You are enjoying your summer beach vacation when your child starts complaining about her ear. “What now?” you think. At first, she says it feels itchy or clogged, but later in the day she mentions that it really hurts. She is holding her ear and whining. She does not want you to touch it. You take your child to the pediatric healthcare provider and find out that it is swimmer’s ear infection. What is swimmer’s ear infection? How did your child get it? How is it treated? Can it be prevented?
Swimmer’s ear infection, known by the medical term otitis externa (OE), is simply an infection of the ear canal that occurs from moisture within the ear canal. This often happens when the ear canal stays wet after swimming or bathing. The moisture causes irritation in the ear canal, allowing bacteria to grow. This commonly occurs to children in the summer after a day at the pool or the beach. It can happen frequently to kids on swim teams as well. You do not have to swim to get swimmer’s ear infection, as it can occur anytime water sits in the ear canal. It can affect one or both ears.
The signs and symptoms of swimmer’s ear infection include ear pain (which may start as a mild discomfort and then progress to more severe pain). The pain worsens if the outer ear is touched or moved. The symptoms may start with itching or fullness. The child may complain of the ear feeling clogged. You may see discharge or drainage from the ear, which may be clear, white, yellow, or even green. Hearing may be temporarily affected due to the swelling and discharge in the ear canal. Usually, there will not be fever, runny nose, or cold symptoms noted. To test your child for swimmer’s ear infection, gently grab the top of the outer ear (the pinna) and wiggle it up and down. If this causes pain, then you need take your child into their pediatric healthcare provider to be evaluated for suspected swimmer’s ear infection.
Swimmer’s ear infections are different from middle ear infections in that the infection is in the outer ear canal, rather than the middle ear. Middle ear infections are usually accompanied by upper respiratory infections (cold symptoms) and may occur with fever. Middle ear infections are generally treated with oral antibiotics, while swimmer’s ear is treated with ear drops. Both types of ear infections generally do require prescription treatment.
Once a child has swimmer’s ear, it is treated with prescription ear drops as over the counter medication will not be effective. See your pediatric healthcare provider who will take a detailed history, complete a thorough physical examination, make an appropriate diagnosis, and prescribe the best medication. Usually, a prescription ear drop containing an antibiotic is used twice daily for 7 days. Follow the prescribing directions closely.
It is very important to keep those ears dry for those 7 days to allow for healing. Stress to your child that there can be no swimming or submerging the head in bath water during the time of treatment. You may use a cotton ball covered in Vaseline placed gently in the outer ear to keep the ears dry while showering if you wish, but it’s not required as showering does not usually submerge the ears. If your child is having pain from swimmer’s ear, consider use of children’s acetaminophen (dosed according to weight).
Prevention is really the key to avoiding a painful case of swimmer’s ear infection. After submerging the head during swimming or bathing, you can dry the ears with a hair dryer on a cool setting. If your child does not have ear tubes (or a punctured eardrum), then you can use over-the-counter swim ear drops, which are dilute acetic acid or alcohol. You can also use a home-made solution of half rubbing alcohol and half vinegar, placing a few drops in the ear after swimming. Make a note that these over the counter and home remedies are only effective to prevent swimmer’s ear infections. If your child already has symptoms, please take him or her to a pediatric healthcare provider.
Swimmer’s ear is a painful ear infection that is common to children who are swimming in the summer. With some common-sense precautions, you can prevent swimmer’s ear in your child.
