Otitis Externa (Swimmer’s Ear)

What is Otitis Externa (Swimmer’s Ear)?

Swimmer's ear, also called (otitis externa) is an irritation of the external ear canal. Otitis externa is caused by fungi or bacteria. Water that remains trapped in the ear canal (when swimming, for example) may provide a source for the growth of bacteria and fungi.

Causes of Otitis Externa

Many different factors can increase your child's chance of developing otitis externa. As the name suggests, one of the factors is excessive wetness from swimming, although it can occur without swimming. Other possible causes of this infection include the following:

  • Being in warm, humid places
  • Harsh cleaning of the ear canal
  • Trauma to the ear canal
  • Dry ear canal skin
  • Foreign body in the ear canal
  • Excess cerumen (ear wax)
  • Eczema and other forms of dermatitis

Signs and symptoms of Otitis Externa

The following are the most common symptoms of otitis externa. However, each child may experience symptoms differently. Symptoms may include:

  • An ear that is painful to touch, or pain when pulling gently on the ear lobe
  • Itching in the ear
  • Drainage from the ear
  • Swollen ear canal
  • Muffled hearing or hearing loss
  • Full or plugged-up feeling in the ear
  • Redness of the outer ear
  • Swollen glands in the neck

The symptoms of otitis externa may resemble other medical conditions or problems. Always consult your child's primary care provider for a diagnosis.

Diagnosis of Otitis Externa

Otitis externa may be diagnosed by a complete medical history and physical examination by your child's primary care provider or otolaryngologist. Your child's provider may use an otoscope, a lighted instrument that helps to examine the ear. This will show if there is also an infection in the middle ear, called otitis media. Although this infection usually does not occur with otitis externa, some children may have both types of infections.

Your child's provider may also take a swab culture of the drainage from the ear and send it to the lab to help determine what type of bacteria or fungus is causing the infection.

Treatment for Otitis Externa

Swimmer's ear, when properly treated by a healthcare provider, usually clears up within seven to 10 days. Specific treatment for otitis externa will be determined by your child's provider based on:

  • Your child's age, overall health, and medical history
  • Extent of the condition
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Treatment may include

  • Antibiotic ear drops
  • Steroid ear drops (to help decrease the swelling)
  • Pain medication
  • Keeping the ear dry, as directed by your child's primary care provider
  • In severe cases, an otolaryngologist may place a special piece of cotton, called an ear wick, within the ear canal to help antibiotic drops reach the ear drum.

Preventing swimmer's ear

The following are some tips to help prevent swimmer's ear:

  • Protect your child’s ear canals from water during swimming and bathing. This can be done using cotton balls coated in vasoline or with ear plugs.
  • Do not aggressively clean your child's ear canal with q-tips and avoid other potentially harmful objects like bobby pins.

Reviewed by Elena Huang, MD, FAAP