Swimmer’s ear, medically known as otitis externa, is an infection of the outer ear canal that occurs when water gets trapped in your ear after swimming, bathing, or water activities. This moisture creates an ideal environment for bacteria or fungi to grow, leading to inflammation and infection. While the condition is commonly associated with swimmers, anyone can develop it, especially in warm, humid climates or during summer months.
Understanding the symptoms of swimmer’s ear is crucial for early detection and proper care. If left untreated, this condition can worsen and lead to more serious complications. The symptoms typically develop within a few days after water exposure and can range from mild discomfort to severe pain. Below, we explore the seven most common symptoms that indicate you may have swimmer’s ear.
1. Itching Inside the Ear Canal
One of the earliest and most common symptoms of swimmer’s ear is an itching sensation deep inside the ear canal. This itchiness often starts as a mild annoyance but can become increasingly uncomfortable as the infection progresses.
The itching occurs because the skin lining the ear canal becomes irritated and inflamed due to the presence of moisture and bacterial growth. You may feel a strong urge to scratch the inside of your ear, but it’s important to resist this temptation. Inserting fingers, cotton swabs, or other objects into the ear canal can further damage the delicate skin, worsen the infection, and push bacteria deeper into the ear.
This symptom is particularly noticeable when you move your jaw, such as when chewing or talking. If you experience persistent itching in your ear, especially after swimming or showering, it could be an early warning sign of swimmer’s ear.
2. Ear Pain and Tenderness
Ear pain is perhaps the most distinctive and distressing symptom of swimmer’s ear. The pain can range from mild discomfort to severe, sharp pain that significantly affects your quality of life and daily activities.
What makes swimmer’s ear pain unique is that it typically worsens when you touch or pull on the outer ear (the part you can see) or when you press on the small flap of tissue in front of your ear canal called the tragus. This is a key distinguishing feature that helps differentiate swimmer’s ear from middle ear infections, where external touch usually doesn’t increase pain.
The pain may also intensify when you chew, lie down on the affected side, or move your jaw. As the infection progresses, the pain can become constant and throbbing, radiating to your jaw, neck, or the side of your head. Some people describe the sensation as a feeling of fullness or pressure in the ear, accompanied by aching pain.
The severity of pain often correlates with the extent of inflammation and infection. In mild cases, you might experience only slight tenderness, while severe cases can cause debilitating pain that interferes with sleep and normal activities.
3. Redness and Swelling of the Outer Ear
Visible redness and swelling of the outer ear and ear canal opening are telltale signs of swimmer’s ear. The inflammation occurs as your body’s immune system responds to the infection, sending increased blood flow to the affected area.
You may notice that the skin around your ear canal entrance appears red, inflamed, and warm to the touch. In some cases, the entire outer ear (pinna) may become swollen and tender. The ear canal itself may narrow due to swelling of the soft tissues, which can affect your hearing and create a sensation of fullness in the ear.
The degree of swelling can vary significantly. In mild cases, the redness may be barely noticeable and confined to the ear canal opening. However, in more severe infections, the swelling can become so pronounced that it partially or completely blocks the ear canal, making it difficult or impossible to see inside the ear.
Some individuals may also develop swelling of the lymph nodes around the ear, particularly those in front of the ear or behind the jawbone. This is part of your body’s natural defense mechanism against infection.
4. Fluid Drainage from the Ear
Drainage or discharge from the affected ear is a common symptom that indicates active infection. The fluid can vary in appearance, color, and consistency depending on the underlying cause and severity of the swimmer’s ear.
The discharge may be:
- Clear and odorless: In the early stages, you might notice clear fluid draining from your ear, which could be a mixture of water that was initially trapped and fluid produced by the inflamed ear canal lining.
- Yellow or yellowish-white: As the infection progresses, the drainage often becomes pus-like, appearing yellow or white with a thicker consistency. This indicates that your body is fighting a bacterial infection.
- Cloudy or bloody: In some cases, the discharge may appear cloudy or contain traces of blood, especially if the ear canal skin has been damaged or scratched.
