Swimmer's ear

A healthcare professional usually can diagnose swimmer's ear during an office visit. An advanced or lasting infection might need more testing.

First steps

Your healthcare professional is likely to diagnose swimmer's ear based on your symptoms, answers to questions and an exam. The exam might include:

• Looking at the ear canal with a lighted tool called an otoscope. The ear canal might appear red, swollen and scaly. Redness might be hard to see on Black or brown skin. There might be skin flakes or other debris in the ear canal.
• Looking at the eardrum, also called the tympanic membrane. This is to be sure it isn't torn or damaged. If the view of the eardrum is blocked, a healthcare professional will clear the ear canal with a small suction device or a tool with a tiny loop or scoop on the end.

Further testing

More testing, if needed, might include sending a sample of fluid from the ear to look for bacteria or a fungus.

Also:

• If the eardrum is damaged or torn, your healthcare professional is likely to refer you to an ear, nose and throat (ENT) specialist. These specialists can use special tools to clean ears with damaged membranes.
• If the infection doesn't get better with treatment, your healthcare professional might take a sample of discharge or debris from your ear and send it to a lab. That's to look for what's causing the infection.

The goal of treatment is to stop the infection and let the ear canal heal.

Cleaning

Cleaning the outer ear canal helps ear drops get to all infected areas. A healthcare professional will use a suction device or ear curet to clean away discharge, clumps of earwax, flaky skin and other debris.

Medicines for infection

Most often, ear drops that have a mix of the following can treat the infection:

• An acidic solution to help restore the ear's natural defenses.
• A steroid to reduce swelling and irritation, called inflammation.
• An antibiotic to fight bacteria.
• An antifungal medicine to fight infection caused by a fungus.

Ask your healthcare professional about the best way to put in ear drops. Here are some tips that might help:

• Warm the drops by holding the bottle in your hand for a few minutes. This will bring the temperature of the drops closer to body temperature.
• If possible, have someone help you put the drops in your ear.
• Lie on your side with your infected ear up for a few minutes after you put in the drops. This helps the medicine travel through the full length of the ear canal.
• To put drops in someone else's ear, pull the earlobe down.

For an ear canal that's blocked, a healthcare professional might put a wick made of cotton or gauze into the ear. This can help the ear drain and help medicines get to the ear canal.

If the infection is more advanced or ear drops don't clear it up, your healthcare professional might prescribe antibiotics that you take by mouth.

Medicines for pain

Pain relievers that you can get without a prescription might ease the discomfort of swimmer's ear. These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).

Helping the treatment work

During treatment, keep your ears dry to help them heal.

• Don't swim or go scuba diving.
• Don't wear an earplug, a hearing aid or earbuds until pain and discharge stop.
• Don't get water in your ear canal when showering or bathing. Use a cotton ball coated with petroleum jelly to protect your ear during a shower or bath.

Here are some suggestions to help you get ready for your appointment.

What you can do

Make a list of:

• Your symptoms and when they started.
• All medications, vitamins and supplements you take, including doses.
• Your allergies, such as skin reactions or medicine allergies.
• Questions to ask your healthcare professional.

Some basic questions to ask about swimmer's ear include:

• What is likely causing problems with my ear?
• What is the best treatment?
• When should I expect to start getting better?
• Do I need to make a follow-up appointment?
• How can I keep from getting swimmer's ear again?
• Do you have brochures or other printed material I can have? What websites do you recommend?

Be sure to ask all the questions you have about swimmer's ear.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, including:

• Have you been swimming lately?
• Do you swim often?
• Where do you swim?
• Have you ever had swimmer's ear before?
• Do you use cotton swabs or other objects to clean your ears?
• Do you use earbuds or other ear devices?
• Have you had any other recent ear exams or procedures?