An infection that happens in the outer ear canal that goes from the eardrum to the outside of the head is called swimmer’s ear. Commonly, this ear infection occurs due to water that stays in the ear for prolonged periods, allowing the bacteria to grow and multiply. Some people, experience swimmer’s ear due to cotton swabs or fingers inserted into the ears that cause damage to the skin lining of the ear canal.
This condition is also called otitis externa and is treated in most cases with eardrops. However, if the infection is left untreated, it may lead to complications and more serious infections.
Symptoms
The symptoms that people with swimmers experience are different because it depends on the severity of the infection. Check below some symptoms according to the severity of the disease:
Mild Symptoms
- Itching and redness in the ear canal
- Mild discomfort
- Odorless fluid discharge from the ear
Moderate Symptoms
- Pain
- Intense itching
- Excessive drainage of the fluid from the ear
- The feeling of fullness in the ear
- Partial blockage of the ear canal
- Reduced or muffled hearing
Severe Symptoms
- Severe pain that may affect a part of the face or neck
- Swelling or redness of the outer ear and lymph nodes in the neck
- Fever
- Blockage of the ear canal
It is advised to seek emergency care if you experience severe pain or fever, or suspect you have a swimmer’s ear.
Causes
In most cases, this infection occurs due to bacteria but sometimes, it may happen due to a fungus or virus. Generally, the ear has protective features that help prevent infections and keep the ears clean. For example:
- Earwax is an accumulation of dead skin cells, waxy film, and other debris that travel through the ear canal opening.
- The outer ear part helps prevent the entering of foreign objects into the ear.
Those who develop this ear infection usually have water (sometimes contaminated water) in the ear for long periods and experience damage to the skin of the ear canal that contributes to infection.
Risk Factors
Check below some factors that may make you more likely to develop this ear infection:
- Water in the ear for prolonged periods (such as from perspiration, staying in the humid weather for a long time, or water that remains in the ear after swimming)
- High bacteria levels exposure (usually found in contaminated water)
- Frequent cleaning of the ear canal with cotton swabs, hairpins, or fingernails
- Ear devices (such as earbuds, hearing aids, and others)
Complications
While this is not a serious infection, leaving it untreated may cause serious complications. Examples include:
- Temporary loss of hearing – Hearing usually improves itself when the infection is cleared.
- Chronic otitis externa (long-term infection) – If the symptoms persist for more than 3 months, it is considered to have chronic otitis externa. In most cases, chronic infections happen if there are conditions difficult to treat. These include rare bacteria strains, allergic skin reactions, skin diseases (such as dermatitis, psoriasis, and others), or a combination of infections (including bacterial and fungal).
- Cellulitis – This is a condition that causes a deep tissue infection. However, a swimmer’s ear rarely causes cellulitis. It happens when the bacteria goes into deep layers and connective tissues of the skin.
- Early skull base osteomyelitis (bone and cartilage damage) – This complication of swimmer’s ear happens quite rarely and involves infection of the cartilage of the outer ear and bone located in the lower skull’s part. Commonly, people with chronic health conditions (diabetes, weakened immune systems, and others) and older adults are more likely to develop this complication. People with early skull base osteomyelitis may experience severe pain.
- Widespread infection – People who do not get treatment for swimmer’s ear may develop more serious infections that negatively affect the brain, certain nerves, and other body parts. Sometimes, this complication can be life-threatening.
How to Prevent Swimmer’s Ear?
Check below some tips that may help prevent or avoid this ear infection:
- Keep your ears dry after swimming or bathing. That’s why it is advised to tip the head to the side to help water go away from the ear canal. However, you should dry your outer ear part only.
- Preventive treatment – People with healthy eardrums can use homemade solutions (including white vinegar and rubbing alcohol) to promote drying and prevent bacteria and fungi from growing. Furthermore, a similar solution is available at pharmacies.
- You should not swim in places where there are warnings of high bacteria counts (such as lakes or rivers). In any case, it is advised to use earplugs or a swimming cap to keep your ears dry.
- You can protect your ears from other irritants (such as hair sprays or dyes) by putting a cotton ball in the ear.
- People who have had recently ear surgery should talk with their healthcare professional before swimming.
- It is not allowed to put foreign items in the ears
Diagnosis
Healthcare providers usually perform initial tests to see if the infection persistent or is advanced. Thereafter, you may need additional evaluation. For example:
Initial Tests
Physicians usually diagnose this ear infection based on physical examinations and questions about your symptoms. Sometimes, they may perform the following tests to confirm the condition. For example:
- Ear examination – This procedure involves an otoscope that helps doctors determine whether the ear canal is red, swollen, or scaly.
- Doctors may check your eardrum (tympanic membrane) to ensure it is not torn or damaged.
Additional Tests
Physicians may perform the following tests to determine the extent of the swimmer’s ear. For example:
- People with damaged or torn eardrums may need an examination of the middle ear to identify the primary infection site. This examination is important because some treatments for outer ear infections are not good for middle ear infections.
- If the treatment does not work, physicians may take a small sample of discharge or debris from the ear and test it in the laboratory.
Treatment
The treatment goal is to get rid of the infection and allow the ear canal to heal. Commonly, treatment for a swimmer’s ear involves the following steps. For example:
Ear Cleaning
First, doctors will clean your outer ear canal to allow the eardrops to flow to the infected area. They often use a suction device or ear curette to get rid of earwax, discharge, and other debris.
Medicines
Physicians often prescribe different medicines because it depends on several factors. For example the severity of the infection, your age, existing health problems, and others. Check below some examples:
- Acidic solution that helps restore the antibacterial environment of the ear
- Steroids
- Antibiotics
- Antifungal medications
Pain Relievers
For those who experience pain, doctors may recommend some over-the-counter (OTC) painkillers. These include Ibuprofen, Naproxen sodium, or Acetaminophen. People with swimmer’s ear and severe pain may need prescription pain relievers.
Frequently Asked Questions
What is the most common cause of a swimmer’s ear?
Commonly, people experience this ear infection due to water that remains in the ear for long periods. As a result, it allows bacteria to grow and multiply.
What happens if the swimmer’s ear is left untreated?
People who ignore the symptoms and do not get treatment for this infection may experience some complications. These include hearing loss, chronic otitis externa, narrowed ear canal, facial infection, cellulitis, early skull base osteomyelitis, and others.
Can a swimmer’s ear be cured?
Yes, proper treatment and early diagnosis can cure this ear infection. Treatment usually includes eardrops, pain medicines, using earplugs to keep the ears dry, warm compresses, and others. If you have additional questions, ask your healthcare provider.