- Foul-smelling: Infected drainage often has an unpleasant odor, which is a strong indicator of bacterial or fungal growth.
The amount of drainage can range from slight moisture you notice when touching your ear to significant discharge that requires frequent cleaning. You may find dried discharge or crusting around the ear opening, particularly after sleeping.
5. Hearing Loss or Muffled Hearing
Temporary hearing loss or the sensation that sounds are muffled is a frequent complaint among people with swimmer’s ear. This symptom can be particularly concerning, but it’s usually temporary and resolves once the infection is properly treated.
The hearing difficulties occur for several reasons:
- Blockage from swelling: As the ear canal tissues swell due to inflammation, the passage narrows, preventing sound waves from traveling efficiently to the eardrum.
- Fluid accumulation: Trapped water, discharge, and debris can physically block the ear canal, acting as a barrier to sound transmission.
- Earwax buildup: The infection and moisture can cause earwax to swell and become impacted, further obstructing the canal.
You might notice that sounds seem distant or quieter than usual, as if you’re wearing earplugs or have cotton in your ear. Some people describe it as hearing underwater. This can affect your ability to follow conversations, hear alarms or notifications, and maintain your usual awareness of environmental sounds.
It’s important to note that the hearing loss associated with swimmer’s ear is conductive, meaning it’s caused by a blockage preventing sound from reaching the inner ear, not by damage to the hearing structures themselves. Therefore, normal hearing typically returns once the infection clears and swelling subsides.
6. Feeling of Fullness or Pressure in the Ear
Many people with swimmer’s ear describe an uncomfortable sensation of fullness, pressure, or blockage in the affected ear. This feeling is similar to what you might experience during airplane takeoff or landing, or when water is stuck in your ear after swimming.
This symptom results from the combination of inflammation, swelling, trapped fluid, and debris accumulation within the narrow ear canal. The swollen tissues and accumulated material take up space in the canal, creating physical pressure against the ear structures.
The sensation can be constant or may fluctuate throughout the day. It often becomes more noticeable when you change positions, such as lying down or standing up. Some people report that the fullness increases when they’re in quiet environments because they become more aware of the internal sensations in their ear.
This feeling of pressure can be frustrating because it creates a persistent awareness of the affected ear, making it difficult to focus on other activities. You might instinctively try to relieve the pressure by yawning, swallowing, or attempting to “pop” your ears, but these techniques typically don’t provide relief for swimmer’s ear since the problem is in the outer ear canal rather than the middle ear.
7. Increased Sensitivity and Fever
In more advanced cases of swimmer’s ear, you may experience increased sensitivity around the ear area along with systemic symptoms like fever. These symptoms indicate that the infection may be worsening or spreading beyond the ear canal.
Increased Sensitivity: The skin around and behind the ear becomes extremely tender and sensitive to touch. Even gentle contact, such as brushing hair behind your ear, resting your head on a pillow, or wearing headphones, can cause significant discomfort or pain. The area may feel warm and appear red or inflamed.
Fever: While not everyone with swimmer’s ear develops a fever, its presence typically indicates a more severe infection or possible complications. The fever is usually low-grade (ranging from 99°F to 101°F or 37.2°C to 38.3°C) but can occasionally be higher, especially in children. Accompanying symptoms may include:
- General feeling of being unwell or fatigued
- Chills or body aches
- Headache
- Irritability, particularly in young children
- Decreased appetite
The presence of fever, severe pain, swelling that extends beyond the ear, or swollen lymph nodes in the neck suggests that medical attention is needed promptly. These symptoms may indicate that the infection is spreading to surrounding tissues or that complications are developing.
If you notice fever accompanied by severe ear pain, significant swelling, redness spreading to the face or neck, or if you have diabetes or a weakened immune system, it’s essential to seek medical care immediately. These situations require professional evaluation and may need more aggressive treatment to prevent serious complications.
