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Ear Canal Problems (Swimmer's Ear)

Overview

Swimmer's ear (otitis externa) is a painful inflammation and infection of the ear canal. It occurs when the protective film that covers the ear canal (lipid layer) is removed. This 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. 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 include ear pain with sudden facial paralysis, hoarseness, and throat pain. 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.
  • Skin problems, such as eczema, psoriasis, or seborrhea.
  • Sweating.

You are more likely to get swimmer's ear if:

  • You have a very narrow or hairy ear canal.
  • 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 "tag" 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.
Yes
Symptoms of inner ear infection
No
Symptoms of inner ear infection
Have you had an injury to your ear in the past week?
The ear can be injured by a direct hit, a very loud noise (like a gunshot or firecracker), or an object being pushed into the ear.
Yes
Recent ear injury
No
Recent ear injury
Yes
Symptoms of ear canal infection
No
Symptoms of ear canal infection
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Do you have a health problem or take medicine that weakens your immune system?
What weakens the immune system in an adult or older child may be different than in a young child or baby.
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Do you have any new hearing loss?
Yes
New hearing loss
No
New hearing loss
Was the hearing loss sudden and complete?
Yes
Sudden and complete hearing loss
No
Sudden and complete hearing loss
Do you have vertigo?
Yes
Vertigo
No
Vertigo
Is the vertigo making it hard to stand or walk?
Yes
Hard to stand or walk
No
Hard to stand or walk
Have you had vertigo for more than a week?
Yes
Vertigo for more than 1 week
No
Vertigo for more than 1 week
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.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Now

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. 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.

  • Use heat.

    To ease ear pain, apply a warm washcloth or a heating pad set on low. There may be some drainage when the heat melts earwax.

    • Don't use a heating pad when you are in bed. You may fall asleep and burn yourself.
  • 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.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Related Information

Credits

Current as of: May 4, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine

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