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Keeping swimmer’s ear at bay

Water is actually teeming with pathogens—so don’t bring it with you
Swimmer's ear can be a real nuisance.

With warm weather upon us, a quick dip in the pool or a drive to the lake can seem like a great way to beat the heat. After a day of cannonballs and swan dives, you may find yourself with some water in your ear when you’re drying off. While most of the time, water stuck in your ear is no more than a nuisance, other times water exposure can lead to acute otitis externa—or swimmer’s ear.

What is swimmer’s ear?

Swimmer’s ear is an infection of the external or outer ear canal, which runs from the eardrum to the outside of the head. It’s often caused by water remaining in the ear after swimming, which causes an environment that helps bacteria grow.

“Swimming is a significant risk factor especially in fresh water,” said Kara Jones-Schubart, DNP, FNP, a clinical assistant professor at the Texas A&M College of Nursing. “For most people, swimmer’s ear is a one-time occurrence, but for others, it can take a more chronic form.”

The main symptom is redness in the outer ear along with some warmness and pain. Parts of the ear are often tender when moved or touched. It’s also common for the ear to feel full, itchy, tender and irritated and to even experience temporary diminished hearing.

What causes otitis externa?

 “The most common pathogen that causes swimmer’s ear is bacteria; Pseudomonas aeruginosa and Staphylococcus aureus (staph) are the main culprits,” Jones-Schubart said. “Less common causes include a fungus, typically Candida or Aspergillus.”

These pathogens all thrive in wet environments, so if they get trapped in your ear canal, they can set up shop and begin causing problems. However, water and the tiny pathogens in it aren’t the only way to get acute otitis externa.

“There are other, more uncommon, ways to get the condition,” Jones-Schubart said. “A buildup of wax can cause the infection, and so can cleaning your ears the wrong way and injuring the canal. Use of cotton-tipped applicators (Q-tips) should be avoided.”

Jones-Schubart recommends wiping the outer part of your ear with a clean towel, and not sticking anything in your ear that can damage your ear or cause irritation. Most of the time, earwax will take care of itself, but if you do think it needs some help working its way out of your ear, visit your health care provider.

Avoiding swimmer’s ear

Apart from not sticking anything in your ears, there are a few ways to avoid swimmer’s ear. “Many people who swim often realize that ear plugs are extremely beneficial when you go swimming,” Jones-Schubart said. “There are also some over-the-counter solutions that you can use to help rinse out everything in your ear and break up any blockage.”

Many people may also try using a hair dryer to help keep their ears dry after a swim. In that case, Jones-Schubart recommends using one on a very low setting so that you don’t damage your hearing with higher settings.

Treating swimmer’s ear

Your primary care provider can diagnose your infection, which can be easily treated with topical ear drops—most often containing antibiotics. It’s also important to note that swimmer’s ear isn’t the same as the typical ear infection that is common in children.

“Those types of infection happen in the middle ear (otitis media) and are treated with an oral antibiotic,” Jones-Schubart said. “Those infections can present with a fever. If a fever or extreme pain presents in otitis externa, it’s because the infection has moved passed the outer ear in severe cases.”

In those more severe cases, oral antibiotics (and possibly ear drops) will be prescribed by a health care provider for treatment.

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