From beach days to pool parties, with warm weather comes the joy of water activities. Along with sunshine and splash time comes the risk of developing a common and uncomfortable condition: swimmer’s ear.
Known medically as otitis externa, swimmer’s ear is an outer ear infection that thrives in warm, moist environments. It may begin with a slight itch or a sensation of fullness in your ear. But if left untreated, it can quickly become painful, disruptive, and even dangerous.
If you spend time swimming, sweating, or showering this season, it’s worth understanding what causes swimmer’s ear, how to recognize it early, and how to keep it from cutting your summer short.
What is swimmer’s ear?
Swimmer’s ear affects the external auditory canal. This narrow passage connects the visible part of your ear to your eardrum. The skin inside this canal is thin, delicate, and protected by a natural acidic film of wax called cerumen. This barrier prevents bacteria and fungi from entering under normal circumstances.
The trouble starts when moisture, irritation, or damage disrupts this natural protection. Water that stays trapped in the ear canal can soften the skin and alter the pH level, making it easier for bacteria or fungi to grow. That’s why swimmer’s ear is more likely to happen during summer or in people who spend a lot of time in the water.
But you don’t have to be an athlete or a frequent swimmer to be at risk. The condition can also develop from skin conditions, cleaning practices, or the use of earbuds or hearing aids.
Is swimmer’s ear a type of ear infection?
Yes, swimmer’s ear is a type of ear infection, but it is different from the middle ear infections most people are familiar with. Understanding how these two conditions differ can help you recognize symptoms early and choose the right course of care.
Swimmer’s ear vs. middle ear infection
Swimmer’s ear is an infection of the outer ear canal. This is the narrow passage that runs from the outside of your ear to the eardrum. The infection typically develops when moisture becomes trapped in the canal, creating the perfect conditions for bacteria or fungi to grow. It can also result from skin irritation, allergic reactions, or tiny abrasions caused by cleaning the ears too aggressively.
In contrast, middle ear infections, known as otitis media, occur in the air-filled space behind the eardrum. These infections often follow a cold, sinus congestion, or respiratory illness. When fluid builds up inside the middle ear, it can become infected and painful, especially in young children. Middle ear infections tend to be associated with fever, irritability, and pressure behind the eardrum, while swimmer’s ear is more likely to cause pain when the outer ear is touched.
Although both are considered ear infections, they affect different parts of the ear and require different types of treatment.
What causes swimmer’s ear?
The most common cause of swimmer’s ear is trapped water in the outer ear canal. But that’s just one piece of the puzzle. The real problem is when the combination of moisture and damage allows harmful microorganisms to multiply.
Here are the most frequent causes of swimmer’s ear:
- Prolonged moisture exposure from swimming, bathing, or sweating
- Tiny abrasions from cotton swabs, fingernails, earbuds, or hearing aids
- Skin irritation from hair sprays, dyes, or excessive chlorine exposure
- Underlying conditions like eczema, psoriasis, or seborrheic dermatitis
- Excessive ear cleaning that strips away protective earwax
- Narrow ear canals that hold onto moisture more easily
Certain bacteria, including Pseudomonas aeruginosa and Staphylococcus aureus, are common culprits in bacterial swimmer’s ear. In some cases, fungal infections may also be responsible, particularly after prolonged use of antibiotics or exposure to contaminated water.
Who is at risk for developing swimmer’s ear?
Swimmer’s ear can affect people of all ages, but certain individuals are more likely to develop it due to factors such as behavior, anatomy, or underlying health conditions. By understanding your personal risk factors, you can take steps to protect your ears and reduce the likelihood of infection, especially during the warmer months.
According to the Centers for Disease Control and Prevention (CDC), approximately 2.4 million U.S. healthcare visits occur each year related to swimmer’s ear. While both children and adults are affected, the condition is most common in children between the ages of 7 and 14, particularly those who swim regularly. However, adults are also at risk. Anyone exposed to water, humidity, or frequent skin irritation may develop swimmers’ ear if proper precautions are not taken.
The most common risk factors include:
Frequent swimming or water exposure
Regular swimming, especially in pools, lakes, or oceans, increases the likelihood of water becoming trapped in the ear canal. Children and teens involved in swim teams or water sports are especially vulnerable during summer. Even frequent showering or bathing can pose a risk if water is not properly drained.
Use of ear-cleaning tools or devices
Inserting cotton swabs, bobby pins, or other objects into the ear canal can cause tiny abrasions. These small injuries allow bacteria or fungi to enter and take hold. Over-cleaning can also strip away protective earwax, which normally serves as a barrier against infection.
