Table of ContentsView AllTable of ContentsWhy It OccursCan It Heal Itself?Seeking TreatmentTreatment OptionsWhat to ExpectSelf-Care TipsComplicationsSeeing an ENT
Table of ContentsView All
View All
Table of Contents
Why It Occurs
Can It Heal Itself?
Seeking Treatment
Treatment Options
What to Expect
Self-Care Tips
Complications
Seeing an ENT
Otitis externa, also known as swimmer’s ear, is an infection of theouter ear canalthat causes pain along with swelling, redness, itching, ear drainage, and decreased hearing.
Prescription ear drops are the mainstay of otitis externa treatment, some of which contain acidifying or drying agents. Bacterial and fungal otitis externa can be effectively treated withantibioticorantifungalear drops. Steroid ear drops can help ease itchiness andinflammation.
FangXiaNuo / Getty Images
This article explainshow to get rid of swimmer’s ear, including preferred treatment options and self-care tips. It also explains when it is time to see an ear, nose, and throat (ENT) specialist if complications arise that might permanently damage your hearing.
Anatomy of the Ear: What You Should Know
Otitis Externa: A Common Outer Ear Infection
Otitis externa is a common ear infection that accounts for nearly 500,000 healthcare provider office or emergency room visits yearly. An estimated 10% of people will get otitis externa at some point in their life.
Otitis externa is called swimmer’s ear because repeated exposure to water can make the ear canal vulnerable to inflammation.Inflammation, in turn, can disrupt the integrity of the skin in the ear and allow bacteria and fungus easier entry into underlying tissues.
This condition can affect all age groups. However, children who spend a lot of time in the water are at greatest risk, particularly during the summer months when swimming is common.
Symptoms of otitis externa often develop rapidly, usually within a span of 48 hours, and may include:
Causes and Risk Factors
Other risk factors include:
What It Means When Your Ear is Draining
Will Otitis Externa Heal Without Treatment?
Unlikeotitis media(middle-ear infection), which sometimes heals on its own, otitis externa generally won’t go away without treatment. While milder cases may clear without medications, it can take weeks—and a lot of aggravation and discomfort—to get there.
Swimmer’s ear is generally not serious, but a prolonged or severe infection can injure the ear canal and make it vulnerable to repeated infections (known as chronic otitis externa). Repeated infections, in turn, can cause the ear canal to narrow, potentially affecting hearing.
By treating otitis externa early with prescription ear drops, you can avoid complications and usually resolve the infection within a week or less.
When to Seek Otitis Externa Treatment
Given the benefits of early treatment, it is important to see a healthcare provider if you even have mild symptoms of otitis externa. Early treatment almost invariably leads to better outcomes.
The diagnosis of swimmer’s ear involves a visual examination of the ear canal using a lighted scope called anotoscope. A swab of your ear canal may beculturedin the lab to determine if the cause is bacterial or fungal. This helps ensure that the correct treatment is dispensed.
Note to ParentsOtitis externa is not only common in children but also more likely to cause complications if left untreated. The spread of infection to the middle ear can lead tootitis media with effusion (OME), a potentially serious condition that can cause temporary or permanent hearing loss.In infants and young children, even temporary hearing loss can lead to delays in speech development and social skills development.
Note to Parents
Otitis externa is not only common in children but also more likely to cause complications if left untreated. The spread of infection to the middle ear can lead tootitis media with effusion (OME), a potentially serious condition that can cause temporary or permanent hearing loss.In infants and young children, even temporary hearing loss can lead to delays in speech development and social skills development.
Otitis externa is not only common in children but also more likely to cause complications if left untreated. The spread of infection to the middle ear can lead tootitis media with effusion (OME), a potentially serious condition that can cause temporary or permanent hearing loss.
In infants and young children, even temporary hearing loss can lead to delays in speech development and social skills development.
Common and Uncommon Causes of Ear Pain
Effective Otitis Externa Treatments
Prescription ear drops are the mainstay of treatment for otitis externa. Oral painkillers are occasionally prescribed to help ease the pain.
The treatment may also involve the cleaning of the ear canal or the use of a tool called an ear wick to deliver medications into a blocked ear canal.
Types of Ear Drops
Depending on the type and severity of infection involved, one or more ear drops may be prescribed. Each has a different mechanism of action that can either kill the underlying germ or make the environment of the ear hostile to the germ.
Ear drops commonly prescribed for swimmer’s ear include:
Why Aren’t Oral Antibiotics Used?
How to Use Ear Drops Correctly
Oral Painkillers
Ear pain is very rarely severe with otitis externa. Pain can make it difficult to sleep, work, or function. Oral painkillers, both over-the-counter and prescription, can often provide short-term relief.
