Medical Edge from Mayo Clinic

DEAR MAYO CLINIC:

What is swimmer's ear and are those who get it more likely to get a repeat infection? My son is 12 and seems to get this every summer.

ANSWER:

Swimmer's ear is an infection of the skin in the ear canal (external auditory canal). It's usually caused by water becoming trapped within the ear. Some people may be more likely to get swimmer's ear repeatedly because of the structure of their ear canal. But several preventive measures may help reduce your son's chances of developing swimmer's ear in the future.

Swimmer's ear (also known as acute external otitis or otitis externa) differs from the middle ear infections (otitis media) that many children get when they are infants and toddlers. Instead of an infection within the lining of the middle ear, swimmer's ear affects the thin layer of skin that lines the outer ear canal. Naturally occurring bacteria normally reside within your ear canal without causing problems. But when water becomes trapped in the canal, the warm environment becomes a perfect breeding ground for microorganisms resulting in overgrowth of bacteria and fungi that can lead to infection.

The inflammation of the skin caused by swimmer's ear can be very painful. One classic symptom of swimmer's ear is that the pain increases when you move the outside of your ear. On the contrary, moving the outer ear typically doesn't affect the pain caused by middle ear infections. Other symptoms of swimmer's ear may include redness and swelling of the ear canal and drainage from the ear.

As the name implies, swimmer's ear often occurs after a person has spent time in water, which results in excess moisture in the ear canal. In particular, swimming in water with higher bacteria levels, such as a river or lake rather than a pool, can increase the risk of developing swimmer's ear.

Water usually drains out of the ear easily because the ear canal slopes slightly downward from the middle ear to the outer ear. But a child's ear canal is smaller and can trap water more easily. In addition, some people have ear canals that are slightly crooked, increasing the likelihood that water will become trapped within the canal.

Fortunately, most cases of swimmer's ear can be treated quickly and effectively with antibiotic eardrops that a primary care doctor can prescribe. Many times, those antibiotic eardrops also contain a steroid medication to decrease inflammation and reduce pain. If the pain is significant, an over-the-counter pain reliever can also help.

For people such as your son who seem predisposed to developing swimmer's ear, it's wise to take steps to prevent future infections. The key is to keep the ear canals as dry as possible. One easy method is to wear earplugs while swimming. Also, your son should dry his ears thoroughly with a soft towel after swimming or bathing, tipping his head to the side to help water drain from the ear canal. Some people even dry their ears with a blow-dryer set on the lowest setting and held at least one foot away from the ear.

Homemade eardrops used after swimming can help dry the ear canal. A mixture of one part white vinegar and one part rubbing alcohol may help prevent the growth of bacteria that can cause swimmer's ear. Pour about 1 teaspoon of the solution into each ear and then let it drain out. You can purchase similar over-the-counter solutions, too.

If swimmer's ear recurs despite these measures, talk to your son's doctor. The doctor may prescribe an antibiotic eardrop that your son can use after he's done swimming to stop an infection before it causes symptoms.

Laura Orvidas, M.D., Otorhinolaryngology, Mayo Clinic, Rochester, Minn.

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care.

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