Swimmer’s Ear Treatment, Diagnosis, and Prevention
Learn the pediatrician’s secret trick for diagnosing swimmer’s ear—so you can diagnose it at home!
by Steve Silvestro, MD @zendocsteve
You can also listen to this article as a podcast on your favorite podcast app or click on the player below:
If you swam often as a kid, then you probably remember getting swimmer’s ear once or twice.
If you don’t, let me tell you—it HURTS.
But if your child has been swimming and suddenly complains of ear pain, how can you tell that it’s swimmer’s ear? How can you be sure it’s not a “regular” middle ear infection, or that it’s not just a bit of water in the ear?
Well, the diagnosis is super simple—you only need to ask two questions and have two readily-available things on hand.
In this article, we’ll cover how you can diagnose swimmer’s ear at home, why it’s different from a “regular” ear infection, how it’s treated, and how you can prevent swimmer’s ear in the first place.
HOW TO DIAGNOSE SWIMMER’S EAR AT HOME
Longtime followers know that everything I do with The Child Repair Guide is designed to pull back the curtain and share everything I know as a pediatrician with you so that you can know it, too.
The truth is, most of what we pediatricians do is really simple and can be learned and used by every single parent.
Swimmer’s ear is a perfect example of this—in fact, I often feel like a sham when a family comes in suspecting their child has swimmer’s ear and I diagnose it in seconds with the trick below:
What You Need
- Your hand
- Your child’s ear
What to Do
First, know that swimmer’s ear won’t make your child’s ear red and swollen, and you shouldn’t see pus coming out of the ear. If you see either of those things, then give your pediatrician a call.
Okay, now for the trick:
Wiggle the back part of your child’s ear (the pinna). Then, press on the little bump in front of your child’s ear (the tragus). [see the video below for a demonstration!]
If either of these causes pain—and your child has been swimming in the past week or so—then your child has swimmer’s ear.
It’s that simple—no med school required!
THE DIFFERENCE BETWEEN SWIMMER’S EAR AND A “REGULAR” EAR INFECTION
“Wait—what?” you might be asking.
To see why the diagnosis is so simple, it helps to understand what swimmer’s ear is.
With a “regular” ear infection (also called a middle ear infection or otitis media), the infection is behind the ear drum. Typically, your child will have been congested for a while, and that congestion causes fluid to build up behind the ear drum. That fluid either drains or it stays, and the longer it stays, the higher the chance an infection develops. With a middle ear infection, you get pus and pressure behind the ear drum, turning the ear drum red and making it bulge out.
To diagnose a regular ear infection, I have to look inside your child’s ear and see what’s happening with the ear drum.
With swimmer’s ear, it’s a whole different story. In swimmer’s ear, your child happened to get an unlucky drop of water in her ear—a drop of water that happened to have bacteria in it. When the water evaporates, the bacteria stays and causes an infection.
Swimmer’s ear, then, is an infection of the canal—of the tunnel leading out of your child’s ear. When you wiggle the back part of the ear, you’re moving the back part of the canal. When you press on the front part of the ear, you’re moving the front part of the canal. If the canal is infected, well, one or both of those movements will hurt.
Sure, I could look inside your child’s ear and see that the canal is red. I might see a bit of flakiness in the canal or even the tiniest bit of clearish fluid.
But the way you diagnose swimmer’s ear—whether you’re a pediatrician or a parent—is by using the wiggle trick you just learned above.
Unlike a regular ear infection, swimmer’s ear is a diagnosis you can make at home.
HOW TO TREAT SWIMMER’S EAR
Unfortunately, to treat swimmer’s ear you’ll still have to call (and probably see) your pediatrician.
That’s because the treatment is antibiotic drops that you put into the ear canal to kill the bacteria. In the United States, those antibiotic drops are prescription only, so they’re not available over the counter.
But what about the over-the-counter swimmer’s ear drops you’ll find at most pharmacies? Some of them can be used to help with the pain. Most of them are used to help prevent swimmer’s ear, as we’ll discuss below. But to truly eradicate the bacteria causing a swimmer’s ear, you’ll need antibiotic drops.
HOW TO PREVENT SWIMMER’S EAR
After your child experiences the pain of swimmer’s ear the first time, both you and he will want to prevent it from ever happening again.
Luckily, there are a few things you can do to greatly decrease the odds of getting it in the future.
The simplest thing to do is to keep the ear canal dry. The germs that cause swimmer’s ear love water, so drying out the ear canal after swimming removes the germs’ favorite environment and makes it harder for them to take hold. Have your child tilt her head to the side and rub the outside of the canal with a towel. You can even wiggle her ear a bit to make sure all the water gets out. If you’re home or have access to a hair dryer, gently blowing it on the low setting about 6 inches away from the ear can also get it dry.
The active ingredient in many of the swimmer’s ear drops you’ll find over the counter is something you might already have at home—rubbing alcohol. Rubbing alcohol helps in two ways: 1). It makes water in the ear evaporate faster, and 2). It can kill off small amounts of bacteria.
While rubbing alcohol and even vinegar can kill some bacteria, they won’t usually work for a full-on swimmer’s ear infection. If you use rubbing alcohol right after swimming, it’s strong enough to kill the small amount of bacteria present in that unlucky drop of water. But by the time your child has a full-on swimmer’s ear, the bacteria has multiplied and there’s usually too much to kill without antibiotic drops.
So while you’ll need prescription drops to fix a swimmer’s ear, keep some rubbing alcohol on hand if your child swims frequently and you might prevent it from coming on in the first place.
WHEN TO GET MORE HELP
More often than not, your child’s ear will feel better within just a couple of days of starting antibiotic drops.
But if he isn’t feeling mostly better in 3-4 days—and entirely better by the end of the prescribed course—then reach out to your pediatrician again. While rare, germs like yeast can cause swimmer’s ear, and these types of germs won’t be killed off by the antibiotic drops we usually prescribe. If your doc thinks that a yeast is responsible for your child’s swimmer’s ear—and the sign is often that the typical antibiotic drops haven’t worked—then a different type of medicine will be used.
If your child has fever, a red or swollen ear, or pus coming out of the ear—call your pediatrician. These things shouldn’t happen with swimmer’s ear, so seeing any of these means your child should be checked out by a doctor.
JUST KEEP SWIMMING
A basic swimmer’s ear? There doesn’t have to be much mystery around that. Like many common illnesses that kids get, the diagnosis is really simple if you know what to look for—and now you do.
With this information, you can now tell when your child has swimmer’s ear, what’s going on, what you need to do about it, and how to prevent it—so that you and your family can get back to enjoying the pool.
I share all of my pediatrician tips, tricks, and secrets on The Child Repair Guide Podcast, as well as on Instagram, Facebook, and YouTube—so subscribe and follow so you can learn everything I know and confidently keep your kids healthy!