By Drs. Sally Robinson and Keith Bly

Swimmer's ear, also known as otitis externa, is an infection of the outer ear and skin in the ear canal. It is different from an inner ear infection (otitis media), which is usually accompanied by cold symptoms, such as a runny nose or congestion.

Swimmer’s ear occurs when water gets stuck in the ear canal after swimming or bathing. Water can irritate the skin in the ear canal and bacteria or fungus can invade and cause an infection. This infection is similar to an infection that can occur on the skin from a cut or bite, and it is not contagious.

To prevent swimmer’s ear, you can buy over-the-counter eardrops, or make your own by mixing equal amounts of white vinegar and rubbing alcohol. Place five to 10 drops into each ear immediately after swimming; allow the drops to stay in the ear for a few minutes and then drain them out onto a tissue. The alcohol evaporates any water in the ear and the vinegar kills any bacteria or fungus that may have gotten in the ear. This is not a treatment for the infection, but it may prevent your child from getting one.

You may also prevent swimmer’s ear by drying your children’s ears thoroughly after water gets into them, and by choosing swimming areas that are not polluted. Never allow your children to put objects (including cotton swabs) into their ears.

Symptoms of swimmer’s ear include itching on the outside of the ear or in the ear canal’ decreased hearing; pain when you push on the small flap that covers the ear canal or if you gently pull on the ear and pain on the face in front of the ear. Pain in only one ear is also a sign that your child has swimmer’s ear. There may also be a greenish-yellow discharge from the ear opening.

If you suspect that your child has swimmer’s ear, consult your doctor. Even though it is not common, severe or untreated swimmer’s ear can spread to the cartilage and bone that surrounds the ear canal, so it is important to consult your doctor, especially if there is drainage coming from the ear.

To relieve pain, put a warm cloth or heating pad against your child’s ear and administer acetaminophen.

If the infection is severe and the ear canal is swollen, your doctor may prescribe antibiotic-steroid drops. The antibiotic will kill the bacteria or fungus and the steroids will soothe and heal the inflamed skin. If the ear canal is especially swollen, your doctor may place a “wick” in the ear, which is a piece of cotton or sponge that will ensure that the drops reach deep into the ear canal. Drops are usually given for about five to 10 days, and your child should not swim or get water into the ear while it is being treated.
Remember to follow-up with your pediatrician after your child’s treatment period ends, and call your doctor immediately if your child continues to have drainage from the ear, continued fever, dizziness, ear pain that lasts longer than 48 hours, or a stiff neck.

Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.