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Health Issues

Swimmer's Ear in Children

Swimmer's ear, which doctors call otitis externa, is an infection of the skin inside the ear canal or outer ear. This type of infection occurs most often after swimming or other activities that allow water into the ears.

What causes swimmer's ear?

Swimmer's ear develops because moisture in the ear canal encourages the growth of certain bacteria. The moisture also causes the skin that lines the ear canal to soften (like the white, swollen area that forms under a wet bandage). The bacteria then invade the softened skin and multiply there, causing this often painful infection.

For reasons that are not clear, some children are more prone to swimmer's ear than others. Injury to the ear canal (sometimes from the improper use of cotton swabs) or conditions such as eczema and seborrheic dermatitis can make a child more likely to get swimmer's ear.

What are symptoms of swimmer's ear?

With the mildest form of swimmer's ear, your child will com­plain only of itchiness or a plugged feeling in the ear. If your child is too young to tell you what's bothering them, you might notice them sticking their finger in their ear or rubbing it with their hand. Within hours to days the opening of their ear canal may become swollen and slightly red, causing a dull pain. If you push on the opening or pull up on their ear, it may be painful.

In more severe cases of swimmer's ear, the pain will be constant and intense. Your child may cry and hold their hand over their ear. The slightest motion, even chewing, will hurt a lot. The ear canal opening may be swollen shut, with a few drops of pus or cheesy material oozing out. Your child may also have a low-grade fever (rarely more than one or two degrees above normal). In the most serious infections, the redness and swelling may spread beyond the ear canal to the entire outer ear.

How is swimmer's ear treated?

If your child has pain in his ear, or if you suspect swimmer's ear, call your pediatrician. Although the condition usually isn't serious, it still needs to be examined and treated by a doctor.

Until you see your pediatrician, you can help relieve your child's pain with acetaminophen or ibuprofen. Keep your child out of the water for several days, and see if the pain subsides. Do not insert a cotton swab or anything else into the ear in an attempt to relieve itching or promote drainage; this will only cause further skin damage and provide more places for bacteria to grow.

What medicine is prescribed for swimmer's ear?

At the pediatrician's office, the doctor first will examine the affected ear. Then, they may carefully clean out pus and debris from the canal. Most doctors also prescribe ear drops for five to seven days. The eardrops fight infection. By doing this, they also decrease swelling, which helps to relieve the pain.In order to be effective, however, eardrops have to be used properly. (See "How to Give Ear Drops to a Child.")

If the ear canal is too swollen for drops to enter, your pediatrician may insert an ear wick—a small piece of cotton or spongy material that soaks up the medicine and holds it in the canal. In this case, you'll need to resaturate the wick with the drops three or four times per day. Rarely, oral antibiotics also are prescribed.

Can you go swimming with swimmer's ear?

When your child is being treated for swimmer's ear, your doctor may recommend they stay out of the water for a few days. However, they can take brief showers or baths daily and have his hair washed, as long as you dry the ear canal afterward with the corner of a towel or a blow-dryer (on a very low setting, held away from the ear). Once that's done, put in more eardrops.

How do you prevent swimmer's ear?

There's no need to try to prevent swimmer's ear unless your child has had this infection frequently or very recently. Under these circumstances, limit his stays in the water, usually to less than an hour. Then, when they come out, remove the excess water from their ear with the corner of a towel, or have them shake their head.

Swimmer's ear home remedy: vinegar rinse

A mixture of half white vinegar and half rubbing alcohol can be a practical and effective home remedy to help prevent swimmer's ear. A few drops in each ear can be used after swimming. To avoid injury, resist the temptation to clean out your child's ear with cotton swabs, your finger or any other object.

Many pediatricians recommend acetic acid eardrops to help prevent swimmer's ear. They are available in various preparations, some of which need a prescription. They usually are used in the morning, at the end of each swim, and at bedtime.

Last Updated
Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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