Swimmer ears

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Overview

Swimmer's ear is an infection in the outer ear canal, which runs from your eardrum to the outside of your head. It's often brought on by water that remains in your ear, creating a moist environment that aids the growth of bacteria.

Putting fingers, cotton swabs or other objects in your ears also can lead to swimmer's ear by damaging the thin layer of skin lining your ear canal.

Swimmer's ear is also known as otitis externa. Usually you can treat swimmer's ear with eardrops. Prompt treatment can help prevent complications and more-serious infections.

Symptoms

Each person’s symptoms may vary. The following are the most common symptoms of swimmer's ear:

Redness of the outer ear

An itch in the ear

Pain, often when touching or wiggling your earlobe

Pus draining from your ear. This may be yellow or yellow-green, and it may smell.

Swollen glands in your neck

Swollen ear canal

Muffled hearing or hearing loss

A full or plugged-up feeling in the ear

Fever

The symptoms of swimmer's ear may look like other health problems. Always see your healthcare provider for a diagnosis.

Causes

Swimming in unclean water is a common cause of swimmer’s ear.

Other possible causes include:

Being in warm, humid places

Cleaning or scratching your ear canal using your fingers, cotton swabs, or other objects

Having an injury to the ear canal

Having dry ear canal skin

Having an object in the ear canal

Having extra ear wax

Risk factors

You are at greater risk for swimmer's ear if you:

Have contact with germs in hot tubs or unclean pool water

Have a cut in the skin of your ear canal

Hurt your ear canal by putting cotton swabs, fingers, or other objects inside your ears

Use head phones, hearing aids, or swimming caps

Have a skin condition such as eczema

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Complications

Swimmer's ear usually isn't serious if treated promptly, but complications can occur.

Temporary hearing loss. You might have muffled hearing that usually gets better after the infection clears.

Long-term infection (chronic otitis externa). An outer ear infection is usually considered chronic if signs and symptoms persist for more than three months. Chronic infections are more common if there are conditions that make treatment difficult, such as a rare strain of bacteria, an allergic skin reaction, an allergic reaction to antibiotic eardrops, a skin condition such as dermatitis or psoriasis, or a combination of a bacterial and a fungal infection.

Deep tissue infection (cellulitis). Rarely, swimmer's ear can spread into deep layers and connective tissues of the skin.

Bone and cartilage damage (early skull base osteomyelitis). This is a rare complication of swimmer's ear that occurs as the infection spreads to the cartilage of the outer ear and bones of the lower part of the skull, causing increasingly severe pain. Older adults, people with diabetes or people with weakened immune systems are at increased risk of this complication.

More-widespread infection. If swimmer's ear develops into advanced skull base osteomyelitis, the infection can spread and affect other parts of your body, such as the brain or nearby nerves. This rare complication can be life-threatening.

Prevention

Keep ears as dry as possible. Place a shower cap over your head to help prevent water or hair shampoo from getting into your ears. Place a cotton ball in the ear but do not push it in far. Use a dry towel to dry your ears after bathing or swimming. Use ear plugs if you play water sports or are frequently in water.

Turn your head from side to side after getting out of water. This helps water drain from your ears.

Don't stick anything into your ear canal. This includes pens/pencils, fingers, bobby clips or cotton-tipped swabs. (Swabs should only be used to dry the outer ear.)

Don't swim in polluted water.

Do not swallow the water you swim in.

Use a simple, homemade solution to help prevent bacteria from growing inside the ear. Mix one drop of vinegar with one drop of isopropyl (rubbing) alcohol and put one drop in each ear after bathing or swimming. Be sure to check with your doctor first before making and using this homemade solution.