Should Your Child See a Doctor?

Ear, Swimmer's

Definition

  • An infection or irritation of the skin that lines the ear canal
  • Has recently been swimming or gotten lots of water in the ear canals

Symptoms  

  • Itchy and somewhat painful ear canal
  • Discomfort when the ear is moved up and down
  • The ear feels plugged or full
  • Discharge may develop as the swimmer's ear becomes worse

Causes  

  • When water repeatedly gets trapped in the ear canal, the lining becomes wet and swollen.
  • This makes it prone to a bacterial superficial infection (swimmer's ear).
  • Wax buildup also traps water behind it. Usually, this is caused by cotton swabs.
  • Ear canals were meant to be dry.

Return to School  

  • Swimmer's ear is not contagious. No need to miss any school or child care.

When to Call Your Doctor for Ear - Swimmer's

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Severe pain
  • Redness and swelling of outer ear
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Constant ear pain
  • Yellow discharge from ear canal
  • Fever
  • Blocked ear canal
  • Swollen lymph node near ear
  • Cause is uncertain (no swimming)
  • Ear symptoms last over 7 days on treatment
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
 

Parent Care at Home If

  • Swimmer's ear with no complications
 

Home Care Advice for Mild Swimmer's Ear

  1. White Vinegar Rinses:
    • Rinse the ear canals twice a day with ½ strength white vinegar (dilute it with equal parts warm water).
    • Start by having your child lie down with the affected ear upward.
    • Fill the ear canal.
    • Wait 5 minutes, then remove the vinegar rinse by turning the head to the side and moving the ear. (Exception: ear tubes or hole in eardrum.)
    • Reason: restores the normal acid pH of the ear canal and reduces swelling.
    • Continue until the ear canal returns to normal.
     
  2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief.
  3. Local Heat: If pain is moderate to severe, apply a heating pad (set on low) or hot water bottle to outer ear for 20 minutes (caution: avoid burns). This will also increase drainage.
  4. Reduce Swimming Times: Try to avoid swimming until symptoms are gone. If on a swim team, it's usually OK to continue. Swimming may slow recovery, but causes no serious harm.
  5. Contagiousness: Swimmer's ear is not contagious.
  6. Expected Course: With treatment, symptoms should be improved in 3 days and resolved in 7 days.
  7. Prevention of Recurrences:
    • Try to keep the ear canals dry.
    • After showers, hair washing, and swimming, help the water run out by turning the head.
    • Avoid cotton swabs. (Reason: Packs in the earwax. The wax buildup then traps water behind it).
    • If swimmer's ear is a repeated problem, rinse the ear canals after swimming with a white vinegar-rubbing alcohol solution (equal parts of each).
     
  8. Call Your Doctor If:
    • Ear symptoms last over 7 days on treatment
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. American Academy of Otolaryngology - Head and Neck Surgery Foundation. Clinical practice guideline: acute otits externa. Otolaryngol Head Neck Surg. 2006;134(4): 4-23.
  2. Beers SL, Abramo TJ. Otitis externa review. Pediatr Emerg Care. 2004;20:250-253.
  3. Bojrab D, Bruderly T, Abdulrazzak Y. Diseases of the external auditory canal: Otitis externa. Otolaryngol Clin. 1996;29:761-782.
  4. Canto RM. Otitis externa and otitis media: A new look at old problems. Emerg Med Clin North Am. 1995;13:445-455.
  5. Consensus Panel. Use of ototopical antibiotics in treating 3 common ear diseases. Otolaryngol Head Neck Surg. 2000;122:934-40.
  6. Hughes E and Lee JH. Otitis externa. Pediatr Rev. 2001;22:191-197.
  7. Marcy SM. Infections of the external ear. Pediatr Infect Dis J. 1985;4:192-201.
  8. Nussinovitch M, Rimon A, Volovitz B, Raveh E, Prais D, Amir J. Cotton-tip applicators as a leading cause of otitis externa. Int J Pediatr Otorhinolaryngol. 2004;68:433-5.
  9. Rubin J, et al. Malignant external otitis in children. J Pediatr. 1988;113:965-70.
  10. Stone KE. Otitis externa. Pediatr Rev. 2007;28:77-78.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 10/1/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.