Kenneth C. Iverson
University of Kentucky
Summer brings plenty of opportunities for kids to swim and play outside, but all that time in the water can also raise the risk of swimmer’s ear. Don’t let it interrupt your child’s fun.
What is swimmer’s ear?
Otitis externa, also known as swimmer’s ear, is an infection affecting the outer ear canal. The infection often develops after swimming or other activities that let water into the ears. Trapped moisture in the ear creates an environment where bacteria can grow. At the same time, the skin lining the outer ear canal can soften, making it easier for bacteria to enter and cause infection.
Some children are more susceptible to swimmer’s ear for reasons that are not always clear. Damage to the outer ear canal — sometimes caused by the misuse of cotton swabs — as well as conditions like eczema and seborrheic dermatitis can increase a child’s risk of developing swimmer’s ear.
What are the symptoms?
Mild cases of swimmer’s ear leave children feeling itchy, slight redness inside the ear and fluid drainage. Children may also feel discomfort that worsens by touching or pulling on the ear, which is distinct from ear pain caused by a typical middle ear infection.
More severe cases may include severe pain and itchiness, a sensation of fullness inside the ear, partial or complete blocking of the outer ear canal, redness or swelling of the outer ear, drainage of thick and cloudy fluid, decreased hearing, swelling of the lymph nodes or fever.
How is swimmer’s ear treated?
Cases of swimmer’s ear are typically mild and respond well to treatment but should be examined and treated by a doctor. Before seeing a pediatrician, you can help manage your child’s pain at home with acetaminophen or ibuprofen.
A doctor can remove infected fluid pus or debris from the ear canal and may prescribe ear drops to treat the infection and reduce swelling and pain. Severe cases may require frequent suctioning of debris.
Other treatment options include oral antibiotics and placement of a wick into the ear canal to help drops reach deeper into a blocked canal.
Avoid getting water in the ear during the treatment process and dry the ears and reapply drops after bathing.
Preventing swimmer’s ear
Most children do not need to take special precautions unless they have recurrent infections or a recent infection. If so, limit time in the water to less than an hour and dry excess water from the outer portion of the in ears with a clean towel or a hair dryer on a cool setting.
Sometimes, certain topical drops can be used after water exposure but consult your doctor to determine which would be appropriate for your child — especially if your child has ear tubes or a hole in the eardrum.
Over-the-counter or custom-made ear plugs can be used as well to prevent prolonged water exposure to the ear canal for children who are susceptible.
Avoid using cotton swabs or other devices that can remove too much ear wax or cause small injuries in the ear canal, creating an opening for bacteria to enter the skin. Ear wax is a natural measure of protection against swimmer’s ear as its oily properties help repel water and has characteristics that naturally resist microbes.
While a case of swimmer’s ear may be unavoidable for some children, recognizing the signs early and seeking proper treatment can help keep a minor infection from disrupting summertime activities.
Kenneth C. Iverson is a chief of pediatric otolaryngology for Golisano Children’s at UK.