Ask the pediatrician: Surprising facts about swimmer’s ear

Swimmer’s ear is different than a typical middle ear infection.

Antibiotic drops — and keeping ears dry — is the general treatment.

Swimmer’s ear can also be caused by a scratch in the ear canal, so don’t put things in your ears.

There’s nothing that spoils a kid’s fun day at the pool or beach like swimmer’s ear. This painful earache isn’t your garden variety ear infection, and it needs to be treated differently. Sherry Baker, MD, a pediatrician at Providence Pediatrics Associates-Northpointe in Spokane, WA, shares some salient facts about swimmer’s ear. Some of them may surprise you.

Swimmer’s ear affects a different part of the ear canal than a typical ear infection.

An ear infection often starts when you have a cold or flu virus, and bacteria grows in the middle ear (the area behind the eardrum). A swimmer’s ear infection, on the other hand, is caused when bacteria grows and divides in the ear canal (the space between the ear and the eardrum) or on the ear.

Swimmer’s ear gets treated differently than a regular ear infection.

Pediatricians often wait before treating middle ear infections with oral antibiotics, because the infection may resolve on its own and there’s the risk of developing antibiotic-resistant bacteria or side effects if they are used too much. However, because a swimmer’s ear infection is in the outer ear canal, it can be treated locally with antibiotic drops.

“We also recommend keeping the ear dry during the antibiotic treatment, so no swimming for seven to 10 days,” Dr. Baker says. To ease pain, try over-the-counter medicines such as ibuprofen or Tylenol or warm packs or cool packs on the affected ear.

There are some symptoms specific to swimmer’s ear.

If your child is complaining of ear pain, you may be able to deduce that swimmer’s ear is the culprit with a couple of telltale signs. “The bacteria from swimmer’s ear sometimes produce pus, so sometimes there will be pus or fluid coming out of the ear; you may see it crusting on the side of the face or in the hair by the ear,” Dr. Baker says. “You won’t see that in a middle ear infection, except in cases where the eardrum ruptures open.

If there’s pain with movement of the ear, that also indicates there may be a problem in the outer ear canal. Pediatricians can look in the ear canal and if the canal walls look inflamed or irritated, or have pus developing, those are ways to diagnose swimmer’s ear.”

Earplugs aren’t necessarily the best preventive measure.

Dr. Baker says wearing earplugs while swimming isn’t the best deterrent against infection, they can increase the risk for infection if worn frequently by injuring the skin, similar to headphones. “I would recommend carefully drying the ears after swimming and bathing, using a towel; kids can also shake the excess water from their ears,” she says.

You can get swimmer’s ear without getting wet.

Despite the name, a swimmer’s ear infection can also develop from a scratch on the outer ear canal. For parents, that means making sure their kids don’t stick anything in their ears and not to clean a child’s ears with an object such as a cotton swab. “Don’t clean ears with anything that can cause injury or scratches (fingers, cotton swabs, or other foreign objects),” Dr. Baker says. “Cotton swabs can actually push earwax deeper into the ear canal where it can harden and accumulate. Earwax is normal and protects the ear canal by cleaning and removing foreign material from the ear.”

Parents who think their child has too much earwax can talk to their pediatrician about over-the-counter wax removal kits such as Debrox or home remedies, such as applying room temperature olive oil to the ears with a dropper to soften the wax so it comes out of the ear more easily. In extreme cases, a doctor can remove the earwax during an office visit. To be safe, Dr. Baker says a very good recommendation is, “Don’t put anything smaller than your elbow in your ear.”

A swimmer’s ear infection can spread.

“If you have an infection somewhere it can extend to other places, and with the location of the ears you don’t want it to extend to an infection in the bone or, in rare cases, meningitis,” Dr. Baker says. “That’s the reason why we want parents to bring in their children if they have an earache, so we can evaluate them and see what kind of infection it is.”

Childhood earaches don’t have to be a pain for parents. Get answers to questions about pregnancy- and child-related health topics with the Circle by Providence app.

You can also find a pediatrician conveniently located near you with our physician directory.

WA: Providence Pediatrics; Providence Pediatric Associates – Spokane, Northpointe

OR: Providence Children’s Health

MT: Grant Creek Family Medicine

CA: Providence Pediatrics; St. Joseph Health Pediatrics, Northern California; St. Joseph & St. Jude Heritage Medical Group

AK: Children’s Hospital at Providence

Need to see a provider today? Providence Express Care clinics offer same-day appointments for common ear, nose and throat issues.

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.