Some of the more common options include:
How to Manage Ear Pain Safely
Other Procedures
The process usually involves:
If the ear canal cannot be adequately cleaned or is very swollen, a device called anotowickmay be used. This spongy wick is inserted into the canal and expands when drops are applied, securing it in place. The wick can be left for several days, allowing the drops to travel deep into the ear canal when applied.
Swimmer’s Ear (Otitis Externa) Self-Care and Treatment
The drops need to be administered without missing a dose. Be sure to space the doses as evenly as possible (every eight hours for ciprofloxacin, every six to eight hours for polymyxin B/neomycin, and roughly every five hours for ofloxacin).
The treatment can be extended up to 10 days, with up to 95% of people experiencing complete clearance within seven to 10 days.
How to Pay for TreatmentThe cost of treating any ear infection can often exceed $300.While insurance may cover some of the expenses, you may still be left withco-pay or coinsurancecosts.To reduce out-of-pocket costs, see if combination ear drops (which are generally more expensive) can be substituted with individual ear drops (which are generally less expensive).You can also compare drug prices and get coupons on consumer websites like GoodRx or find low-cost drugs (like ofloxacin ear drops) from online retailers like Mark Cuban’s CostPlus.
How to Pay for Treatment
The cost of treating any ear infection can often exceed $300.While insurance may cover some of the expenses, you may still be left withco-pay or coinsurancecosts.To reduce out-of-pocket costs, see if combination ear drops (which are generally more expensive) can be substituted with individual ear drops (which are generally less expensive).You can also compare drug prices and get coupons on consumer websites like GoodRx or find low-cost drugs (like ofloxacin ear drops) from online retailers like Mark Cuban’s CostPlus.
The cost of treating any ear infection can often exceed $300.While insurance may cover some of the expenses, you may still be left withco-pay or coinsurancecosts.
To reduce out-of-pocket costs, see if combination ear drops (which are generally more expensive) can be substituted with individual ear drops (which are generally less expensive).
You can also compare drug prices and get coupons on consumer websites like GoodRx or find low-cost drugs (like ofloxacin ear drops) from online retailers like Mark Cuban’s CostPlus.
Self-Care With Otitis Externa
While undergoing treatment for otitis externa, there are five self-care tips that can ensure the best possible outcomes, which are:
Chronic Otitis Externa and Other Complications
Otitis externa is consideredacuteif it lasts less than six weeks. If it lasts longer than three months, it is classified aschronicotitis externa.
With chronic otitis externa, ear pain is uncommon. Instead, there may be itching (sometimes intense) along with muffled hearing in the affected ear. Over time, the persistent inflammation can cause the ear canal to narrow, leading to significant and sometimes irreparable hearing loss.
The treatment of chronic otitis externa is focused on resolving the underlying cause. During flares, corticosteroid ear drops can help ease inflammation and swelling. Antibiotic ear drops may also be used to prevent bacterial infection.
Other possible complications of otitis externa include:
Seeing an ENT Specialist for Otitis Externa
Otolaryngologists are typically at the forefront of the latest treatment approaches and are generally better equipped to perform delicate ear procedures like ear cleanings and otowick placement.
To receive certification from the American Board of Otolaryngology (ABO), applicants must complete medical school and an average of five to seven years of postgraduate surgical training.
It is important to see an otolaryngologist if you experience:
As surgical specialists, otolaryngologists are qualified to perform ear surgeries.
5 Ways to Prevent Swimmer’s Ear
Summary
The treatment of otitis externa primarily involves prescription ear drops. These include drying, acidifying, antibiotic, antifungal, and steroid ear drops used either alone or in combination. Oral painkillers (very rarely), ear cleaning, and ear wicks may also be included in the treatment plan.
