Swimmer's ear (otitis externa) is an inflammation or infection of the ear canal, the passage that leads from the outer ear to the eardrum. This condition is called swimmer's ear, because it commonly occurs when water remains in your ear after swimming. But other people can get it too. Bacteria or fungus can grow when something (for example water or sand) irritates or damages the delicate skin in the ear canal. Other things that can irritate the ear canal include hearing aids, lots of ear cleaning, and eczema of the ear canal. Usually you can treat swimmer's ear with eardrops. Prompt treatment can help prevent complications and more-serious infections.
Doctors can usually diagnose swimmer's ear during an office visit. If your infection is at an advanced stage or persists, you may need further evaluation.
Your doctor or medical provider will likely diagnose swimmer's ear based on symptoms you report, questions he or she asks, and an office examination. You probably won't need a lab test at your first visit. Your doctor will examine your ear canal with a lighted instrument (otoscope). Your ear canal may appear red, swollen and scaly. Flakes of skin and other debris may be present in the ear canal. It is important to see if your eardrum (tympanic membrane) is torn or damaged. If the view of your eardrum is blocked, your doctor will clear your ear canal with a small suction device or an instrument with a tiny loop or scoop on the end (ear curette).
If your eardrum is damaged or torn, your doctor will likely refer you to an ear, nose and throat specialist (ENT). The specialist will examine the condition of your middle ear to determine if that's the primary site of infection. This examination is important because some treatments intended for an infection in the outer ear canal aren't appropriate for treating the middle ear.
If your infection doesn't respond to treatment, your doctor may take a sample of discharge or debris from your ear at a later appointment and send it to a lab to identify the exact microorganism causing your infection.
Swimmer's ear is usually not a dangerous condition and often clears up within a few days after starting treatment. However, if untreated, it can become extremely and surprisingly painful. In rare cases, especially in diabetes patients or anyone with problems with their immune system, the infection may be more difficult to treat and can spread and damage underlying bones and cartilage, requiring hospitalization.
Cleaning your outer ear canal is necessary to help eardrops flow to all infected areas. Your doctor will use a suction device or ear curette to clean away any discharge, clumps of earwax, flaky skin and other debris.
For most cases of swimmer's ear, your doctor will prescribe eardrops that have some combination of the following ingredients, depending on the type and seriousness of your infection:
If your ear canal is completely blocked by swelling, inflammation or excess discharge, your doctor may insert a wick made of cotton or gauze to promote drainage and help draw medication into your ear canal.
If your infection is more advanced or doesn't respond to treatment with eardrops, your doctor may prescribe oral antibiotics.
Your doctor may recommend easing the discomfort of swimmer's ear with over-the-counter pain relievers. If your pain is severe or your swimmer's ear is at a more advanced stage, your doctor may prescribe a stronger medication for pain relief.
During treatment, the following steps will help keep your ears dry and avoid further irritation: