You just returned from vacation. Your child says, “My ear hurts.” You do not see any discharge, but it is tender to the touch. You schedule a same-day appointment with your pediatric healthcare provider, and the diagnosis is swimmer’s ear. What is swimmer’s ear?

Swimmer’s ear, or otitis externa, is a condition caused by water that remains in the outer ear canal (which runs from the outer ear to the eardrum) after swimming or bathing. Moisture in the ear canal can lead to bacterial growth. Swimming in contaminated water can also cause this.

Swimmer’s ear can be painful. It may start with mild itching and progress to more severe pain. There may be drainage from the ear or a decreased ability to hear. Wiggling the outer ear will cause pain.

If you suspect your child may have swimmer’s ear, call your pediatric healthcare provider. He will take a complete history and do a thorough physical exam. He will check for a pain response by moving the outer ear (pinna) and pushing on the bump in front of the ear (tragus). He will then examine the ear canal, which may be uncomfortable for your child. Once swimmer’s ear (otitis externa) is diagnosed, your child will need to be treated with a prescription ear drop. Use the medication as directed, generally 2-3 times daily for 7-10 days.

Sometimes the pediatric healthcare provider will need to place a wick in your child’s ear. A wick is a small piece of cotton which will lie the length of the outer ear canal, like a candle wick. It helps to distribute the liquid ear medication the entire length of the canal. It also helps to push back some of the discharge and debris which can accumulate within the canal due to this infection.

The wick will likely stay in place anywhere from a few hours to a few days and then fall out on its own. It will not bother the child, but there may be a decreased ability to hear from that ear while it is in place. Some children may feel a little dizzy when a wick is placed, so lying down for a few minutes and rising slowly may be helpful. As the ear canal is already tender, it may not be comfortable to place the wick, but the medication will soothe that area.

To place the drops in your child’s ear, have your child lie down on her side with the affected ear up. Hold the bottle so that the tip does not touch the surface of the ear, and drop the prescribed number of drops of medication into the opening of the ear canal. If a wick is present, drop the medication directly on the exposed wick, as it will distribute the medication into the ear canal. Have your child remain lying for a few minutes after placing the drops in the ear, then sit her up slowly. Do not worry if a drop runs out of the ear.

While under treatment for swimmer’s ear (otitis externa), it is important to keep your child’s ears dry. No swimming or submerging the head while bathing for 7 days after treatment begins. Showers are fine, as they do not force water into the external ear canal. Avoid use of ear buds during this time as well. Swimmer’s ear can be painful, so use of children’s acetaminophen may be helpful.

Swimmer’s ear is much easier to prevent than to treat. Keep your child’s ears dry. After swimming or bathing, tip your child’s head to each side to allow the water to run out. Dry the ears gently with a hair dryer on warm. Swim only in clean water, avoiding water with high bacteria counts.

You can prevent swimmer’s ear by placing a few drops of rubbing alcohol and vinegar in your child’s ears after each time that they swim or bathe. You can make this mixture at home by combining 1 part rubbing alcohol to 1 part white vinegar. You can also purchase a product known as swim-EAR which is an option if you do not care to make your own mixture.

With careful prevention, your child can avoid swimmer’s ear. If your child gets swimmer’s ear this summer, proper medical care will have her back in the water soon.