Swimmer's ear (otitis externa) is a painful inflammation and infection of the ear canal. It causes the ear canal to look red and swollen. The ear canal may be narrower than normal and is tender when the outside of the ear is gently pulled up and back.
Swimmer's ear may occur when water, sand, dirt, or other debris gets into the ear canal. This can damage the protective layer of the ear canal, which may lead to inflammation. It gets its name because it often occurs when excess water enters the ear canal. If you've had swimmer's ear in the past, you are more likely to get it again.
A rare but serious infection called malignant external otitis can develop if bacteria invade the bones inside the ear canal and spread to the base of the skull. But not many people get this infection. It's mainly seen in older adults who also have diabetes, people who have HIV, and children who have impaired immune systems. But it can be fatal. Symptoms may include severe ear pain with drainage, loss of movement in part of the face, swelling, and breakdown of the skin in the ear canal. Antibiotics are used to treat this infection.
Other causes of inflammation or infection of the ear canal include:
Allergies.
Bony overgrowths in the ear canal called exostoses.
Bubble baths, soaps, and shampoos.
Cleaning the ear canal harshly or with a sharp object.
Headphones inserted into the ear.
Scratching the ear canal with a cotton swab, bobby pin, fingernail, or other sharp object.
You have earwax stuck in the ear canal (impacted) because you often use cotton swabs that may push the ear wax deeper into the ear canal.
Symptoms can include itching, pain, and a feeling of fullness in the ear. Your ear canal may be swollen. You may have moderate to severe pain, drainage, or hearing loss. The pain is worse when you chew, press on the bump (tragus) in front of the ear, or wiggle your earlobe. This is different from the pain of a middle ear infection (acute otitis media).
You may be able to prevent swimmer's ear. Symptoms often get better or go away with home treatment.
Check Your Symptoms
Do you have a problem with the ear canal?
This includes problems like fluid in the ear after swimming.
Yes
Ear canal problem
No
Ear canal problem
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
The medical assessment of symptoms is based on the body parts you have.
If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Have you had any ear symptoms for more than a week?
Yes
Ear symptoms for more than 1 week
No
Ear symptoms for more than 1 week
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.
Symptoms of an infection in the ear canal (swimmer's ear) may include:
Pain, especially when you touch your ear, wiggle your earlobe, or chew.
Redness or swelling in the ear canal.
Drainage from the ear.
Symptoms of an inner ear infection may include:
Pain deep in the ear. (External ear infections may itch or hurt in the outer part of the ear, but not deep in the ear.)
Fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
Long-term alcohol and drug problems.
Steroid medicines, which may be used to treat a variety of conditions.
Chemotherapy and radiation therapy for cancer.
Other medicines used to treat autoimmune disease.
Medicines taken after organ transplant.
Not having a spleen.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
Steroid medicines, which are used to treat a variety of conditions.
Medicines taken after organ transplant.
Chemotherapy and radiation therapy for cancer.
Not having a spleen.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care in the next hour.
You do not need to call an ambulance unless:
You cannot travel safely either by driving yourself or by having someone else drive you.
You are in an area where heavy traffic or other problems may slow you down.
Ear Problems and Injuries, Age 12 and Older
Ear Problems and Injuries, Age 11 and Younger
Self-Care
Some home treatment can help mild swimmer's ear. Do not put eardrops or anything else in the ear unless your doctor has told you to. Try the following tips to help mild swimmer's ear.
Rinse out your ear.
Gently rinse your ear using a bulb syringe and a mixture of equal parts white vinegar and rubbing alcohol. Make sure the flushing solution is body temperature. Inserting cool or hot fluids in the ear can make you dizzy.
Try eardrops.
If your ear is itchy, try nonprescription swimmer's eardrops, such as Swim-Ear. Use them before and after you swim or get your ears wet. Read and follow all instructions on the label, and learn how to insert eardrops safely.
Take over-the-counter medicines to reduce pain.
Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
Do not use ear candles.
They have no proven benefit in the removal of earwax or other objects in the ear. And they can cause serious injury.
If you are concerned that your symptoms are more serious, you may need to check with your doctor.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
New or worse bleeding or drainage.
New symptoms, such as hearing loss or dizziness.
The ear canal or skin around the ear becomes red, swollen, itchy or painful.
Author: Ignite Healthwise, LLC Staff Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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