What you’ll learn
We’ll help you recognize the symptoms of swimmer’s ear, understand when ear pain needs medical attention, and explore treatment options from ear drops to home care. You’ll learn how to prevent future outer ear infections, spot warning signs of complications, and discover how QuickMD’s virtual urgent care can provide fast relief.
That sharp, throbbing pain in your ear after a day at the pool or beach may not be just an annoyance. It could easily be swimmer’s ear.
If your ear feels sore to the touch, sounds are muffled, or there’s drainage or itching, you’re not imagining it. These are common signs of an outer ear infection, and getting it checked early can bring faster relief.
Swimmer’s ear, called otitis externa, is an infection of your outer ear canal that’s surprisingly common. It doesn’t just affect competitive swimmers, either. Just being in humid weather, showering frequently, or cleaning your ears too aggressively with cotton swabs can be enough to trigger it.
The good news? Most cases clear up quickly with the right treatment. But swimmer’s ear can sometimes look and feel like other ear infections, especially middle ear infections (otitis media). Knowing the difference matters. It can help you avoid unnecessary pain and complications, and get the care you actually need.
At QuickMD, we regularly help patients identify and treat ear infections through secure virtual urgent care visits. Whether you’re unsure if it’s serious or just want relief that actually works, you can talk to a QuickMD provider from home, often the same day, so you can feel better faster.
In this guide, you’ll learn how to recognize swimmer’s ear symptoms, understand your treatment options from ear drops to home care, and know exactly when ear pain requires more attention. Let’s start with the basics: What is exactly is swimmer’s ear, and how do you know if that’s what’s causing your discomfort?
What is swimmer’s ear (otitis externa)?
Swimmer’s ear is an infection that affects your outer ear canal, the tube that runs from your outer ear to your eardrum.
Unlike a middle ear infection that happens behind the eardrum, swimmer’s ear develops in the skin lining of your ear canal itself. The medical term otitis externa literally means inflammation of the outer ear, and that’s exactly what’s happening.
When water gets trapped in your ear canal, it creates the perfect environment for bacteria or fungi to multiply. The warm, moist conditions allow these microorganisms to irritate and infect the delicate skin inside your ear.
The condition gets its name because it’s common among people who spend lots of time in water. Understanding the risk factors can help:
- Taking frequent showers or baths
- Living in humid environments
- Accidentally scratching your ear canal with cotton swabs or other objects
- Use of hearing aids or ear plugs
- Flushing ear from cerumen or foreign bodies
- Prolonged swimming, particularly in fresh water
The infection typically starts as mild irritation but can progress if the moisture problem isn’t addressed. That’s why early recognition and proper treatment matter. Catching swimmer’s ear in its early stages usually means faster relief and fewer complications.
Most cases are caused by bacterial infections, particularly Pseudomonas and Staphylococcus bacteria that naturally live on your skin. Pseudomonas is commonly found in water and damp places, while Staphylococcus (or “Staph”) is often found on the skin. In some cases, fungal infections can cause similar symptoms, especially if you’ve been in polluted water or have irritated or broken skin in your ear canal.
Understanding what swimmer’s ear actually is helps explain why certain treatments work and others don’t, and why the symptoms can feel so distinct once you know what to look for.
Swimmer’s ear symptoms: how to know if your ear pain needs attention
The telltale sign of swimmer’s ear is pain that gets worse when you touch or pull on your outer ear. This simple test, gently tugging on your earlobe or pressing on the small cartilage in front of your ear canal, can help distinguish swimmer’s ear from other types of ear infections.
But don’t just rely on ear pain alone. Swimmer’s ear usually starts mild and ramps up over time, so catching it early can save you from days of pain.
Watch for these early signs of swimmer’s ear:
- Itching deep in your ear canal
- Slight redness inside your ear
- Mild discomfort that gets worse when you touch your ear
- Clear, odorless drainage
- Sensation of ear canal fullness
- Hearing loss
As things get worse, you might notice:
- Intense ear pain that shoots to your face or neck
- Muffled hearing or that “stuffed up” feeling
- Thick, smelly discharge that’s yellow or green
- Swelling around your ear canal
- Fever (though this is less common with outer ear infections)
One key characteristic of swimmer’s ear is that the pain typically gets worse when you chew, yawn, or move your jaw. That’s because these movements affect the infected skin in your outer ear canal.
The drainage is another important clue. While any ear infection can cause discharge, swimmer’s ear drainage often has a distinct smell and may increase when you move your head or lie on the affected side.
