Dr. Greene’s Answer:
Swimmer’s ear is an infection of the skin lining the ear canal. Bacteria normally live on the surface of this skin with no ill effect. If there is a break in the skin’s normal barrier, however, the bacteria can get inside and cause an infection called external otitis or swimmer’s ear (this is different from otitis media ). If the ear is wet for a long period of time, the skin can become prune-like in the same way one’s fingers and toes become soft and wrinkled when they are in water for a long period of time. Bacteria can easily move into the soft skin. Tiny scratches in the ear canal (usually from sticking a finger or some other object into the ear) also leave the skin vulnerable to infection. The skin can even be breached as a result of the ear’s becoming extraordinarily dry, causing the skin to crack. Ironically, swimmer’s ear can be the result of spending time in desert conditions.
Swimmer’s ear is more common in water with higher bacterial counts, which generally include lakes or other unchlorinated bodies of water. For unclear reasons, swimmer’s ear is not common in infants, but it is particularly prevalent in pre-school and school-age children.
There are a couple of ways to prevent swimmer’s ear. One is to make sure the ears get dry after being in the water. This can be facilitated by turning the head and gently pulling the ear in different directions to help drain the water out of the ear. It is also very helpful to dry the opening of the ear very carefully as far as you can reach with a towel or even try using a blow dryer. If swimmer’s ear becomes a recurrent problem, you can put a few drops of rubbing alcohol in each time it becomes wet, to facilitate drying. Another good alternative is instilling a few drops of white vinegar. The acetic acid inhibits the growth of bacteria in the skin. Wearing ear plugs may also prevent swimmer’s ear.
The symptoms of swimmer’s ear are itchy and/or painful ear. This is often accompanied by a small amount of clear discharge. The ear is particularly sensitive to the ear lobes being moved up and down. Most cases of swimmer’s ear are easily treated with antibiotic drops. For very serious infections, oral antibiotics may be necessary.
Swimming is generally not associated with the other type of ear infections — otitis media. This is true even if a child has ear tubes.