Earbud or hearing aid use
Wearing in-ear devices for long periods creates a warm, moist environment that supports microbial growth. Earbuds may also irritate the skin inside the canal or introduce bacteria if not kept clean.
Narrow or curved ear canals
Some individuals naturally have ear canals that are narrower or more curved in shape. This anatomical feature makes it more difficult for water to drain, increasing the likelihood that moisture will remain trapped inside the ear.
Skin conditions affecting the ear canal
Individuals with eczema, psoriasis, or seborrheic dermatitis are more susceptible to skin inflammation and cracking. These disruptions weaken the ear’s natural defenses, making it easier for bacteria and fungi to cause infection.
Allergies or sensitivities to hair and skin products
Hairsprays, shampoos, and other cosmetic products can enter the ear canal and irritate its lining. Over time, repeated exposure may cause chronic inflammation or disrupt the balance of healthy bacteria.
Age and activity level
Children between the ages of 7 and 14 are the most commonly affected, particularly during the summer. However, active adults who engage in swimming, surfing, or outdoor sports in hot or humid conditions are also at risk. Sweat, heat, and high humidity all increase moisture in and around the ear canal.
Weakened immune system or chronic illness
People with conditions that affect immune function, such as diabetes, cancer, or autoimmune disorders, have a higher risk of developing severe or recurring infections. In these cases, swimmer’s ear may require more aggressive treatment and should be monitored closely by a healthcare provider.
While swimmer’s ear can affect anyone, certain individuals are more likely to develop it due to their habits, environment, or health status. Children and teens who swim regularly, adults who frequently use earbuds or hearing aids, and individuals with skin conditions or compromised immune systems face a higher risk. Understanding these risk factors and making small changes, such as thoroughly drying your ears, avoiding irritation, and protecting the ear canal, can reduce your chances of infection and help you stay comfortable throughout the season.
What are the common symptoms of swimmer’s ear?
Swimmer’s ear symptoms usually develop within a few days of exposure. The infection often begins with mild discomfort or itching, but can progress quickly if left untreated.
Common symptoms include:
- Itching inside the ear canal
- Pain that worsens when the ear is pulled or touched
- Redness and visible swelling of the outer ear
- A sense of fullness or pressure inside the ear
- Drainage from the ear, which may be clear, yellow, or pus-like
- Muffled or reduced hearing on the affected side
- Swollen lymph nodes near the jaw or neck
- Low-grade fever in more advanced infections
In severe cases, pain may radiate into the face, neck, or head. If the infection spreads beyond the ear canal, it may cause systemic symptoms and requires immediate medical care.
If you notice these symptoms, especially if the pain is increasing or drainage persists, it is essential to seek care promptly. Prompt treatment can reduce discomfort and prevent complications.
Is swimmer’s ear serious?
Swimmer’s ear is usually mild when caught early, but it should never be ignored. Without treatment, the infection can worsen and lead to more significant health issues.
Potential complications include:
- Persistent pain and inflammation that interferes with sleep or daily activities
- Temporary hearing loss caused by swelling or fluid in the canal
- Recurring infections that lead to thickened skin and narrowed canals
- Chronic otitis externa, where the infection lingers for weeks or returns frequently
- Cellulitis, a bacterial skin infection that can spread to surrounding areas
- Malignant otitis externa is a rare but life-threatening condition in which the infection spreads to the bones of the skull. This occurs most often in people with diabetes, weakened immune systems, or chronic illness.
Even if the infection stays local, it can be disruptive. Children may miss camp, sports, or swimming lessons. Adults may struggle with work, sleep, or using headphones. If left unaddressed, what starts as a small issue can take a significant toll.
When to seek medical care for swimmer’s ear
Not every case of swimmer’s ear requires medical treatment, especially if symptoms are caught early and managed appropriately at home. However, when the condition progresses, becomes more painful, or fails to improve within a few days, professional care is essential.
Even mild outer ear infections can worsen if left untreated. In some cases, the infection may spread beyond the ear canal or lead to long-term complications that affect hearing, comfort, or skin health.
Warning signs that require medical attention include:
- Symptoms lasting longer than 48 hours, especially if they show no signs of improvement
- Pain that intensifies or begins to radiate into the face, jaw, or neck
- Visible drainage from the ear, especially if it is yellow, green, foul-smelling, or persistent
- Noticeable swelling or redness of the outer ear or surrounding skin
- Muffled or reduced hearing, which may indicate swelling or fluid blockage inside the canal
- Fever, chills, or signs of systemic infection
- Chronic conditions such as diabetes, autoimmune disorders, or immunosuppression, which can increase the risk of complications
Prompt diagnosis not only relieves symptoms more quickly but also prevents the infection from becoming more severe or difficult to treat. Early intervention is especially important for children, older adults, and anyone with underlying health concerns.
