Swimmer's Ear - Otitis Externa

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Introduction

Swimmer’s ear is an outer ear infection.  It is also called an external ear infection, external otitis, or otitis externa.  It commonly results from an infection that develops in trapped water in the ear after swimming.  Irritants or germs that enter the outer ear through open sores may also cause it.  Swimmer’s ear can cause pain, itching, and decreased hearing.  Swimmer’s ear is treated with prescription medication.
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Anatomy

The ear is divided into three areas: the outer, middle, and inner ear.  Your ear not only enables you to hear, but it plays a role in balance as well.  The ear canal, a hollow passageway, travels from your outer ear to your eardrum.  Your outer ear and middle ear are separated by the eardrum.
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Causes

Swimmer’s ear develops when there is too much moisture in the ear canal, which allows a bacteria or fungus infection to develop.  Moisture may become trapped in the ear while swimming, build up from bathing or from living in a humid environment.  Irritants, such as hairspray and hair dye, can cause an infection.  Skin breakage or sores in the ear can allow germs to enter.
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Symptoms

Swimmer’s ear usually only affects one ear.  A main symptom is ear pain.  Your pain may become worse if you touch or pull on your ear.  Hearing may change and become muffled.  You may develop an ear itch or drainage.  The drainage may be yellow, yellow-green, bad smelling, or contain pus.
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Diagnosis

You should contact your doctor if you suspect that you or your child has swimmer’s ear.  The inside of your ear will be examined with an otoscope.  An otoscope is a lighted device with a magnifying glass.  If discharge is present, a sample may be tested to determine what type of infection it is.  You may be referred to an otolaryngologist, a doctor that specializes in ear, nose, and throat conditions.  You may receive a hearing test to measure your degree of hearing loss.
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Treatment

Your doctor will remove the drainage and clean your ear in the office.  You will receive prescription antibiotic eardrops, oral antibiotics, or both.  You should protect your ear from water and avoid swimming, diving, or flying in aircraft until it heals.
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Prevention

It can be helpful to wear earplugs when swimming.  You should avoid swimming in water that may be polluted.
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Am I at Risk

Swimmer’s ear occurs most frequently in children and young adults, but it may develop in anyone.

Risk factors for swimmer’s ear:

_____ Swimming in contaminated or polluted water
_____ Living in a humid environment
_____ Use of hairspray and hair dye
_____ People with certain skin conditions, such as eczema, psoriasis, allergies, or dermatitis
_____ Open or broken skin from scratching or foreign objects in the ear
_____ Wearing dirty earplugs or dirty hearing aids
_____ Ear wax buildup
_____ People with poorly controlled diabetes, especially older adults

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Complications

Untreated swimmer’s ear can cause chronic infection or infection that spreads to other parts of the body.  People with diabetes have a higher risk of complications from infection.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.