Other signs that swimmer’s ear symptoms signal something more serious
Most swimmer’s ear cases are straightforward, but certain symptoms suggest you need medical attention right away. Severe pain that keeps you awake, fever above 100.6°F, or red streaking around your ear could indicate the infection is spreading beyond your ear canal.
If you notice swelling that extends to your face or neck, or if you develop severe headaches along with ear symptoms, these could be signs of a rare complication called malignant otitis externa (MOE).
What is malignant otitis externa?
Malignant otitis externa is a more severe form of swimmer’s ear where the infection spreads beyond your ear canal into the surrounding bone and tissue. While rare, it’s most dangerous for people with diabetes or weakened immune systems. If you have diabetes or immune system problems, don’t wait to get your ear pain checked out.
Watch for these warning signs of malignant otitis externa that need immediate attention from a healthcare provider:
- Severe, unrelenting ear pain that doesn’t respond to pain medication
- Facial weakness or drooping
- Persistent high fever
- Granulation tissue (looks like small, red bumps) in your ear canal
- Symptoms that rapidly worsen despite treatment
Malignant otitis externa is uncommon in healthy people and almost always preventable with prompt treatment of regular swimmer’s ear. The key is recognizing that swimmer’s ear symptoms usually start mild and gradually worsen. If you catch it early, when you’re just noticing itching or mild discomfort, treatment is typically simpler.
Now that you know what swimmer’s ear looks and feels like, let’s talk about what actually causes it and who’s most likely to deal with it.
What causes swimmer’s ear, and who’s at risk?
The main cause is pretty straightforward. Water gets trapped in your ear canal and can’t drain out properly. When that happens, bacteria that normally live harmlessly on your skin suddenly have the perfect warm, moist environment to multiply and cause trouble.
Your ears actually have some built-in protection. Earwax acts like a natural water repellent and keeps the environment slightly acidic, which bacteria don’t love. Your ear canal even slopes downward a bit to help water flow out on its own. But when something disrupts these defenses, that’s when infections can take hold.
What are the most common swimmer’s ear triggers?
Swimming in contaminated water creates obvious risk, but everyday activities cause problems too. Hot tubs with poor chemical balance, exposure to dirty water, aggressive ear cleaning with cotton swabs, or even just living somewhere humid can set you up for swimmer’s ear.
Who gets swimmer’s ear most often?
Kids and teens face a higher risk of swimmer’s ear because their ear canals are narrower, making drainage harder. But adults who swim frequently, shower with very hot water, or work in steamy environments deal with it regularly, too.
If you’ve had swimmer’s ear before, you’re more likely to get it again, especially if you haven’t changed whatever caused it the first time.
Have more health questions? Our Learning Center has answers on everything from weight loss treatments, addiction medicine, and common illnesses.
Swimmer’s ear vs middle ear infection
Telling the difference between swimmer’s ear and a middle ear infection matters because they’re treated differently.
Here’s a closer look at the differences.
| Symptom | Swimmer’s ear | Middle ear infection |
| Touch test | Pain worsens when pulling on outer ear | No pain when touching outer ear |
| Cold symptoms | Rarely present | Often includes stuffy nose, sore throat |
| Drainage | Common throughout infection | Only if eardrum ruptures |
| Age | Affects all ages equally | More common in children under 3 |
| Pain pattern | Persistent or worsening | Often decreases if eardrum ruptures |
The touch test is your best diagnostic clue. Gently pull on your outer ear. If this makes the pain worse, it’s likely swimmer’s ear.
The best treatment for swimmer’s ear
Antibiotic ear drops
Your provider will likely prescribe ear drops designed for outer ear infections.
Common options include aminoglycoside drops such as neomycin or gentamicin or quinolone drops such as ciprofloxacin or ofloxacin, often paired with anti-inflammatory medications. Treatment typically involves several drops 2-3 times daily for about a week.
How to use ear drops effectively
- Warm drops to room temperature before use.
- Gently pull your outer ear up and back to straighten the ear canal.
- Let drops fall in without forcing them.
Managing swimmer’s ear pain and discomfort
Over-the-counter ibuprofen or acetaminophen can help manage discomfort. Ibuprofen also reduces inflammation, which can help restore hearing faster.
When you might need oral antibiotics for swimmer’s ear
Sometimes the infection spreads beyond your ear canal or affects people with compromised immune systems (malignant otitis externa), requiring additional oral antibiotics.
Home care for swimmer’s ear that helps
- Keep your affected ear as dry as possible during treatment.
