Outer Ear Infection (Swimmer's Ear)

Written by Joe Bowman | Published on January 14, 2014
Medically Reviewed by George Krucik, MD, MBA on January 14, 2014

What Is an Outer Ear Infection?

An outer ear infection is an infection in the tube that connects the opening of the ear to the eardrum. It is medically known as otitis externa and is commonly referred to as “swimmer’s ear.” These outer ear infections sometimes result from exposure to moisture. They are common in children and young adults who spend a lot of time swimming. Swimmer’s ear results in nearly 2.4 million healthcare visits annually in the U.S. (CDC).

What Causes an Outer Ear Infection?

Swimming (or possibly even bathing or showing too frequently) can lead to an outer ear infection. The water left inside the ear canal can become a breeding ground for bacteria.

An infection can also occur if the thin layer of skin that lines the outer ear is ruptured. Intense scratching or using headphones or cotton swabs can create a rupture. When the layer of skin becomes damaged, it can provide a foothold for bacteria.

Cerumen, or earwax, is the ear’s natural defense against infection, but constant exposure to moisture and scratching can deplete the ear of cerumen, making infections more likely.

Who Is at Risk for an Outer Ear Infection?

Swimming is the biggest risk factor for otitis externa, especially swimming in water with high levels of bacteria. It is less risky to swim in a chlorinated pool than a natural body of water.

Showering or cleaning your ears too frequently can also leave the ears open to infection. The narrower the ear canal, the more likely it is that water will be trapped inside. Children’s ear canals are typically narrower than adults’ ear canals. The use of headphones or a hearing aid, as well as skin allergies and skin irritation from hair products, also increase the risk of developing an outer ear infection.

Swimmer’s ear is not contagious.

What Are the Symptoms of an Outer Ear Infection?

Symptoms of otitis externa include:

  • swelling
  • redness
  • heat
  • pain or discomfort in the ear
  • pus discharge
  • itching
  • excessive fluid drainage
  • muffled or diminished hearing

Severe pain in the face, head, or neck can signify that the infection has advanced considerably. Symptoms accompanied by a fever or swollen lymph nodes may also indicate advancing infection.

How Is an Outer Ear Infection Diagnosed?

A doctor can usually diagnose an outer ear infection by assessing the patient’s symptoms and looking into the patient’s ear with an otoscope.

How Are Outer Ear Infections Treated?

Antibiotic eardrops are the most common treatment for an outer ear infection that has not healed on its own.

What Is the Outlook for an Outer Ear Infection?

The prognosis for these types of infections is usually quite good, as infections can often heal on their own or can be eliminated simply by taking eardrops.

How Can an Outer Ear Infection Be Prevented?

The best way to prevent swimmer’s ear is to keep your ears as dry as possible. When you are swimming, using earplugs or a bathing cap can help. After swimming or showering, it is recommended that you dry your ears thoroughly. Tilting one’s head so that each of the ears face the ground helps empty out the excess water. Putting cotton swabs, hairpins, pens, pencils, or any other objects inside the ear canal is not advisable.

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