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Otitis Externa

What is otitis externa (swimmer's ear)?

Anatomy of the ear
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Otitis externa, also called swimmer's ear, is an inflammation, irritation, or infection of the external ear canal. Swimmer's ear 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.

What causes swimmer's ear?

Many different factors can increase the chance of developing swimmer's ear. As the name implies, one of the factors is excessive wetness as with swimming, although it can occur without swimming. Other possible causes of this infection include the following:

Ear infections

Ear infections can occur due to a variety of medical conditions and can occur in the external and internal ear areas. The external ear includes the visible portion (called the auricle) and the external auditory canal or tube.

The inner ear includes the cochlea (which contains the sensory hearing nerves); vestibule (which contains the sensory receptors for balance); and semicircular canals (which also contain sensory receptors for balance).

Ear infections cause painful earaches and, if left untreated, may lead to hearing loss. Two of the more common types of ear infections are infection of the middle ear infection, or otitis media, and infection of the outer ear canal, or otitis externa (swimmer's ear).

  • 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

What are the symptoms of swimmer's ear?

The following are the most common symptoms of swimmer's ear. However, each individual may experience symptoms differently. Symptoms may include:

  • Redness of the outer ear
  • Itching in the ear
  • Pain, especially when touching or wiggling the ear lobe that may spread to the head, neck, or side of the face
  • Drainage from the ear
  • Swollen glands in the upper neck or around the ear
  • Swollen ear canal
  • Muffled hearing or hearing loss
  • Full or plugged-up feeling in the ear
  • Fever

The symptoms of swimmer's ear may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.

How is swimmer's ear diagnosed?

Swimmer's ear may be diagnosed with a complete medical history and physical examination by your health care provider. He or she may use an otoscope, a lighted instrument that helps to examine the ear and to aid in the diagnosis of ear disorders. This will help your health care provider know if there is also an infection in the middle ear, called otitis media. Although this infection usually does not occur with swimmer's ear, some people may have both types of infections.

Your health care provider may also take a culture of the drainage from the ear to help determine proper treatment.

Treatment of swimmer's ear

Swimmer's ear, when properly treated by your health care provider, usually clears up within seven to 10 days. Specific treatment for swimmer's ear will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference
Treatment may include:
  • Antibiotic ear drops
  • Corticosteroid ear drops (to help decrease the swelling)
  • Pain medication
  • Keeping the ear dry, as directed by your health care provider

Preventing swimmer's ear

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

  • Use ear plugs for swimming or bathing.
  • Do not aggressively clean your ear canal.

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