Types of Ear Infection: How to Tell Them Difference
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jackson EA, Geer K.Acute otitis externa: rapid evidence review.Am Fam Physician.2023;107(2):145-51.National Health Service (UK).Otitis externa.Hajiofff B, MacKeith S.Otitis externa,BMJ Clin Evid.2015;2015:0510.Gruber M, Damry D, Ibrahim N, Glikman D, Ronen O.Pediatric acute otitis externa: characteristics and predictors for hospital admission.Int J Pediatr Otorhinolaryngol.2021;140:110534. doi:10.1016/j.ijporl.2020.110534Victora Department of Health (Australia).Swimmer’s ear.Sakulchit T, Goldman RD.Antibiotic therapy for children with acute otitis media.Can Fam Physician.2017;63(9):685–7.Weigand S, Berner R, Schneider A, Lundershausen E, Dietz A.Otitis externa.Dtsch Arztebl Int.2019;116(13):224–234. doi:10.3238/arztebl.2019.0224Jamal A, Alsabea A, Tarakmeh M.Effect of ear infections on hearing ability: a narrative review on the complications of otitis media.Cureus.2022;14(7):e27400. doi:10.7759/cureus.27400Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Khatri H, Huang J, Guazzo E, Bond C.Review article: topical antibiotic treatments for acute otitis externa: emergency care guidelines from an ear, nose and throat perspective.Emerg Med Australas.2021;33(6):961–965. doi:10.1111/1742-6723.13874Navaneethan N, YaadhavaKrishnan RPD.Type of antifungals: does it matter in empirical treatment of otomycosis?Indian J Otolaryngol Head Neck Surg..2015;67(1):64–67. doi:10.1007/s12070-014-0780-9Bhutta MF, Head K, Chong LY, et al.Aural toilet (ear cleaning) for chronic suppurative otitis media.Cochrane Database Syst Rev.2020;9(9):CD013057. doi:10.1002/14651858.CD013057.pub2Bola S, Rashid M, Hickey S.Optimising the use of otowicks in otitis externa.J Laryngol Otol.2017;131(9):809-812. doi:10.1017/S002221511700144XTong S, Amand C, Kieffer A, Kyaw MH.Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008–2014.BMC Health Serv Res.2018;18:318. doi:10.1186/s12913-018-3139-1Alberta Health Services (Canada).Swimmer’s ear: care instructions.Kaya İ, Sezgin B, Eraslan S, et al.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-10. doi:10.5152/tao.2018.3075American Medical Association.Otolaryngology specialty description.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jackson EA, Geer K.Acute otitis externa: rapid evidence review.Am Fam Physician.2023;107(2):145-51.National Health Service (UK).Otitis externa.Hajiofff B, MacKeith S.Otitis externa,BMJ Clin Evid.2015;2015:0510.Gruber M, Damry D, Ibrahim N, Glikman D, Ronen O.Pediatric acute otitis externa: characteristics and predictors for hospital admission.Int J Pediatr Otorhinolaryngol.2021;140:110534. doi:10.1016/j.ijporl.2020.110534Victora Department of Health (Australia).Swimmer’s ear.Sakulchit T, Goldman RD.Antibiotic therapy for children with acute otitis media.Can Fam Physician.2017;63(9):685–7.Weigand S, Berner R, Schneider A, Lundershausen E, Dietz A.Otitis externa.Dtsch Arztebl Int.2019;116(13):224–234. doi:10.3238/arztebl.2019.0224Jamal A, Alsabea A, Tarakmeh M.Effect of ear infections on hearing ability: a narrative review on the complications of otitis media.Cureus.2022;14(7):e27400. doi:10.7759/cureus.27400Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Khatri H, Huang J, Guazzo E, Bond C.Review article: topical antibiotic treatments for acute otitis externa: emergency care guidelines from an ear, nose and throat perspective.Emerg Med Australas.2021;33(6):961–965. doi:10.1111/1742-6723.13874Navaneethan N, YaadhavaKrishnan RPD.Type of antifungals: does it matter in empirical treatment of otomycosis?Indian J Otolaryngol Head Neck Surg..2015;67(1):64–67. doi:10.1007/s12070-014-0780-9Bhutta MF, Head K, Chong LY, et al.Aural toilet (ear cleaning) for chronic suppurative otitis media.Cochrane Database Syst Rev.2020;9(9):CD013057. doi:10.1002/14651858.CD013057.pub2Bola S, Rashid M, Hickey S.Optimising the use of otowicks in otitis externa.J Laryngol Otol.2017;131(9):809-812. doi:10.1017/S002221511700144XTong S, Amand C, Kieffer A, Kyaw MH.Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008–2014.BMC Health Serv Res.2018;18:318. doi:10.1186/s12913-018-3139-1Alberta Health Services (Canada).Swimmer’s ear: care instructions.Kaya İ, Sezgin B, Eraslan S, et al.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-10. doi:10.5152/tao.2018.3075American Medical Association.Otolaryngology specialty description.