Risk Factors

Symptoms

Otitis Externa

(Swimmer’s Ear)

by Amy Scholten, MPH

Definition

Otitis externa is redness and swelling of the ear canal. The ear canal is the tube leading from the outer ear to the eardrum.

Otitis externa may be:

Short-term (acute)
Long-term (chronic)

Some people develop malignant otitis externa. This is an infection of tissue and bone around the ear and skull base. If left untreated, it can be life-threatening.

Regions of the Ear

Causes

Otitis externa is caused by infection, irritation, or damage to the ear canal.

Risk Factors

The acute type is more common in children. Risks for otitis externa are:

Getting water in the ear—especially from swimming or bathing
Sweating
Putting objects in the ear
Burns to the ear
Soap in the ear
Blockage in the ear canal from:
- Impacted ear wax
- Cysts
- A defect, or too much ear hair
Having health conditions, such as:
- Diabetes
- Weak immune system
- Skin problems—such as seborrheic dermatitis, eczema, or psoriasis
- A middle ear infection—otitis media
- Emotional stress

Symptoms

This condition may cause:

Drainage from the ear
Redness or itching inside the ear canal
Pain in the ear
Hearing loss or a plugged-up feeling in the ear

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. The doctor will look in the ear with a lighted device. An ear swab may be done to check for infection.

If the doctor suspects malignant otitis externa, scans may be done, such as CT scan, MRI and bone scans. Other tests may also be done.

Treatment

The goal of treatment is to ease symptoms and clear any infection.

Options may be:

Medications

The doctor may advise:

Pain medicines
Antibiotic ear drops—to treat infection
Antifungal medicines by mouth— to treat fungal infections
Antibiotics by mouth or IV—for severe infections
Corticosteroid ear drops to reduce inflammation

If the ear canal is very swollen, a small sponge may be inserted in it. It will absorb the drops. It is usually removed after 24 to 48 hours.

If treatments do not work, drainage may be removed from the ear canal. This is rarely needed.

Surgery

Malignant otitis externa needs hospital care right away. Surgery may be needed if:

The infection spreads to the base of the skull
There is a bone abscess
Other treatments do not work

Dead tissue may also need to be removed.

Prevention

The risk of this condition may be lowered by:

Keeping water and objects out of the ear, if possible
Using acetic acid ear drops
Draining and drying ears after swimming or showering

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

Canadian Society of Otolaryngology
http://www.entcanada.org

Health Canada
https://www.canada.ca

References:

Otitis externa. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/otitis-externa . Accessed January 29, 2021.

Otitis externa (swimmer's ear). National Center for Emergency Medicine Informatics website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.

Prentice P, et al. American Academy of Otolaryngology: head and neck surgery foundation clinical practice guideline on acute otitis externa 2014. Arch Dis Child Educ Pract Ed. 2015 Aug;100(4):197.

Rosenfeld RM. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014 Feb;150(2):161-8.

Swimmer’s ear. American Academy of Otolaryngology—Head and Neck Surgery website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.

Swimmer’s ear (otitis externa). Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.

Last reviewed September 2020 by EBSCO Medical Review Board Shawna Grubb, RN
Last Updated: 2/22/2021

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.