treatment
swimmer's ear must be obtained with a
prescription from a doctor.
Do not try and treat the ear infection with
drops purchased over-the-counter. This
can make the a ected ear worse and
prolong recovery. Consult your health-
care professional before using any ear
drops for swimmer's ear.
What Prescription
Medicine Helps Swimmer's
Ear Pain?
Medications are generally aimed at symptom

relief as well as a cure for swimmer's ear. The
main steps to treat swimmer's ear and include:
Clean the ear thoroughly
Treat in ammation and infection


Control pain
Obtain sample of any drainage and
culture it (to see if any bacteria grows)
Avoid factors that may promote
De nition and Facts

in ammation about Swimmer's Ear
or infection

If there is a large amount of drainage or debris in
the ear, the doctor will clean out the ear canal 
before medicine is placed in the ear.

The ear canal may be cleaned out using a 
wire or plastic loop instrument or under
direct vision using a suction device.
After cleaning the ear, the doctor may
place a foam wick in the canal. This allows
antibiotic or antifungal ear drops or both
to be placed onto the wick. The wick
swells up inside the ear canal, thus
holding the medicine in place against the
lining of the skin.
Oral pain medicines may be prescribed if
OTC medicines are not strong enough.
Oral antibiotics are not often prescribed
unless the infection is severe
(complicated otitis externa including
extension of the infection to the adjacent
skin).
Topical Remedies
Topical remedies or swimmer's eardrops are

generally directed toward treatment of
in ammation and infection.

Acidifying Drugs
Acidifying agents are e ective because the

common bacteria responsible for outer ear
infection cannot survive in a very acidic
environment. Examples include acetic acid
(vinegar), hydrochloric acid, salicylic acid, boric
acid, sulfuric acid, and citric acid solutions.
Antiseptic Drugs
De nitionAntiseptic
andagentsFacts about
work by potentially Swimmer's
killing the Ear 
o ending bacteria. Some of these antiseptic
solutions are alcohol, gentian violet, m-cresyl
acetate, thimerosal, and thymol. Most of these

are typically applied into the ear canal by an ear
specialist (otolaryngologist).

Anti-in ammatory Drugs

Anti-in ammatory agents help with
in ammation and may reduce pain. Some
studies have shown the combination of anti-
in ammatory and acidifying agents was
superior to acidifying agents alone in reducing
the duration of symptoms and providing pain
relief for swimmer's ear. Anti-in ammatory
steroids such as hydrocortisone (Acetasol HC,
Vosol HC) or dexamethasone/cipro oxacin
(Ciprodex) are usually found in products in
combination with antibiotics, acidifying agents,
and antiseptics.
Antibiotics
Many topical antibiotics are available for

treatment of swimmer's ear (otitis externa).
These are usually found in combination with the
other three groups of medications to increase
the e ectiveness of treatment.
Some common examples of eardrops for

swimmer's ear, which include all four classes of
antiseptic, acidifying agent, anti-in ammatory,
and antibiotics are:
neomycin/polymyxin/hydrocortisone
(Cortisporin Otic Suspension)
neomycin/polymyxin/hydrocortisone
(Cortisporin Otic Solution)


neomycin/colistin/hydrocortisone
(Neomycin Coly-Mycin S Otic
tobramycin and dexamethasone
(Tobradex)
cipro oxacin/hydrocortisone (Cipro HC
De nition and
Otic) Facts about Swimmer's Ear

gentamicin and prednisolone acetate
(Pred-G) 

Oral or intravenous antibiotics are generally not
used in the treatment of uncomplicated (simple)

swimmer's ear. However, they may be
appropriate in cases of severe infection in
people with diabetes or those with weakened
immune systems. They may also be used if
applying topical eardrops is not possible due to
severe swelling and closure of the ear canal. In
cases of complicated otitis externa (redness and
swelling extending down the neck and face),
oral antibiotics can be helpful.
Less commonly, an outer ear infection may be

related to a fungal infection (otomycosis).
Typically, this condition is suspected in people
who do not respond to the usual treatment for
swimmer's ear, those in tropical climates, or in
people with multiple previous infections. Fungal
infection can also cause more itching and less
pain than bacterial infections. The examination
of the ear may reveal a white, mold-like
appearance.
The treatment of fungal outer ear canal infection

also focuses on the combination of topical
antiseptics, acidifying agents, anti-in ammatory
agents, and anti-fungal medicines. Clotrimazole
(Lotrimin, Mycelex) and miconazole (M-Zole,
Micatin, Lotrimin) are the most commonly used
anti-fungal medications used to treat fungal ear
infections.
Eardrops are usually placed into the ear canal

two to three times a day. It is helpful to have a
second person put the ear drops in while the 
patient lies on their side with the a ected ear
facing up. The person should lie on the opposite
side of the head when the drops are placed to
allow the drops to soak in the ear, and not run
out of the ear canal (if the patient prematurely
stands up).
Swimmer's ear clears up within a week for most

people. Pain generally goes away within 24
hours if appropriate therapy is used.
Failure to promptly reduce pain and swelling is

often caused by excess debris in the canal that
De nitionneeds
and to beFacts
removed byabout
the doctor. Swimmer's Ear 

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What Are the
Complications of
Swimmer's Ear?
People with diabetes or those whose immune

systems are weakened can develop a more
worrisome form of the disorder that might

require hospitalization for intensive medical
De nitiontreatment.
andThis Facts about
is referred Swimmer's
to as malignant otitis Ear 
externa, and is not related to swimmer's ear, per
se. If a person is concerned about malignant
otitis externa, an evaluation by a health-care

professional or an emergency department is
imperative as this can be a serious condition.

