Swimmer's Ear v. Ear Infection

June 7, 2019

by Dr. Joe Kahn, Mercy Kids president

Summer break is in full swing with pools, lakes and oceans ready for kids to be in the water. Although most children enjoy swimming with no problems, some might develop otitis externa – swimmer’s ear.

Swimmer’s ear is an infection involving the sensitive, skin-lined ear canal. This part of the ear produces wax that can help clean and waterproof the canal and that provides an acidic pH, giving it an antibiotic effect to help fend off infections.

Disruption to the healthy environment of the canal causes swimmer’s ear. Moisture breaks down the protective layer of wax and leads to swelling of the canal skin, allowing bacteria to enter and cause inflammation and infection. Warmer summertime temperatures and swimming offer the perfect setting to develop swimmer’s ear. An infection can develop even after exposure to pools’ clean, chlorinated water.


A child complaining of ear pain, regardless of the cause, should be evaluated by a physician. A history of recent swimming and/or manipulation of the ear canal will raise the suspicion of swimmer’s ear. It can sometimes be difficult to distinguish between swimmer’s ear and a middle ear infection, which is more common in cold-weather months after an upper respiratory infection. If moving your child’s ear up and down causes pain and he or she has recently been swimming, it’s most likely swimmer’s ear.

Treatment of swimmer’s ear is usually handled by your child’s pediatrician; only complicated cases require a referral to an ear, nose and throat specialist, also known as an ENT or otolaryngologist. The most common treatment is the application of antibiotic eardrops. During treatment, swimming should be avoided, and when your child bathes, the canal can be protected with a petroleum jelly-covered cotton ball. Pain is the dominant symptom and can be treated with acetaminophen or ibuprofen.

If your child suffers from recurrent swimmer’s ear, preventive measures can be taken, such as getting all water out of the ear after swimming and using over-the-counter swimmer’s eardrops to evaporate any residual water in the ear canal. Using earplugs is generally not recommended to manage swimmer’s ear because it may cause mild trauma to the ear canal and can lead to impaction of earwax.

If the proper precautions are taken, your child can enjoy a fun and pain-free summer of swimming.

My thanks to Dr. Jim Forsen, pediatric otolaryngologist at Mercy Children’s Hospital, for his input on this article.