Otitis Externa: causes and treatment

Otitis externa (or swimmer's ear)

Earache is a common symptom with Otitis media from the middle ear infection. This can cause great discomfort for the sufferer from the inflammation of the infection swelling can occur.

Otitis Externa is a condition that causes inflammation of the external ear canal, the tube between your outer ear and your eardrum. It is often referred to as 'swimmers ear', because a common cause is water remaining in the ear canal after swimming. With treatment, any symptoms should clear up within a few days, but some severe cases it may persist for several months or longer, despite normally only affecting one ear at any given time. 

Symptoms of Otitis Externa:

  • Ear pain, varying in severity according to the intensity of your infection
  • An itchy feeling in your ear canal
  • Temporary hearing loss, or difficulty understanding quiet sounds
  • Experience some discharge from your ear, normally a clear, white or yellowy in colour
  • Redness and swelling of your outer ear and ear canal
  • Tenderness when moving your ear or jaw
  • Swollen and/or sore throat glands

Causes and triggers

Otitis externa can be attributed to a wide range of causes, as well as some triggers that might make you more susceptible to the condition.

Possible triggers can include:

  • Overexposure to moisture - swimming (especially in dirty water), sweating or humid environments can all introduce bacteria-laden liquid to the delicate ear canal, or wash away protective layers of earwax.
  • Ear damage - most often caused by the insertion of cotton buds, or incorrect insertion of ear plugs or earphones.
  • Chemicals - such as hair spray, hair dye or some earwax softeners.
  • Underlying skin conditions - such as psoriasis, eczema and acne.
  • Weak immune system or allergic conditions - such as asthma, diabetes or as a result of using certain cancer treatments such as chemotherapy.

Common causes can include:

  • A bacterial infection, usually by strains of pseudomonas aeruginosa or staphylococcus aureus.
  • Allergic reaction to ear medication, ear plugs, certain shampoos or cosmetics.
  • A fungal infection, is more likely if you use antibacterial or steroid ear drops for an extended period of time
  • Discharge from a middle ear infection (otitis media).
  • Seborrhoeic dermatitis - a common skin condition where naturally greasy areas of the skin become inflamed.

Otitis Externa can also occur when a hair follicle in your ear becomes infected by bacteria, developing into a boil. Even if you can reach this boil with your fingers, it is very important not to squeeze or pop it without the advice of a medical professional, as it may spread the infection elsewhere.


Otitis Externa can usually be remedied with a simple course of eardrops, as prescribed by your local GP. If your symptoms linger or your case has been particularly severe, you may be referred to a specialist who may undertake, micro-suction or dry swabbing to remove earwax and other debris to make your drops more effective. Severe cases may require an earwick, a plug made from soft cotton gauze that helps insert medication into your ear.

While you take your medication, it is important to take certain steps at home to help aid your recovery. Avoid getting your ear wet by wearing a shower cap when you bathe, and gently remove any discharge by gently swabbing around your ear rather than in it. Remove any hearing aids, ear plugs and earrings will also help prevent the spread of bacteria.

If you are experiencing symptoms of Otitis Externa, it is important to make an appointment with your local doctor. To learn more about other ear infections, visit our Otitis Media, Labyrinthitis or ear infection pages.

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