Understanding swimmer's ear: How to protect your ears from infection after swimming and symptoms to watch out for

Long periods in water can lead to prolonged dampness in the ears, which may result in infection. Dr Kumari shares the signs that shouldn't be ignored.

Stepping out of the pool only to find one ear feeling blocked can be uncomfortable, especially when your hearing seems muffled. While swimming is generally safe for your ears, water trapped in the outer ear canal can cause temporary discomfort and, in some cases, lead to irritation or an infection.

What is swimmer’s ear?

In a conversation with HT Lifestyle, Dr Punam Kumari, head audiologist at Centre for Hearing, explains, “Swimmer’s ear, medically known as otitis externa, is inflammation or infection of the outer ear canal – the passage that runs from the outside of the ear to the eardrum. Earwax helps protect the canal by providing a natural barrier against moisture and germs.”

Repeated or prolonged exposure to water can soften the skin lining the ear canal and disturb its natural protective barrier. This can create conditions in which bacteria, and sometimes fungi, can grow. Moisture is not the only risk factor: scratching the canal, inserting cotton buds, or using objects to remove earwax can also increase the risk.

Prolonged periods in water can increase the risk of infection.

Symptoms of swimmer’s ear

According to Dr Kumari, the following symptoms may develop over a day or several days:

• Itching inside the ear canal
• Pain or tenderness when touching or gently pulling the outer ear
• A blocked or full sensation
• Redness or swelling of the ear canal
• Fluid or discharge from the ear
• Muffled or reduced hearing

The audiologist explains, “Muffled hearing can occur when swelling or discharge narrows the ear canal and interferes with sound reaching the eardrum. Hearing often improves once the underlying problem is treated, but persistent hearing changes should not be ignored. Severe or complicated infections can cause more significant problems, so seek medical advice if symptoms worsen or do not improve.”

Swimmer’s ear is different from a middle-ear infection

Swimmer’s ear affects the outer ear canal. A middle-ear infection occurs behind the eardrum and commonly develops in association with a cold or other upper respiratory infection, particularly in children. Water in a swimming pool does not usually cause a middle-ear infection when the eardrum is intact.

“Anyone with a perforated eardrum, a history of ear surgery or ear tubes should ask their doctor what water precautions are appropriate before swimming,” Dr Kumari advises. “The right advice depends on the person’s ear condition and the procedure or treatment they have had.”

How to care for your ears after swimming?

• Tilt your head to each side to help water drain naturally, then gently pat the outer ear dry with a clean towel.
• If appropriate for your ears, use well-fitting swim earplugs or a swim cap to reduce water entry. Stop using earplugs if they cause pain or irritation.
• Do not insert cotton buds, hairpins, keys or other objects into the ear canal. They can injure the skin and push earwax deeper.
• Avoid trying to remove earwax yourself. Earwax is protective and usually does not need to be removed unless it is causing a problem.
• Choose clean, well-maintained swimming facilities.
• If your ear is painful, itchy or discharging, avoid swimming and seek medical advice before returning to the water.

Pain, swelling and discharge from the ear are symptoms that deserve medical attention.

When to seek medical attention?

Dr Kumari recommends arranging for an ear examination if you have persistent pain, discharge, swelling or hearing that remains muffled after swimming. She emphasises, “Seek prompt medical attention for severe pain, fever, spreading redness or swelling, or a sudden change in hearing. A clinician can examine the ear and decide whether treatment, such as prescription ear drops, is needed.”

She also cautions against using leftover ear medication or home remedies without professional advice, especially since some products may be unsuitable, particularly if the eardrum is perforated or its status is unknown. The audiologist recommends paying particular attention to children, who may not be able to describe their symptoms clearly. Ear tugging, unusual irritability, or not responding to sounds as usual can be signs that they need assessment.

“We take care of our eyes, teeth and heart without hesitation, but we can overlook changes in our hearing. A blocked feeling after swimming may settle on its own, but if it persists, recurs or is accompanied by pain or discharge, it should be evaluated. Hearing helps us stay connected to the people around us. A few simple precautions can help protect the ears and allow swimming to remain an enjoyable activity. If symptoms develop, getting the right advice early is the best approach,” concludes Dr Kumari.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Punam Kumari is Head Audiologist at Centre for Hearing, the flagship retail brand of Anand Hearing Care Pvt. Ltd. With over 12 years of clinical experience, she specialises in hearing diagnostics, hearing aid fitting and aural rehabilitation. A former Senior Audiologist at Amplifon India, she has extensive experience in evidence-based hearing care and clinical leadership.