How is swimmer’s ear diagnosed?
If you visit a healthcare provider with symptoms of swimmer’s ear, the diagnostic process usually begins with a detailed clinical exam. This enables the provider to confirm the diagnosis, identify potential complications, and tailor the treatment plan to your unique symptoms and medical history.
During the exam, the provider may:
- Use an otoscope to visually examine the ear canal and eardrum
- Look for signs of redness, swelling, flaking skin, or visible discharge
- Gently manipulate the outer ear to assess pain and tenderness
- Ask about recent water exposure, ear cleaning habits, or use of earbuds or hearing aids
In some cases, a sample of fluid or debris from the ear canal may be collected and tested in a lab to determine whether the infection is caused by bacteria or fungi. Identifying the exact organism helps ensure that the prescribed treatment is appropriate and effective.
If the infection is unusually severe, recurring, or unresponsive to treatment, the provider may recommend additional imaging, such as a CT scan, to rule out deeper infections or structural issues. This step is more common in high-risk individuals or when symptoms extend beyond the ear.
By combining a physical exam with a patient’s history and symptom progression, healthcare providers can accurately diagnose swimmer’s ear and prescribe treatment that relieves symptoms and prevents future infections.
How is swimmer’s ear treated?
The treatment approach for swimmer’s ear depends on how far the infection has progressed, what caused it, and how your body is responding to it. In its early stages, swimmer’s ear may be managed with basic home care. When symptoms become more advanced or persistent, professional medical treatment is necessary to fully resolve the infection and prevent complications.
Home treatment options for mild swimmer’s ear
For mild symptoms, the goal is to stop the infection from progressing while relieving discomfort. If the infection is caught early and symptoms are limited to mild itching or a sense of fullness in the ear, self-care at home may be enough to resolve the issue.
Recommended home care includes:
- Keeping the ear dry at all times. Avoid swimming or exposing the ear to water while symptoms are present. Use a shower cap or earplugs if needed.
- Using over-the-counter drying drops, especially after swimming or bathing. These solutions, which often contain isopropyl alcohol and acetic acid, help remove moisture and maintain the ear canal’s natural protective acidity.
- Taking oral pain relievers, such as acetaminophen or ibuprofen. These can help manage discomfort and reduce inflammation.
- Applying a warm compress, such as a clean washcloth soaked in warm (not hot) water and wrung out, then placed against the outer ear. The warmth may help ease localized pain or tension around the ear and jaw.
- Resting on the opposite side to promote natural drainage and reduce pressure. If your right ear is affected, lying on your left side may encourage gravity to assist in fluid movement and relieve pressure.
While these steps may resolve early symptoms, it’s important to monitor for any signs of worsening. If symptoms persist longer than two days, become more painful, or involve discharge, professional evaluation is recommended.
Medical treatment for moderate to severe infections
When swimmer’s ear progresses beyond the mild stage, medical intervention is typically required. A healthcare provider will evaluate the ear canal and determine the type and extent of the infection. Treatment usually involves ear drops that target the source of infection and reduce inflammation.
Common prescriptions include:
- Antibiotic ear drops are used to treat the infection by killing the bacteria that cause it. These often contain medications like ciprofloxacin or ofloxacin, which are effective against common bacterial strains found in outer ear infections.
- Steroid ear drops help calm the body’s inflammatory response. Swelling, redness, and pain may decrease more rapidly with the addition of corticosteroids.
- Antifungal ear drops are prescribed when a fungus rather than bacteria causes the infection. Fungal infections are less common but may occur after prolonged exposure to moisture or repeated use of antibiotic drops.
Additional medical procedures for treating swimmer’s ear
In more severe cases, the ear canal may be too swollen or obstructed for ear drops to work effectively. To improve medication delivery and reduce symptoms, a provider may need to:
- Gently clean the ear canal using specialized tools and techniques. This procedure removes debris, wax buildup, or discharge that may be blocking the canal or harboring bacteria.
- Insert a medicated wick into the ear canal. This small, soft piece of material absorbs the prescribed drops and helps carry the medication deeper into the swollen canal. The wick may stay in place for 24 to 72 hours and is removed or replaced as needed during follow-up care.
