Patient education: Outer ear infection (The Basics)

What is an outer ear infection? — An outer ear infection is a condition that can cause pain in the ear canal. The ear canal is the part of the ear that goes from the outer ear to the eardrum (figure 1).

An outer ear infection is sometimes called "swimmer's ear." But an outer ear infection does not just happen in people who swim. People who do not swim can also get it.

What causes an outer ear infection? — An outer ear infection happens when the skin in the ear canal gets irritated or scratched, and then gets infected. This can happen when a person:

●Puts cotton swabs, fingers, or other things inside the ear

●Cleans the ear canal to remove ear wax

●Swims on a regular basis – Water can soften the skin of the ear canal, which allows germs to infect the skin more easily.

●Wears hearing aids, headphones, or ear plugs that can irritate or damage the skin inside the ear canal

What are the symptoms of an outer ear infection? — The most common symptoms are:

●Pain inside the ear, especially when the ear is pulled or moved

●Itching inside the ear

●Fluid or pus leaking from the ear

●Trouble hearing

Is there a test for an outer ear infection? — No. There is no test. Your doctor or nurse will be able to tell if you have it by asking about your symptoms and looking in your ear. During the visit, your doctor might also clean out your ear so that it can heal more quickly.

How is an outer ear infection treated? — Treatments can include:

●Ear drops – Be sure to finish all the medicine, even if you feel better after a few days. When you use ear drops, you should:

•Lie on your side or tilt your head, with the affected ear facing up

•Make sure the ear drops go into the ear canal

•Stay in this position for 20 minutes (after the ear drops are put in)

●Medicines to relieve pain

What else should I do during treatment? — It is important to keep the inside of the ear dry while the infection heals. You should not swim for 7 to 10 days after starting treatment. You can take a shower, but make sure to keep the ear dry. You can put some petroleum jelly (sample brand name: Vaseline) on a cotton ball, and then put the cotton ball in your outer ear, covering the opening of your ear canal. Do not push the cotton ball into the ear canal.

You should also avoid wearing hearing aids or headphones, or putting anything into the infected ear, until your symptoms improve.

Should I see a doctor or nurse? — Call your doctor or nurse if:

●Your symptoms get worse at any point

●Your symptoms have not gone away 6 days after starting treatment

Can an outer ear infection be prevented? — You can reduce your chances of getting an outer ear infection by:

●Not sticking anything in your ears, even to clean them – The inside of the ears do not usually need to be cleaned. It is normal to have some ear wax in your ears. Ear wax protects the ear canal. But if you are worried that you have too much ear wax, talk to your doctor or nurse. He or she can look in your ears and tell you how to clean them safely.

●Following these tips if you swim a lot:

•Shake your ears dry after you swim, or use a blow dryer to help dry them. If you use a blow dryer, put it on the lowest setting and be careful to avoid burns.

•Use over-the-counter ear-drying drops after you swim. These usually contain alcohol or vinegar, and might help prevent infection.

•Wear ear plugs to prevent water from getting in your ears. Keep the ear plugs clean and get new ones if your ear plugs are too dirty or start to fall apart.

More on this topic

Patient education: Ear infections (otitis media) in children (The Basics)
Patient education: Removing objects stuck in the ear (The Basics)

Patient education: External otitis (including swimmer's ear) (Beyond the Basics)
Patient education: Ear infections (otitis media) in children (Beyond the Basics)