Otitis Externa (Swimmer's Ear)

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“Swimmer’s ear”, also called otitis externa (oh TIE tis  ex TER nuh), is an infection of the skin in the outer ear canal.  This is the area from the eardrum to the outside of the ear (Picture 1).  It is called “swimmer’s ear” because it often occurs when water stays in the ear canal and it is usually caused by bacteria or fungus found in swimming pools, lakes and rivers.  Because the ear canal is dark and warm, bacteria and fungus can easily grow.

Causes of Swimmer’s Ear

  • Swimming or playing in water including lakes or ponds, as well as swimming in pools with chlorine
  • Cleaning your child’s ears (can remove the protective layer of wax in the ear canals and cause small scratches, making him or her more prone to infection)
  • Skin allergies and eczema
  • Injury to the skin in the ear canal 

Otitis Externa (Swimmer’s Ear)Symptoms of Swimmer’s Ear

  • Pain, which can be severe, when the ear is touched or moved or with chewing
  • Reddened or swollen outer ear or ear canal opening
  • Itching or dull pain in the ear
  • Plugged feeling in the ear 
  • Ear drainage
  • Fever
  • Muffled hearing for a short time


Your child’s doctor will examine your child’s ears and gently clean them.

  • An antibiotic (an ti by AH tik) ear medicine, typically a topical ear drop, may be prescribed to fight the infection and lessen itching and swelling.
  • You may be taught how to suction drainage from your child’s ear before putting the ear drops in.
  • An ear wick (a small sponge that stays in the ear and hold the ear drops against the skin) may be necessary – your doctor or nurse will explain this to you.
  • Treat pain with over-the-counter pain relievers, such as Tylenol® or ibuprofen. 

How to use Warm Compresses

Warm compresses (packs) may help to ease the pain.  To use the warm compresses:

  1. Wet a folded washcloth in comfortably warm (not hot) water, and wring out the excess water.
  2. Have your child hold the warm washcloth over the ear several times a day for 10 to 15 minutes each time. The best times may be before school, after school, after dinner, 
    and at bedtime.
  3. When the compress cools, wet the washcloth again with warm water.  You will probably need to wet the washcloth 3 or 4 times during a 15-minute treatment.
  4. Use a clean washcloth every day.  Launder the washcloth before it is used again.


  • Keep the ear as dry as possible for 7 to 10 days.
  • Dry your child’s ears well after swimming or showering.
  • To help prevent Otitis Externa, use a mixture of half rubbing alcohol and half white vinegar to dry the ears after your child swims. Put three to four drops of the mixture in each ear. Do not do this if your child has ear tubes or a hole in his ear drum.
  • A hair dryer on the coolest setting can be used to dry the ear.  Hold the dryer four to six inches from the ear.
  • Your child should avoid swimming until the ear is completely pain-free.  Check with your child’s doctor or nurse before he or she goes swimming. Avoid showers or try to keep water out of the ear during showering using a cotton ball coated in ointment in the outer ear.
  • Your child should never put anything in the ear that can injure or scratch the canal.
  • Ask your child’s healthcare provider about wearing earplugs for swimming. 

Medicine Storage and Safety

  • Store all medicine out of children's reach.  
  • Keep a list of what medicines your child takes and when and why they are taken.
  • Always keep medicine in the labeled container it came in.
  • Do not use this medicine after the expiration date printed on the container.
  • Do not stop giving this medicine or change the amount given without first talking with your child's doctor.
  • Do not give this medicine to anyone other than the child for whom it was prescribed.
  • If your child sees a new doctor or goes to an emergency room, be sure to tell them about all the medicines your child is taking.
  • Your child's school will need a note from you and the doctor if this medicine is to be given at school by the school nurse.

When to Call the Doctor

Call your child’s doctor if he or she has any of the following:

  • Pain that is not eased by eardrops or heat or that lasts more than 2 days
  • Any discharge or drainage from the ear
  • Redness or swelling of the outer ear or behind the earlobe
  • Temperature over 101°F by mouth or 102°F under the arm
  • Any problems with taking the medicine

If you have any questions, be sure to ask your child’s doctor or nurse.

Ear: Otitis Externa (Swimmer’s Ear) (PDF)

HH-I-223 2/03, Revised 3/19 | Copyright 2003, Nationwide Children’s Hospital