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jackson EA, Geer K.Acute otitis externa: rapid evidence review.Am Fam Physician.2023;107(2):145-51.National Health Service (UK).Otitis externa.Hajiofff B, MacKeith S.Otitis externa,BMJ Clin Evid.2015;2015:0510.Gruber M, Damry D, Ibrahim N, Glikman D, Ronen O.Pediatric acute otitis externa: characteristics and predictors for hospital admission.Int J Pediatr Otorhinolaryngol.2021;140:110534. doi:10.1016/j.ijporl.2020.110534Victora Department of Health (Australia).Swimmer’s ear.Sakulchit T, Goldman RD.Antibiotic therapy for children with acute otitis media.Can Fam Physician.2017;63(9):685–7.Weigand S, Berner R, Schneider A, Lundershausen E, Dietz A.Otitis externa.Dtsch Arztebl Int.2019;116(13):224–234. doi:10.3238/arztebl.2019.0224Jamal A, Alsabea A, Tarakmeh M.Effect of ear infections on hearing ability: a narrative review on the complications of otitis media.Cureus.2022;14(7):e27400. doi:10.7759/cureus.27400Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Khatri H, Huang J, Guazzo E, Bond C.Review article: topical antibiotic treatments for acute otitis externa: emergency care guidelines from an ear, nose and throat perspective.Emerg Med Australas.2021;33(6):961–965. doi:10.1111/1742-6723.13874Navaneethan N, YaadhavaKrishnan RPD.Type of antifungals: does it matter in empirical treatment of otomycosis?Indian J Otolaryngol Head Neck Surg..2015;67(1):64–67. doi:10.1007/s12070-014-0780-9Bhutta MF, Head K, Chong LY, et al.Aural toilet (ear cleaning) for chronic suppurative otitis media.Cochrane Database Syst Rev.2020;9(9):CD013057. doi:10.1002/14651858.CD013057.pub2Bola S, Rashid M, Hickey S.Optimising the use of otowicks in otitis externa.J Laryngol Otol.2017;131(9):809-812. doi:10.1017/S002221511700144XTong S, Amand C, Kieffer A, Kyaw MH.Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008–2014.BMC Health Serv Res.2018;18:318. doi:10.1186/s12913-018-3139-1Alberta Health Services (Canada).Swimmer’s ear: care instructions.Kaya İ, Sezgin B, Eraslan S, et al.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-10. doi:10.5152/tao.2018.3075American Medical Association.Otolaryngology specialty description.
Jackson EA, Geer K.Acute otitis externa: rapid evidence review.Am Fam Physician.2023;107(2):145-51.
National Health Service (UK).Otitis externa.
Hajiofff B, MacKeith S.Otitis externa,BMJ Clin Evid.2015;2015:0510.
Gruber M, Damry D, Ibrahim N, Glikman D, Ronen O.Pediatric acute otitis externa: characteristics and predictors for hospital admission.Int J Pediatr Otorhinolaryngol.2021;140:110534. doi:10.1016/j.ijporl.2020.110534
Victora Department of Health (Australia).Swimmer’s ear.
Sakulchit T, Goldman RD.Antibiotic therapy for children with acute otitis media.Can Fam Physician.2017;63(9):685–7.
Weigand S, Berner R, Schneider A, Lundershausen E, Dietz A.Otitis externa.Dtsch Arztebl Int.2019;116(13):224–234. doi:10.3238/arztebl.2019.0224
Jamal A, Alsabea A, Tarakmeh M.Effect of ear infections on hearing ability: a narrative review on the complications of otitis media.Cureus.2022;14(7):e27400. doi:10.7759/cureus.27400
Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083
Khatri H, Huang J, Guazzo E, Bond C.Review article: topical antibiotic treatments for acute otitis externa: emergency care guidelines from an ear, nose and throat perspective.Emerg Med Australas.2021;33(6):961–965. doi:10.1111/1742-6723.13874
Navaneethan N, YaadhavaKrishnan RPD.Type of antifungals: does it matter in empirical treatment of otomycosis?Indian J Otolaryngol Head Neck Surg..2015;67(1):64–67. doi:10.1007/s12070-014-0780-9
Bhutta MF, Head K, Chong LY, et al.Aural toilet (ear cleaning) for chronic suppurative otitis media.Cochrane Database Syst Rev.2020;9(9):CD013057. doi:10.1002/14651858.CD013057.pub2
Bola S, Rashid M, Hickey S.Optimising the use of otowicks in otitis externa.J Laryngol Otol.2017;131(9):809-812. doi:10.1017/S002221511700144X
Tong S, Amand C, Kieffer A, Kyaw MH.Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008–2014.BMC Health Serv Res.2018;18:318. doi:10.1186/s12913-018-3139-1
Alberta Health Services (Canada).Swimmer’s ear: care instructions.
Kaya İ, Sezgin B, Eraslan S, et al.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-10. doi:10.5152/tao.2018.3075
American Medical Association.Otolaryngology specialty description.
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