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Ear - Swimmer's  
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Does this describe your symptoms?

Definition
  • Painful or itchy ear
  • Pain increases when ear moved up and down
  • Swimming recently or use Q-tips frequently

General Information

  • Otitis externa is an infection of the skin that lines the ear canal. It is also referred to as Swimmer's Ear.
  • When water repeatedly gets trapped in the ear canal, the lining becomes wet and swollen. This makes it prone to superficial infection (Swimmer's Ear). Ear canals are meant to be dry.
  • Wax (cerumen) is produced by the ear canal as a natural water-proofing agent. Frequent use of cotton ear swabs depletes the wax barrier and increases the likelihood of developing otitis externa. On the other hand, excessive amounts of ear wax can inhibit water drainage from the ear, leading to skin break down, which leads to development of otitis externa.  

If not, see these topics
  • EARACHE and your symptoms do not match the Main Symptoms described above

When to Call Your Doctor

Call Your Doctor Now (night or day) If
  • You feel weak or very sick
  • Severe pain
  • Fever
  • Redness and swelling of outer ear
  • Have diabetes mellitus or a weakened immune system (e.g., HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think you need to be seen
  • Yellow discharge from ear canal
  • Blocked ear canal or decreased hearing
  • Swollen lymph node near ear
  • Cause is uncertain
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
Self Care at Home If
  • Preventing swimmer's ear, questions about
  • Swimmer's ear with no complications and you don't think you need to be seen
HOME CARE ADVICE

Treatment of Swimmers Ear
  1. White Vinegar Rinses. Vinegar (acetic acid) restores the normal acid pH of the ear canal. This helps Swimmer's Ear to get better. Rinse the ear canals twice daily with 1/2-strength white vinegar (dilute it with equal parts water). Here are some instructions on how to do this:
    • Lie down with the affected ear upward. Fill the ear canal.
    • After 5 minutes, remove the fluid by tilting the head to one side and gently pulling on the ear.
    • Continue doing this twice daily until the ear canal returns to normal.
    • CAUTION: Do not do use if you have ear tubes or hole in eardrum.
  2. Pain Medication:
    • For pain relief, take acetaminophen or ibuprofen.
    • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
    • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
    • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
    • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • CAUTION: Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  3. Local Heat: If pain is moderate to severe, apply a heating pad (set on low) or hot water bottle (wrapped in a towel) to outer ear for 20 minutes (Caution: avoid burns). This will also increase drainage.
  4. Avoid Earplugs: If pus or cloudy fluid is draining from the ear canal, wipe the pus away as it appears. Avoid plugging with cotton (Reason: retained pus causes irritation or infection of the ear canal).
  5. Avoid Swimming: Try to avoid swimming until symptoms are gone.
  6. Contagiousness: Swimmer's ear is not contagious.
  7. Expected Course: With treatment, symptoms should improve in 3 days and resolve within 7 days.
  8. Call Your Doctor If:
    • Ear symptoms last longer than 7 days with treatment
    • You become worse
Prevention of Swimmers Ear
  1. Prevention - Keep Ear Canals Dry:
    • Try to keep your ear canals dry.
    • After showers, hair washing, and swimming, help the water run out by tilting the head to one side. You can also use a hair dryer set on the lowest setting to dry out your ears.
  2. Prevention - Avoid Cotton Swabs:
    • Avoid cotton swabs (i.e., Q-Tips, cotton tip applicator).
    • These remove the protective earwax of the ear canal.
  3. Prevention - Rinse Ear Canal with Vinegar After Swimming:
    • After swimming, place several drops of 1/2-strength white vinegar (dilute it with equal parts water) in your ear canals.
    • After 5 minutes, remove the fluid by tilting the head to one side and gently pulling on the ear.
    • REASON: Vinegar (acetic acid) restores the normal acid pH of the ear canal.
    • INDICATION: You may want to try this if you tend to get swimmer's ear frequently.
    • CAUTION: Do not use if you have ear tubes or hole in eardrum.

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 1/19/2009

Last Revised: 4/5/2008

Content Set: Adult HouseCalls Online

Portions Copyright 2000-2009 Self Care Decisions LLC; Copyright LMS, Inc.

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