Swimmer’s ear can ruin a summer holiday. Here’s how to avoid it

With the mercury rising, more Australians will head to their favourite beach or pool to cool off. Unfortunately, as well as being the peak period for this great Aussie pastime, it’s also peak time for an often-painful condition: swimmer’s ear.

Swimmer’s ear, scientifically referred to as otitis externa, is a really common infection in Australia, typically in summer, says the head of rhinology at Royal Victorian Eye and Ear Hospital Yi Chen Zhao.

The infection can occur anywhere from the outer part of the ear on the outside of the head to the eardrum, typically starting with the feeling of water in the ear.

Swimming in the ocean carries a greater risk of the condition than swimming in pools, experts say.Credit: iStock

“A day or two down the track, the ear becomes more painful and more muffled, essentially because the skin of the external ear canal is swelling and because it’s trapped inside a bone, it doesn’t have anywhere to go, so it shuts the ear canal, which is why you have the blocked sensation,” he says.

The skin inside the ear can also break off and form debris, contributing to the blocked sensation as well, Zhao adds.

Founding director of ear science and clinical adviser to Lions Hearing Clinic Professor Marcus Atlas says swimmer’s ear gets its name because most outer ear infections are caused by exposure to water.

“Many avid swimmers will experience an outer ear infection at some point,” he says.

What causes swimmer’s ear?

The infection, which is usually bacterial or caused by fungus, is distinct from the water that can get stuck in your ear canal when you swim. Instead, swimmer’s ear can be painful and serious, with signs of the infection including itching, redness and swelling of the ear canal, ear pain, draining fluid or discharge.

“Symptoms are usually mild at first but can worsen if the infection isn’t treated,” Atlas says. “Left untreated, the infection can become more serious and spread to nearby tissue and, more rarely, to bone.”

While the two aren’t exclusive, Atlas says having water retained in your ear after swimming can contribute to or put someone at more risk of an ear infection “because a wet ear canal means that the skin in the ear canal softens, which makes it easier for bacterial growth and infection”.

And contaminated water carries a greater risk. “Freshwater swimming – like lakes, rivers, ponds, streams or oceans – sometimes carries a greater risk compared to swimming in a well-kept pool, as fresh water contains more bacteria,” he says.

Swimmer’s ear can be caused by other factors, including showering and bathing, heavy perspiration or humidity.

Damage to the ear canal, like that caused by cotton tips, and wearing ear devices, such as headphones or hearing aids, could also cause breakages in the skin that, when coupled with bacteria, can lead to infection.

Who is most at risk?

While anyone can experience swimmer’s ear, some are more susceptible than others: those who have smaller, narrower ear canals because moisture can’t drain as effectively; diabetics, because the earwax can be less acidic and more alkaline, which can encourage more bacterial growth; and those who suffer from eczema or psoriasis, as they are more prone to dry and damaged skin in the ear.

Anyone diagnosed with swimmer’s ear will need to avoid water for between seven and 10 days, after starting treatment.Credit: iStock

The best course of action for swimmer’s ear is prevention, which, Zhao assures, doesn’t mean avoiding the water completely.

“You just need to avoid getting water in your ear, which can be done by plugging them up,” he says. Earplugs designed for swimming are a good option.

“Swim plugs are custom-made for each ear, ensuring a snug fit so that no water can enter the ear canal,” says Rhea Sethi, a senior audiologist at Neurosensory in Victoria. While relatively expensive, ranging between $100 and $250 for a pair and not covered by Medicare, they do last many years, she says.

If water still manages to find its way into your ear, despite your best efforts, Zhao says the quicker you can dry it out, the better.

“There are things you can do to help evaporate the water, such as drops you can buy from the pharmacy, and the other thing I tell my patients to do, if they get water in their ear, is to use a little fan or hair dryer to dry out the ear.”

However, if you are experiencing pain, itching, discharge or any other symptoms after swimming, Atlas says you should visit a doctor so they can determine the type of infection (bacterial or fungal) and treat it accordingly.

“Swimmer’s ear will typically require prescription medication, like antibiotic or antifungal eardrops, to manage the infection,” he says.

Unfortunately, if you have an active infection, you’ll need to avoid getting the ears wet (even when showering) for at least seven to 10 days.

“This will assist in recovery and preventing complications,” Atlas says.

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