Dr. Shapiro completed his undergraduate education at UC San Diego, earning a B.S. in Biochemistry and Cell Biology, and a B.A. in Political Science. He furthered his education at UCLA where he earned a Masters Degree in Public…
Swimmer's Ear (Acute Otitis Externa): Symptoms and Treatment
Posted in Fitness Goals by Dr. Jeremy F. Shapiro on Jul 08, 2011
Summer has arrived and with it the usual seasonal conditions have began to present themselves as well. One of the most common summer illnesses out there (and something I’ve been seeing over the past couple of weeks in my office) is acute otitis externa (AOE) which is also known as “swimmer’s ear.”

Now for those who don’t know, even though it typically is a mild illness, the pain associated from it can be rather intense (quite often more than what I will see from a middle ear infection that typically follows a cold). Not only will it lead to visits to the physician’s office, but sometimes the pain becomes so intense, emergency room and urgent care clinics often capture a lot of the visits because parents aren’t sure what to do.

Swimmer’s ear is an inflammation of the outer ear where the ear can become red, swollen, itchy, and as mentioned above, quite painful. Bacteria are the typical culprits but factors that predispose a child or adult to swimmer’s ear includes swimming (or any prolonged water exposure for that matter) as well as heat and humidity. What can happen is the skin of the outer ear (including the ear canal) becomes macerated from all the water exposure and any little trauma... scratching the ear with your finger or using a cotton-tip swab to remove the cerumen (AKA wax which is a general no-no)... will allow the bacteria to infect the area.

Treatment measures are rather straight-forward as typically antibiotic ear drops (often including a corticosteroid) for at least a week’s time are all that is needed. The general rule of thumb is the drops should be continued for a few days after the symptoms resolve. The catch during the treatment period is the child or adult needs to avoid submerging their head in water during the treatment period which is obviously not an easy task when your 6-year-old fish of a child wants to be in the pool all day long. In my experience, I have seen more tears from a child when I say they can’t go underwater swimming for the next week when compared to the actual pain from the infection.

As far as preventing swimmer’s ear, it’s pretty straight forward... keep the outer ear (again, including the ear canal) as dry as possible and try not to traumatize the ear (even a simple scratch from a fingernail). And for more specific tips, I leave you with some specific pointers from the Centers for Disease Control and Prevention (CDC):
- After swimming or bathing (particularly with children with long hair covering their ears), it is important to dry the ears thoroughly with a towel.

- Tilt your head and hold ear facing down to allow water to run out of the ear canal.

- Pull your earlobe in different directions while ear is face-down to help water drain out.

- OK to use a hairdryer on the lowest heat and lowest speed to move the air within the canal. But so important to keep the hairdryer a few inches from the ear when doing this.

- Never put objects in the ears... including cotton-tip swabs, pencils, fingers, etc.

- Leave the ear wax alone... it helps to protect the canal from infection.

And as far as using preventive ear drops (typically a commercial alcohol-based drop), I encourage you to discuss further with your child’s physician before using to see if it makes sense for your child.

Have a great summer.

Dr. Jeremy

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