- Avoid swimming and use a shower cap when bathing.
- Don’t use cotton swabs like Q-tips to clean your ears. This can push infected material deeper and even rupture your eardrum.
How to prevent swimmer’s ear
The best way to deal with swimmer’s ear is to prevent it in the first place.
Most prevention strategies focus on keeping your ears dry and protecting the natural barriers that keep bacteria away.
Keep water out when possible:
- Use a swimming cap that covers your ears.
- Dry your ears thoroughly after swimming or showering.
Protect your ears’ natural defenses:
- Don’t clean your ears with cotton swabs. They remove protective earwax.
- Avoid putting anything in your ear canal.
- Choose well-maintained pools over questionable water sources.
If you keep getting swimmer’s ear despite taking precautions, there might be underlying factors like narrow ear canals that may need addressing.
When to see a doctor for possible complications from swimmer’s ear
While mild swimmer’s ear sometimes improves with careful ear care, certain symptoms could point to more severe cases, and they mean you shouldn’t wait to get professional help.
See a provider if you notice symptoms like these:
- Severe pain that interferes with sleep or daily activities
- Fever above 100.6°F
- Red streaking around your ear, swelling extending to your face or neck, or swollen lymph nodes
- Thick, green, or bloody discharge, or drainage that suddenly increases or develops a foul smell
- Symptoms that persist or worsen after 2-3 days of home care
- Hearing loss that doesn’t improve, or new symptoms like dizziness or ringing
Seek immediate care for these red flag symptoms:
- Sudden severe headache with ear symptoms (could indicate malignant otitis externa)
- Facial weakness, severe dizziness, or high fever with ear pain
Again, higher-risk individuals should seek care sooner. If you have diabetes, a compromised immune system, or other health conditions, don’t wait to see if symptoms improve.
Safe activities and precautions during treatment
To help your ear heal and avoid making the infection worse, follow these simple guidelines while you’re being treated for swimmer’s ear:
- Resist manipulating the ear. Avoid touching it or messing with it to help it heal faster.
- Keep ear dry (e.g. using ear plugs or a cotton ball with Vaseline before showering or swimming).
- After swimming or bathing, a hair dryer on the lowest heat setting, held at a safe distance, can help remove moisture.
- No water sports for 7-10 days during treatment.
- Swimming in pool may be allowable in mild cases, but avoid long periods under water.
- Limit use of ear phones and hearing aids until infection has cleared. If you need to use them, make sure they’re clean and limit wear until your ear is fully healed.
How QuickMD can help diagnose and treat your ear infection
Dealing with ear pain doesn’t have to mean sitting in a crowded waiting room. You can consult a healthcare provider online. Our virtual urgent care makes it easy to get expert evaluation and treatment from home.
During your video visit, licensed providers can assess your symptoms and determine whether you’re dealing with swimmer’s ear or another condition. If antibiotic ear drops are needed, your prescription can be sent directly to your local pharmacy within minutes.
Same-day appointments are available 7 days a week, so you don’t have to endure pain while waiting for care. Whether it’s your first case of swimmer’s ear or a recurring infection, getting prompt treatment helps you feel better faster.
Frequently asked questions about swimmer’s ear
Can you give someone a swimmer’s ear?
No, you can’t pass swimmer’s ear to someone else. Swimmer’s ear is not contagious like a cold or flu. The bacteria that cause swimmer’s ear are already living on everyone’s skin.
They only become a problem when water gets trapped in your ear canal, creating the perfect environment for them to multiply. So you don’t need to avoid people with swimmer’s ear or worry about spreading it to your family.
But multiple people can get swimmer’s ear from the same contaminated water source, like a poorly maintained pool.
What position should you sleep in with swimmer’s ear?
Sleep with your infected ear facing up. This helps any drainage flow out and takes pressure off the sore ear canal.
Propping yourself up with an extra pillow can help with drainage, too. Whatever you do, don’t sleep on the infected ear. That just traps moisture and makes the pain worse. If both ears are bothering you, try sleeping slightly upright or switching sides during the night.
Can swimmer’s ear go away by itself?
Very mild cases might clear up if you keep your ear bone dry, but swimmer’s ear infections need antibiotic treatment to actually get better. Without proper treatment, the infection can get worse, spread beyond your ear canal, or turn into a chronic problem. Since swimmer’s ear can cause serious pain and potentially dangerous complications, it’s best to get it checked out and get ear drops, rather than hoping it disappears.
