Surf Cat

The dog days of summer are here. After so many fun days of swimming in the pool, boogie boarding in the surf and wakeboarding at the lake, it hits. And it pierces like a spear.

“OUCH! Mom! My EAR hurts! It really HURTS!”

After a quick trip to see your doc, a diagnosis is delivered. The verdict? Swimmer’s ear.

What Is Swimmer’s Ear?

Swimmer’s ear, also known as otitis externa, is an infection of the ear canal. Unlike otitis media, the more common ear infection that affects the middle ear (and is closely associated with colds and commonly seen in the winter), swimmer’s ear is associated with excessive water exposure and is most commonly seen in the swimming months of summer.

What Causes Swimmer’s Ear?

Swimmer’s ear is most commonly caused by a bacterial infection. Frequent water exposure can cause the lining of the ear canal to break down and allow bacteria to infect.

In some cases, the moist environment caused by wet ear canals will allow a fungus to grow among us.

How Is It Diagnosed?

A doctor can usually diagnose swimmer’s ear by taking a history and doing a quick exam. Early on, kids may complain that their ear is itchy. As the infection progresses, the ear becomes very sensitive to the touch. The doctor usually suspects otitis externa when he pulls (or presses) on the outside of the ear and it elicits pain.

The ear canal may be filled with debris or pus. If discharge is present, the doctor may take a culture to help identify the presence of a bacteria or fungus.

What Can Be Done to Treat Swimmer’s Ear?

Once a diagnosis has been made, the doctor will prescribe treatment based on the cause of the infection. The most common remedy for bacterial swimmer’s ear is a prescription for eardrops that contain both an antibiotic (to kill the bacteria) and a steroid (to help reduce inflammation, swelling and pain). Pain relievers, such as ibuprofen or acetaminophen, may also be prescribed. During the treatment period, the doctor will likely recommend keeping the ears dry.

If you fail treatment with the antibiotic/steroid drops, it might be because you kept swimming or because you have a fungal infection. Either way, please be sure to go back to see your doctor.

Fungal infections can be a little trickier to diagnose and treat, but with a little help from your friendly ENT (Ear, Nose and Throat) specialist you can get started on some topical antifungals and possibly some sessions to suck the fungus out of the canal (yuck!).

What Can Be Done to Prevent Swimmer’s Ear?

If you are in the water regularly, you might consider using a preventive swimmer’s eardrop. These drops are usually purchased over-the-counter (they are not antibiotics), and they work by helping to dry out the ear canals between swims.

Most of these remedies contain rubbing alcohol, and they work by “flushing out” the water from the canal. Once the drops flush the water out of the canal, the alcohol residue will evaporate, essentially “drying out” the ear.

What About Earwax?

My childhood pediatrician taught me to never stick anything smaller than my elbow into my ear canal (cotton swabs are a no-no). While most people dislike earwax, I am actually a big fan. While you might think I am gross, I like to think of earwax as nature’s way of waterproofing our ear canals. If you leave your earwax alone, it might just help prevent you from getting swimmer’s ear.

Dr. B’s Recommendations

Summertime should be a time to enjoy the water. If you are worried about getting swimmer’s ear, here is what I would recommend:

» Leave the wax alone. It’s in your ear for a reason, and if your doctor needs to remove it (at your next checkup), he has tools to safely do it.

» Buy an inexpensive bottle of over-the-counter, rubbing alcohol-based eardrops to dry out your ears after swimming. You don’t need to use the drops every time you go in the pool, but if you keep it in your swim bag you will have a better chance of remembering to use them.

» If you develop ear pain (and you suspect swimmer’s ear) don’t self-treat with the alcohol-based drops (they’ll sting like nothing else!). The second “don’t” is don’t wait too long to see the doctor.

» If you start treatment right away, the infection will clear up sooner and you’ll miss less pool time.

Don’t let your summer turn into a bummer. When in doubt, call your doc to get it checked out. During this time of year, we expect to see lots of swimmer’s ear, and we have operators standing by.

— is a board-certified pediatrician and a Santa Barbara native who enjoys swimming with his wife and three boys. He can be contacted at 805.563.6211, or about Santa Barbara Pediatrics. The opinions expressed are his own.