A common source is increased moisture trapped in the ear canal from baths, showers, swimming, or moist environments. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection of the ear canal. Swimmer’s ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing, and prevent the spread of infection.

Other factors that may contribute to swimmer’s ear include:

• Contact with excessive bacteria that may be present in hot tubs or polluted water
• Excessive cleaning of the ear canal with cotton swabs or anything else
• Contact with certain chemicals such as hair spray or hair dye (avoid this by placing cotton balls in your ears when using these products)
• Damage to the skin of the ear canal following water irrigation to remove wax
• A cut in the skin of the ear canal
• Other skin conditions affecting the ear canal, such as eczema or seborrhea

The most common symptoms of swimmer’s ear are itching inside the ear and pain that gets worse when you tug on the auricle (outer ear). Other signs and symptoms may include any of the following:

• The sensation that the ear is blocked or full
• Drainage
• Fever
• Decreased hearing
• Intense pain that may spread to the neck, face, or side of the head
• Swollen lymph nodes around the ear or in the upper neck
• Redness and swelling of the skin around the ear

Treatment for the early stages of swimmer’s ear includes careful cleaning of the ear canal and the use of eardrops that inhibit bacterial or fungal growth and reduce inflammation. Mildly acidic solutions containing boric or acetic acid are effective for early infections.

• Drops are more easily administered if done by someone other than the patient
• The patient should lie down with the affected ear facing upwards
• Drops should be placed in the ear until the ear is full
• After drops are administered, the patient should remain lying down for a few minutes so the drops can be absorbed

If you do not have a perforated eardrum (an eardrum with a hole in it) or a tympanostomy tube in your eardrum, you can make your own eardrops using rubbing alcohol or a mixture of half alcohol and half vinegar. These eardrops will evaporate excess water and keep your ears dry.

Before using any drops in the ear, it is important to ensure you do not have a perforated eardrum. Check with your otolaryngologist if you have ever had a perforated, punctured, or injured eardrum or if you have had ear surgery.

For more severe infections, your doctor may prescribe antibiotics to be applied directly to the ear. If the ear canal is swollen shut, a sponge or wick may be placed in the canal so the antibiotic drops will enter the swollen canal more effectively. Pain medication may also be prescribed. If you have tubes in your eardrum, a non-ototoxic (do not affect your hearing) topical treatment should be used. Topical antibiotics are effective for infection limited to the ear canal. Oral antibiotics may also be prescribed if the infection goes beyond the skin of the ear canal.

Follow-up appointments are critical to monitor improvement or worsening, to clean the ear again, and to replace the ear wick as needed. Your otolaryngologist has specialized equipment and expertise to clean the ear canal and treat swimmer’s ear effectively. With proper treatment, most infections should clear up in 7-10 days.