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Swimmer's Ear (Otitis Externa)

External Otitis or "swimmer's ear" is an infection of the skin covering the outer ear and/or the ear canal. Acute external otitis is commonly caused by a bacterial infections, the swimmer's ear infection is usually caused by excessive water exposure from swimming or other water sports. When water collects in the ear canal, it can often get trapped inside and be prevented from exiting by being absorbed by earwax, then the warm moist conditions allow bacteria to grow rapidly. Cuts or abrasions of the skin lining the ear canal can also lead to bacterial infection of the ear canal. Other causes include a spot or pimple developing inside the ear, a fungal infection or something directly irritating the ear canal, such as a hearing aid or an ear plug for example.

Otitis externa is relatively common. It is estimated that around 10% of the population will be affected at some point in their lives. People with certain long-term (chronic) conditions, such as eczema, asthma or allergic rhinitis, are at greater risk of developing otitis externa.

Chronic (long-term) swimmer's ear is otitis externa that persists for longer than four weeks or that occurs more than four times a year.

Symptoms of otitis externa are usually a feeling of fullness and a very itchy ear. They may include ear pain, (this may range from moderate to severe pain, which may be due to the ear canal swelling. If severe this may cause the face to appear swollen too and it may not be immediately obvious that the pain is coming from the ear. Sometimes discharge may be present from the ear and you may be noticing a temporary or fluctuating hearing loss. Often only one ear is affected and while otitis externa can clear up by itself, it can take several weeks without treatment.

Antibiotics may be prescribed to treat the infection along with painkillers if necessary and sometimes ear drops. Treatment for other underlying conditions that may aggravate otitis externa, such as dermatitis, psoriasis or eczema may prove beneficial.

Moisture may prolong otitis externa so for this reason, the ear should be kept as dry as possible. While showering or swimming use an ear plug (available for water sports these are available and are designed to keep water out). Despite the temptation, scratching the inside of the ear, inserting any object including the use of cotton buds should be avoided. This will only aggravate the irritated skin, and in most situations will make the condition worse. If a hearing aid is worn this should be left out as much as possible until any swelling, pain and discharge stops.