When oral antibiotics are prescribed
If the infection has spread beyond the ear canal or if topical treatment fails to resolve symptoms, oral antibiotics may be prescribed. These are usually reserved for cases where:
- There is visible swelling around the outer ear or face
- Lymph nodes in the neck are inflamed
- The patient has a fever or signs of systemic infection
- The patient has a chronic illness or a compromised immune system
Oral medications provide systemic support, reaching areas that topical treatments cannot. Your provider will select the most suitable antibiotic based on the suspected bacteria and your individual health profile.
Recovery timeline and follow-up
With proper treatment, most people begin to feel better within 48 to 72 hours. Pain, swelling, and discharge usually improve first, followed by a gradual return to normal hearing and comfort. However, the length of recovery can vary depending on how early the infection was treated and whether there are any underlying risk factors, such as skin conditions or diabetes.
It’s important to:
- Complete the full course of prescribed medication, even if symptoms improve quickly. Stopping treatment early can allow bacteria to return or become resistant.
- Keep the ear dry throughout treatment and recovery, using shower caps or earplugs to protect against additional moisture.
- Avoid inserting anything into the ear, including fingers, cotton swabs, or earbuds, until the ear has fully healed.
Your provider may schedule a follow-up visit to assess healing and ensure that the infection has fully resolved. If symptoms recur or do not improve, further testing may be needed to rule out a fungal infection, resistant bacteria, or a chronic skin condition affecting the ear canal.
Can chiropractic help with swimmer’s ear?
While research is limited, many patients report improvement in symptoms related to middle ear infections while receiving chiropractic care. These benefits are believed to result from improved nervous system function, enhanced fluid drainage, and reduced inflammation in the vicinity of the auditory canal. When spinal alignment supports clearer communication between the brain and body, it may also support the natural mechanisms that help regulate pressure and drainage in the ear.
In swimmer’s ear, the infection begins in the outer ear canal and is usually triggered by trapped moisture, skin irritation, or bacterial exposure. Because this condition results from local environmental factors rather than internal congestion, chiropractic care is not used to treat swimmer’s ear directly. However, chiropractic care may still support the body’s natural ability to recover from infections by promoting a properly functioning nervous system, which may help reduce inflammation.
That said, people who experience frequent ear infections, tension in the jaw or neck, or reduced lymphatic drainage may benefit from chiropractic care as part of a broader wellness routine. A licensed chiropractor can evaluate your spine and nervous system and recommend a care plan tailored to your individual needs.
Expert tips for preventing swimmer’s ear
The best way to manage swimmer’s ear is to prevent it from occurring in the first place. With a few consistent habits, you can keep your ears healthy all season long.
Here’s how to protect yourself or your kiddos from swimmer’s ear:
- Keep your ears dry: After swimming or showering, tilt your head to help water drain from your ears. Gently dry the outer ear with a towel. Avoid inserting anything into the canal.
- Use a hairdryer: Set it on the lowest setting and hold it at least 12 inches from your ear. This helps evaporate moisture that may have become trapped.
- Wear ear protection in the water: Use waterproof earplugs or a swim cap to prevent water from entering your ears, especially if you’re prone to infections.
- Avoid contaminated water: Don’t swim in lakes, rivers, or poorly maintained pools. These environments may contain bacteria or fungi that increase your risk of infection.
- Don’t use cotton swabs: Resist the urge to clean your ears with swabs, bobby pins, or fingers. These items can scratch the skin and push wax deeper into the ear.
- Use ear drops preventively: If you’re prone to swimmer’s ear, ask your provider about using over-the-counter drops made with acetic acid or alcohol to maintain a healthy pH in your ear canal.
- Manage skin conditions: If you have eczema or psoriasis, follow your provider’s guidance for care. These conditions can make the ear canal more vulnerable to infection.
- Monitor for early symptoms: Be aware of itching, fullness, or mild discomfort. Treating symptoms early can help prevent the infection from becoming serious.
Keep your ears healthy all summer long
Swimmer’s ear may seem like a seasonal inconvenience, but it can quickly become a more serious issue if left untreated. The good news is that it is one of the most preventable summer health concerns.
Taking a little care after swimming, packing a few protective tools in your pool bag, and understanding what your ears need can help keep you comfortable, active, and enjoying every moment. From diving boards to beach waves, your ears play a bigger role in your health than you may realize.
Pay attention to how they feel. Keep them clean, dry, and protected. And take early signs seriously. Your ears will thank you with clarity, comfort, and full participation in everything summer brings