4 tips to prevent swimmer's ear

Mother and son in a pool

If you like to spend time in the water during the summer months, you’ve probably experienced your share of swimmer’s ear.

An infection in the outer ear canal, swimmer’s ear (also known as otitis externa), is common in children and adults and is often caused by moisture that stays in your ear after swimming or other activities. This creates an environment that promotes bacterial or even fungal growth. Otitis externa can also be caused by minor trauma such as scratching or irritating the inside of your ear canal. This includes excessive use of cotton swabs, putting your fingers or other objects such as ear buds or hearing aids. These objects may cause skin breaks can create an opportunity for bacteria to grow. Chronic skin conditions like eczema and psoriasis can also lead to otitis externa.

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To help prevent swimmer’s ear, follow these four tips:

  1. Gently dry your outer ears after swimming or showering. You can also dry your ears with a blow dryer if you keep it at the lowest setting and hold it at least a foot from your ear.
  2. Use over-the-counter swimmer’s ear drops before and after swimming or you can make your own. My preference is to use white distilled vinegar 7 to 8 drops in the affected ear for 3 to 4 minutes followed by a cotton ball gently placed into the opening of the ear canal to wick away the liquid. The vinegar will help remove the remaining moisture in the ears and prevent the growth of bacteria or fungi.
  3. Avoid putting any type of objects in your ear to prevent irritation or perforation of the eardrum. This can also push earwax deeper into your ear canal.
  4. If you’ve had an ear infection, ear tubes or  ear surgery, talk to your doctor about taking extra precautions before swimming. While mild cases of swimmer’s ear will usually resolve on their own, you may need to seek treatment if the infection persists.

Signs that the infection may be getting worse include a bleeding, excessive fluid drainage, increasing pain, fevers, substantial hearing loss and even facial drooping.

Initially, you can try an over-the-counter ear drop for swimmer’s ear to help treat the infection. If the pain doesn’t subside after a day or two, however, you should seek treatment by your doctor to prevent a more serious infection or other complications. An untreated infection in the ear canal can spread to deep layers of the skin and sometimes the bone of the ear canal.

Individuals with diabetes, cancer or a weakened immune system are at higher risk for developing a more serious and potentially life-threatening infection called malignant otitis externa or skull base osteomyelitis. The infection may spread to the bones of the skull base causing severe pain. In the most serious cases, the infection can involve damage to the cranial nerves that control hearing, balance, facial muscle movement, swallowing and talking.

For otitis externa, your doctor or health care provider may prescribe antibiotic, antifungal or steroid drops. In cases in which antibiotics or steroids do not work, cleaning or debridement of the ear canal in clinic is necessary along with continuing antibiotics. Malignant otitis externa, however, requires a much more aggressive approach which includes intravenous (IV) antibiotics and sometimes surgery to remove the involved bone of the skull base. As a board-certified otolaryngologist (ear, nose and throat specialist) who has additional training and expertise in complex conditions of the ear and related structures, I treat many complex diseases that affect the ears, balance system and base of the skull.