Otitis Externa

What is otitis externa (swimmer's ear)?

Anatomy of the ear
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Swimmer's ear, also called otitis externa, is an infection of the outer ear canal. Although swimmer's ear is most commonly caused by a bacterial infection, it can also be caused by a fungal infection or a noninfectious dermatologic problem. Water that remains trapped in the ear canal (when swimming, for example) can provide a breeding ground for 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
  • Drainage from the ear
  • Swollen glands in the neck
  • Swollen ear canal
  • Muffled hearing or hearing loss
  • Full or plugged-up feeling in the ear

The symptoms of swimmer's ear may resemble other medical conditions or problems. Always consult your physician 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 physician. Your physician 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 physician 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 individuals may have both types of infections.

Your physician 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 a physician, usually clears up within seven to 10 days. Specific treatment for swimmer's ear will be determined by your physician 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 physician

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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