Although the two entities sound the same, they
are distinctly di erent, and also are managed 
di erently.
How Long Does It Take to

Treat Swimmer's Ear?
In most cases, no additional care or visits to the

doctor are necessary once medication has been
prescribed, and the doctor's instructions are
followed. If pain increases and swelling or
drainage do not decrease within 48 hours, a
doctor should be contacted for a follow-up
appointment. When a foam wick is placed, it is
important to follow-up with a doctor to ensure it
is properly and completely removed. Avoid
further trauma or the chance of getting moisture
in the ear for a couple of weeks after an
infection.
Swimming, scuba diving, and ying
should be restricted until all pain and
swelling are gone and no debris remains
in the ear canal.
Severe, recurrent, or di cult to treat
swimmer's ear may be referred to an ear 

specialist (otolaryngologist).
People who have had ear surgery such as
tympanic membrane (eardrum) surgery
and mastoidectomy (removal of part of
the bone behind the ear or removal of the
air spaces in that bone) should discuss
water sports and ear protection with their

ear specialist.

People with tubes in their ears (a common
technique used to prevent ear infections 

in smaller children) may also talk with

their ear specialist about the best ways to
swim and protect their ears at the same 

time.
How Can You Prevent

Swimmer's Ear?
Use of shower caps while bathing and
earplugs while swimming will help keep
water out of the ear canal.
The best earplugs are often soft balls of
special wax. The wax can be purchased at
most pharmacies. Simply roll a small ball
of wax in your hands and press it into the
outer ear.
Many individuals make their own earplugs
by placing a cotton ball coated with
Vaseline in the ear.
Homemade eardrops also help prevent
swimmer's ear after water exposure.


Make a 50:50 mixture of white
vinegar and rubbing alcohol for use
after swimming or exposure to
water. Apply 3-4 drops in each ear
canal after swimming. This helps
dry the canal and maintain the
De nition and Facts about

acidic environment of theSwimmer's
ear canal. Ear 
Avoid placing objects in the ear that can

scrape or scratch the skin of the canal
because this may cause an infection. 

Do not use cotton swabs to remove
earwax from the ears. More often than
not, this ends up pushing wax father into
the ear canal and making problems
worse.
Dry ears thoroughly after swimming or
showering with a fresh, dry towel.
Reviewed on 1/23/2018
Medically reviewed by Margaret A. Walsh, MD; Board

Certi cation Pediatrics
REFERENCE:
Waitzman, A. A., MD. "Otitis Externa." Medscape.

Updated: May 04, 2017.
<http://emedicine.medscape.com/article/994550-
overview>
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4/22/2018 Early Swimmer's Ear Infection Symptoms, Home Remedies & Prevention

Topics A-Z Slideshows Images Quizzes Medications Medical Dictionary

Swimmer's Ear (Symptoms,

The de nition of swimmer's ear is an

infection, in ammation, or pain in the ear

caused by water trapped in the ear canal.

This condition frequently occurs in

swimmers, which is why it's known as

swimmer's ear but it can occur in anyone,

even from showering.

The main cause of swimmer's ear is a

break in the skin lining of the outer ear or

ear canal that allows bacteria or fungi to

invade the outer ear. A break in the skin

may be caused by scratching the ear

area, skin conditions such as seborrheic

dermatitis and psoriasis, improperly

cleaning your ears with cotton-tipped

swabs or other objects inserted in the ear,

using devices inserted into the ear (ear

TOPICS THAT MIGHT plugs, hearing aids, headphones, ear

redness, FEATURED SLIDESHOWS

swelling, ADHD in Children

di culty hearing, Atrial Fibrillation (AFib)

De nition and Facts about Swimmer's Ear

the ear. Any drainage may be examined

under a microscope to determine the

Home remedies to treat and cure

swimmer's ear include avoiding water

exposure (including avoiding swimming),

applying heat to the a ected ear to

control pain, and over-the-counter (OTC)

Medical treatment for swimmer's ear

includes medications prescribed for

symptom relief, cleaning the a ected ear,

antibiotics, topical ear remedies, or

acidifying, antiseptic, or anti-in ammatory

Swimmer's ear may be prevented by

using ear plugs when swimming, use of

ear drops after swimming to help dry the

ear canal, avoiding placing objects in the 

canal and lead to infection, not using

cotton swabs to remove earwax from the

ears, and drying ears thoroughly after

The prognosis for swimmer's ear is good.

De nition and Facts

treatment begins, and the infection

typically clears up within a week.

What Is Swimmer's Ear

Swimmer's ear (also called otitis externa) is a

The main function of the ear canal is to protect

Males and females of all ages are a ected by

Swimmer's Ear vs. Ear

There are many types of ear infections, and

Swimmer's Ear and

Swimmer's Ear and Other Ear Infection

Itching or soreness of the ear when 

Learn more about ear infection symptoms and

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Early symptoms of swimmer's ear

De nition and Facts about Swimmer's Ear 

swimmer's ear is ear pain or earache. Pain

Early Swimmer's Ear Infection Symptoms, Home Remedies & Prevention

Early Swimmer's Ear Infection Symptoms, Home Remedies & Prevention