Swimmer’s ear (otitis externa) is an inflammation and infection of the ear canal. It occurs when the protective film that covers the ear canal (lipid layer) is removed. This causes the ear canal to look red and swollen. The ear canal may be narrower than normal and is tender when the outside of the ear is gently pulled up and back.

Swimmer’s ear may develop when water, sand, dirt, or other debris gets into the ear canal. Since it often occurs when excess water enters the ear canal, a common name for this inflammation is “swimmer’s ear”. If you have had swimmer’s ear in the past, you are more likely to get it again.

A rare but serious infection called malignant external otitis can develop if bacteria invade the bones inside the ear canal and spread to the base of the skull. Not many people get this infection — it is mainly seen in older adults who also have diabetes, people who have HIV, and children who have impaired immune systems — but it can be fatal. Symptoms include ear pain with sudden facial paralysis, hoarseness, and throat pain. Antibiotics are used to treat this infection.

Other causes of inflammation or infection of the ear canal include:

• Allergies
• Bony over growths in the ear canal called exostoses
• Bubble baths, soaps, and shampoos
• Cleaning the ear canal harshly or with a sharp object
• Headphones inserted into the ear
• Scratching the ear canal with a cotton swab, bobby pin, fingernail, or other sharp object
• Skin problems, such as eczema, psoriasis, or seborrhea
• Sweating

Swimmer’s ear is more likely if you have a very narrow or hairy ear canal, live in a warm, humid climate, have impacted earwax, or have had a head injury that also injured your ear.

Symptoms can include:

• Itching
• Pain
• A feeling of fullness in the ear
• Your ear canal may be swollen
• You may have moderate to severe pain, drainage, or hearing loss

Unlike a middle ear infection, the pain is worse when you chew, press on the “tag” in front of the ear, or wiggle your earlobe.

Symptoms often get better or go away with home treatment.

• Gently rinse the ear using a bulb syringe and warm saline solution or a half-and-half solution of white vinegar and warm water. Make sure the flushing solution is body temperature. Inserting cool or hot fluids in the ear may cause dizziness.
• If your ear is itchy, try non-prescription swimmer’s eardrops, such as Star-Otic. Use them before and after swimming or getting your ears wet.
• To ease ear pain, apply a warm face cloth or a heating pad set on low. There may be some drainage when the heat melts earwax. Do not use a heating pad on a child.
• Do not use ear candles. They have no proven benefit in the removal of earwax or other objects in the ear and can cause serious injury.

See your doctor if:

• Ear pain persists or gets worse
• The ear canal, the opening to the ear canal, the external ear, or the skin around the external ear becomes swollen, red, or very painful
• Drainage from the ear that does not appear to be earwax develops
• Drainage from the ear that smells bad develops
• Dizziness or unsteadiness develops
• Ear discomfort lasts for longer than 1 week
• Symptoms become more severe or frequent