Main Causes of Swimmer’s Ear
Understanding what causes swimmer’s ear can help you recognize your risk factors and take appropriate preventive measures. The following are the primary causes of this common ear infection:
Water Exposure
The most common cause of swimmer’s ear is prolonged exposure to water, which is how the condition got its name. When water remains trapped in the ear canal after swimming, bathing, or showering, it creates a moist environment that promotes bacterial and fungal growth. The protective barrier of earwax can wash away, leaving the skin vulnerable to infection. This is particularly common after swimming in lakes, rivers, or pools with improper chemical balance.
Bacterial or Fungal Infection
The infection is typically caused by bacteria such as Pseudomonas aeruginosa or Staphylococcus aureus, though fungi can also be responsible in some cases. These microorganisms naturally exist in water and on our skin but can multiply rapidly when conditions are favorable, such as when the ear canal remains moist and its natural defenses are compromised.
Damage to the Ear Canal
Scratches, abrasions, or damage to the delicate skin lining the ear canal can provide entry points for bacteria. This damage commonly occurs from:
- Inserting cotton swabs, fingers, or other objects into the ear
- Aggressive ear cleaning
- Using earbuds or hearing aids
- Scratching the ear canal due to allergic reactions or skin conditions like eczema or psoriasis
Excessive Moisture and Humidity
Living in warm, humid climates or environments with high humidity increases your risk of developing swimmer’s ear. Perspiration and environmental moisture can accumulate in the ear canal, creating conditions favorable for infection even without swimming.
Narrow Ear Canals
Some people are anatomically predisposed to swimmer’s ear due to narrower-than-average ear canals. This structural variation makes it more difficult for water to drain naturally from the ear, increasing the likelihood that moisture will become trapped.
Lack of Earwax or Excessive Cleaning
While too much earwax can cause problems, having too little is also problematic. Earwax serves as a natural protective barrier that waterproofs the ear canal and has antimicrobial properties. Excessive cleaning that removes this protective layer leaves the ear canal vulnerable to infection.
Skin Conditions and Allergies
Pre-existing skin conditions such as eczema, dermatitis, or psoriasis can affect the ear canal, making the skin more susceptible to infection. Similarly, allergic reactions to hair products, earrings, or other substances that come in contact with the ear can compromise the skin’s protective barrier.
Prevention Tips
Preventing swimmer’s ear is often easier than treating it. By following these practical prevention strategies, you can significantly reduce your risk of developing this uncomfortable condition:
Keep Ears Dry
After swimming, bathing, or showering, take time to thoroughly dry your ears. Tilt your head to each side to help water drain out naturally. Gently dry the outer ear with a soft towel, and use a hairdryer on the lowest, coolest setting held at arm’s length to help evaporate any remaining moisture in the ear canal.
Use Ear Protection When Swimming
Wear properly fitted swim caps, earplugs, or custom-molded swimming ear protection when swimming, especially if you swim frequently or have a history of swimmer’s ear. These barriers help prevent water from entering the ear canal in the first place.
Avoid Inserting Objects into Your Ears
Never insert cotton swabs, fingers, towel corners, or any other objects into your ear canal. These can push earwax deeper, scratch the delicate skin, remove the protective earwax layer, or compact debris. Remember that ears are generally self-cleaning, and earwax will naturally work its way out.
Create an Acidic Environment
Some people benefit from using over-the-counter preventive ear drops after swimming. These solutions typically contain alcohol (to help dry the ear) and acetic acid (to create an acidic environment that discourages bacterial growth). However, never use these if you have ear tubes, a perforated eardrum, or an existing ear infection. Consult with a healthcare provider before using any ear drops.
Be Cautious About Water Quality
When possible, swim in well-maintained pools with proper chlorine and pH levels rather than in lakes or rivers where bacteria levels may be higher. Avoid swimming in water that appears dirty or has posted warnings about water quality.
Remove Hearing Aids and Earbuds Regularly
If you wear hearing aids or use earbuds frequently, remove them periodically to allow air circulation in your ear canals. Keep these devices clean and dry, and avoid wearing them when your ears are wet.
