Swimmer's ear
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Definition
Swimmer's ear is inflammation, irritation, or infection of the outer ear and ear canal. The medical term for swimmer's ear is otitis externa.
Swimmer's ear may be acute or chronic.
Alternative Names
Ear infection - outer ear - acute; Otitis externa - acute; Chronic swimmer's ear; Otitis externa - chronic; Ear infection - outer ear - chronic
Causes, incidence, and risk factors
Swimmer's ear is fairly common, especially among teenagers and young adults. It is occasionally associated with middle ear infection (otitis media) or upper respiratory infections such as colds.
Swimming in polluted water can lead to swimmer's ear. Water-loving bacteria such as Pseudomonas, as well as other bacteria or fungi (in rare cases), can cause ear infections.
Other causes of swimmer's ear include:
Inflammation and irritation of the bone and tissues at the bottom of the skull (malignant otitis externa)
Scratching the ear or inside the ear
Getting something stuck in the ear
Trying to clean wax from the ear canal, especially with cotton swabs or small objects, can irritate or damage the skin.
Long-term (chronic) swimmer's ear may be due to:
References
Guss J, Ruckenstein MJ. Infections of the external ear. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 137.
Pfaff JA, Moore GP. Otolaryngology. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 70.
Review Date: 8/3/2010
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Ear infection - outer ear - acute; Otitis externa - acute; Chronic swimmer's ear; Otitis externa - chronic; Ear infection - outer ear - chronic
Symptoms
- Drainage from the ear -- yellow, yellow-green, pus-like, or foul smelling
- Ear pain, which may get worse when you pull on the outer ear
- Hearing loss
- Itching of the ear or ear canal
Signs and tests
The doctor will perform a physical exam, which includes looking inside the ears. The ear, including the ear canal, appears red and swollen. The skin inside the ear canal may be scaly or shedding.
Touching or moving the outer ear increases the pain. The eardrum may be difficult for the doctor to see because of a swelling in the outer ear. Or, the eardrum may have a hole in it. This is called a perforation.
The doctor may take a sample of fluid from the ear and send it to a lab so any bacteria or fungus can be identified.
References
Guss J, Ruckenstein MJ. Infections of the external ear. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 137.
Pfaff JA, Moore GP. Otolaryngology. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 70.
Review Date: 8/3/2010
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Ear infection - outer ear - acute; Otitis externa - acute; Chronic swimmer's ear; Otitis externa - chronic; Ear infection - outer ear - chronic
Treatment
Ear drops containing antibiotics are typically given, usually for 10 to 14 days. If the ear canal is very swollen, a wick may be applied in the ear to allow the drops to travel to the end of the canal. Your doctor or nurse can show you how to do this.
Other treatments may include:
Antibiotics taken by mouth if you have a middle ear infection or infection that spreads beyond the ear
Corticosteroids to reduce itching and inflammation
Pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
Vinegar (acetic acid) ear drops
People with chronic swimmer's ear may need long-term or repeated treatments to avoid complications.
Placing something warm against the ears may reduce pain.
Expectations (prognosis)
When treated properly, swimmer's ear usually gets better.
Complications
The infection may spread to other areas around the ear, including the skull bone. In elderly people or those who have diabetes, a severe infection called malignant otitis externa is a possibility. Malignant otitis externa is treated with high-dose antibiotics given through a vein.
Calling your health care provider
Call for an appointment with your health care provider if:
You develop any symptoms of swimmer's ear
You notice any drainage coming from your ears
Your symptoms get worse or continue despite treatment
You have new symptoms, such as fever or pain and redness of the skull behind the ear
References
Guss J, Ruckenstein MJ. Infections of the external ear. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 137.
Pfaff JA, Moore GP. Otolaryngology. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 70.
Review Date: 8/3/2010
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Ear infection - outer ear - acute; Otitis externa - acute; Chronic swimmer's ear; Otitis externa - chronic; Ear infection - outer ear - chronic
Prevention
Protect ears from further damage.
Do not scratch the ears or insert cotton swabs or other objects in the ears.
Keep ears clean and dry, and do not let water enter the ears when showering, shampooing, or bathing.
Dry the ear thoroughly after exposure to moisture.
- Avoid swimming in polluted water.
- Use earplugs when swimming.
- Consider mixing 1 drop of alcohol with 1 drop of white vinegar and placing the mixture into the ears after they get wet. The alcohol and acid in the vinegar help prevent bacterial growth.
References
Guss J, Ruckenstein MJ. Infections of the external ear. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 137.
Pfaff JA, Moore GP. Otolaryngology. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 70.
Review Date: 8/3/2010
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 8/3/2010
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.