Swimmer's Ear: Symptoms, Causes and How to Treat It
Swimmer's ear, medically known as otitis externa, is an infection of the outer ear canal that develops when moisture becomes trapped in the ear, creating the warm, damp conditions in which bacteria thrive. Despite its name, it is just as common in people who spend time outdoors in humid conditions or who frequently use earbuds as it is in swimmers. Left untreated, it can progress from mild irritation to a painful and potentially serious infection.
What is swimmer's ear?
Swimmer's ear affects the skin lining the outer ear canal (the passage leading from the outer ear to the eardrum). When the ear canal becomes damp, its natural defences are compromised and bacteria can multiply rapidly. The warm, enclosed environment of the ear canal accelerates this process, particularly when water is trapped behind earwax or debris. While swimming is the most common trigger, any prolonged exposure to moisture — showers, baths, humid weather — can cause the same effect.
Risk factors for swimmer's ear
Several factors increase the likelihood of developing swimmer's ear:
- Swimming: particularly in water with high bacterial counts
- Inserting objects into the ear: cotton swabs, fingers or earbuds can damage the thin skin lining the ear canal
- Vigorous ear cleaning: removes the protective layer of earwax
- Earbuds or hearing aids: prolonged use can trap moisture in the canal
- Eczema, psoriasis or skin conditions: break down the skin's natural barrier
- Allergies: to hair dyes, hairspray or jewellery can cause irritation
- Diabetes: high blood sugar creates an environment where yeast and bacteria thrive, making diabetic patients particularly susceptible to otitis externa
Swimmer's ear symptoms
Swimmer's ear symptoms generally start mild and worsen without treatment.
If untreated, swimmer's ear can lead to long-term or deep tissue infection, damage to bone and cartilage, or a more widespread infection. It is one of the most preventable causes of hearing loss.
Recognising the stage of infection helps determine the urgency of treatment.
Mild symptoms
Moderate symptoms
- More intense itching and increasing pain
- More extensive redness and swelling
- Significant discharge from the ear
- Sensation of fullness or partial blockage in the ear canal
- Reduced or muffled hearing
Advanced symptoms
- Severe pain that may radiate to the jaw or neck
- Complete blockage of the ear canal
- Outer ear very red and swollen
- Swollen lymph nodes in the neck
- Fever
Swimmer's ear infection: ear drops and antibiotic
For most cases of swimmer's ear, ear drops are the first-line treatment. They work by delivering antibiotics, antifungals or corticosteroids directly to the infected area.
- Antibiotic ear drops: such as ciprofloxacin or neomycin-based drops — are the most commonly prescribed treatment for bacterial otitis externa. They are typically used for 7 to 10 days and are highly effective when the infection is caught early.
- Antifungal ear drops: prescribed when the infection is caused by a fungus rather than bacteria, which is more common in people who have used antibiotic drops repeatedly or who are immunocompromised.
- Earclear: a product widely available in Australian pharmacies, Earclear swimmer's ear drops contain acetic acid and can help treat mild infections and prevent recurrence by restoring the natural acidic environment of the ear canal.
- Corticosteroid drops: often combined with antibiotics to reduce inflammation and relieve pain and swelling more quickly.
Before using ear drops, a specialist may use a suction device to clean the ear canal, allowing the drops to reach the infected area more effectively. If the underlying cause is a skin condition or allergy, your doctor will address this first.
Remedies and Home Treatments for swimmer's ear
For mild discomfort, several home remedies can provide temporary relief while you wait for medical treatment:
- Warm compress: applying a warm towel over the affected ear can help ease pain
- Over-the-counter pain relief: ibuprofen or paracetamol can reduce pain and inflammation
- Keep the ear dry: avoid swimming or submerging the ear until symptoms resolve
- Tilt the head: gently tilting the affected ear downward can help drain any trapped water
- Avoid inserting anything into the ear: including cotton swabs, which can worsen irritation and push debris further into the canal
These remedies can support recovery but do not replace medical treatment. If symptoms persist beyond 48 hours or worsen, see a doctor.
Prevention of swimmer's ear
Several simple measures can significantly reduce the risk of developing swimmer's ear:
- After bathing or swimming, dry your ears thoroughly (wipe the outer ear gently with a soft towel)
- Tip your head to each side after swimming to encourage water to drain from the ear canal
- Use a blow dryer on the lowest setting, held at least 30 cm from the ear, to dry the canal
- Check water quality before swimming and avoid swimming on days when bacterial counts are high
- Never clean your ears with cotton swabs, paperclips, hairpins or any other object
- Put cotton wool gently in your ears when using hair dye or hairspray
If you swim regularly, consider using swimmer's ear plugs to prevent water entering the canal.
When to see a doctor
Contact your doctor promptly if you experience pain in the ear that is worsening rather than improving, significant discharge or a feeling of complete blockage, reduced or muffled hearing, fever or swollen lymph nodes in the neck, or symptoms that have not improved after 48 hours of home treatment.
Seek emergency care if pain becomes severe, if the infection appears to be spreading beyond the ear, or if you have diabetes or a compromised immune system (these groups are at higher risk of complications).
FAQs about swimmer's ear
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