Manage Underlying Skin Conditions
If you have eczema, psoriasis, or other skin conditions that affect your ears, work with your healthcare provider to keep these conditions well-managed. Healthy skin is less susceptible to infection.
Protect Your Ears During Hair Care
When using hair sprays, dyes, or other hair products, protect your ears with cotton balls placed just inside the ear opening (not deep in the canal). Remove them promptly after finishing your hair routine.
Don’t Swim with Existing Ear Problems
If you already have an ear infection, perforated eardrum, or ear surgery recovery in progress, avoid swimming until your healthcare provider confirms it’s safe to do so.
Frequently Asked Questions
How long does swimmer’s ear last?
With appropriate care, swimmer’s ear symptoms typically begin to improve within a few days, and the infection usually resolves completely within 7-10 days. However, if left untreated, it can persist for weeks or develop into a more serious chronic condition. The duration also depends on the severity of the infection and how quickly treatment is started.
Can swimmer’s ear go away on its own?
Mild cases of swimmer’s ear may resolve on their own with careful home care, including keeping the ear dry and avoiding further irritation. However, most cases benefit from medical treatment to prevent the infection from worsening or becoming chronic. If symptoms persist beyond 2-3 days, worsen, or are accompanied by severe pain or fever, you should seek medical attention.
Is swimmer’s ear contagious?
No, swimmer’s ear is not contagious and cannot be spread from person to person through casual contact. The infection develops due to bacteria or fungi growing in your own ear canal under favorable conditions. However, the bacteria that cause the infection may be present in contaminated water sources that multiple people might swim in.
How can I tell the difference between swimmer’s ear and a middle ear infection?
The key difference is that swimmer’s ear (outer ear infection) causes pain when you touch or pull on the outer ear or press on the tragus, while middle ear infections typically don’t cause increased pain with external touch. Middle ear infections are more common in children, often follow colds or respiratory infections, and may cause symptoms like fever and general illness. Swimmer’s ear is associated with water exposure and typically affects the visible ear canal.
Can I swim with swimmer’s ear?
No, you should avoid swimming and keep the affected ear dry while you have swimmer’s ear. Exposing the infected ear to more water will likely worsen the condition, prolong healing, and may spread the infection. Wait until your symptoms have completely resolved and, if you received medical treatment, until your healthcare provider confirms it’s safe to resume swimming.
When should I see a doctor for swimmer’s ear?
You should seek medical attention if you experience severe ear pain, fever, hearing loss, symptoms lasting more than a few days, discharge from the ear, swelling that extends beyond the ear, or if you have diabetes or a weakened immune system. Additionally, children with suspected swimmer’s ear should be evaluated by a healthcare provider to ensure proper treatment and prevent complications.
Can I use hydrogen peroxide for swimmer’s ear?
While hydrogen peroxide is sometimes used to soften earwax, you should not use it for treating suspected swimmer’s ear without consulting a healthcare provider first. If you have an active infection, perforated eardrum, or ear tubes, hydrogen peroxide could potentially worsen the condition or cause complications. Always consult with a medical professional before using any home remedies or over-the-counter treatments in your ears.
Why do I keep getting swimmer’s ear?
Recurrent swimmer’s ear can occur due to several factors including frequent water exposure, narrow ear canals, aggressive ear cleaning that removes protective earwax, underlying skin conditions like eczema, or chronic moisture in the ear canals. If you experience repeated episodes, consult with an ear, nose, and throat specialist (ENT) who can identify the underlying cause and recommend strategies to prevent future infections.
References:
- Mayo Clinic – Swimmer’s Ear
- Centers for Disease Control and Prevention – Ear Infections
- NHS – Swimmer’s Ear (Otitis Externa)
- Healthline – Swimmer’s Ear: Symptoms, Causes, and Treatment
- WebMD – Swimmer’s Ear
The information on this page is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions related to your health.
Read the full Disclaimer here →