Swimmer’s Ear Or Ear Infection?

How to Tell the Difference 

Whether you're spending time at the beach in Virginia Beach, boating on the Chesapeake Bay, or enjoying a neighborhood pool, summer in Hampton Roads often means more time in the water. Unfortunately, it can also mean more ear problems.

One of the most common questions patients ask is, "Do I have swimmer's ear or an ear infection?"

While the two conditions may seem similar, they affect different parts of the ear and often require different treatments. Understanding the difference can help you know when it's time to seek medical attention and how to prevent future problems. 

What Is Swimmer's Ear?

Swimmer's ear, also known as otitis externa, is an infection of the outer ear canal. This is the passage that carries sound from the outside of the ear to the eardrum.

The condition typically develops when water becomes trapped in the ear canal. The moisture creates an environment where bacteria can grow and irritate the delicate skin inside the ear. Despite its name, swimmer's ear is not limited to swimmers. It can also occur after bathing, showering, excessive sweating, or irritation from cotton swabs, earbuds, or hearing aids.

People who spend significant time in pools, lakes, rivers, or the ocean are at increased risk, particularly during the warm summer months. 

What Does Swimmer's Ear Feel Like?

Swimmer's ear often begins with mild itching or irritation inside the ear canal. As the infection progresses, discomfort may become more noticeable and can sometimes become quite painful.

Common symptoms include:

• Pain that worsens when touching or pulling on the ear
• Itching inside the ear canal
• Ear fullness or blockage
• Drainage from the ear
• Redness or swelling of the ear canal
• Temporary hearing changes or muffled hearing

One of the most telling signs of swimmer's ear is pain when the outer ear is moved or touched. This symptom helps distinguish it from many middle ear infections. 

What Is a Middle Ear Infection?

When most people refer to an "ear infection," they are talking about a middle ear infection, also called otitis media. Unlike swimmer's ear, a middle ear infection occurs behind the eardrum rather than in the ear canal itself.

Middle ear infections frequently develop after a cold, sinus infection, seasonal allergies, or another upper respiratory illness. When inflammation causes the Eustachian tube to become blocked, fluid can become trapped behind the eardrum. That fluid may then become infected.

Middle ear infections are especially common in children, but adults can develop them as well. 

What Does a Middle Ear Infection Feel Like?

Because the infection is located behind the eardrum, the symptoms are often different from swimmer's ear.

Many patients experience a deep aching pain or pressure inside the ear rather than irritation in the ear canal. Children may become fussy, have trouble sleeping, or pull at their ears because they cannot explain the discomfort.

Common symptoms may include:

• Ear pain or pressure
• Fever
• Difficulty hearing
• Trouble sleeping
• Ear fullness
• Irritability in young children
• Symptoms following a cold or allergy flare-up

Unlike swimmer's ear, moving or pulling on the outer ear usually does not make the pain significantly worse. 

What's the Biggest Difference Between Swimmer’s Ear and Ear Infection?

The easiest way to understand the difference is to consider where the infection occurs.

Swimmer's ear affects the ear canal and is usually related to moisture, trapped water, or irritation of the ear canal skin. It often causes pain when the ear is touched and may be associated with itching or drainage.

A middle ear infection occurs behind the eardrum and is more commonly related to colds, allergies, sinus congestion, or Eustachian tube dysfunction. Fever and pressure are often more prominent symptoms.

Although both conditions can cause ear pain and hearing changes, the location of the infection and the treatment approach are very different. That is why a proper examination by a healthcare provider is important. 

Who Is Most Likely to Develop Swimmer's Ear?

Certain activities and conditions can increase your risk of developing swimmer's ear.

You may be more susceptible if you:

• Swim frequently
• Spend time in humid environments
• Use cotton swabs in your ears
• Wear earbuds or hearing aids regularly
• Have eczema or psoriasis affecting the ears
• Have naturally narrow ear canals

Many cases occur because the protective barrier of skin inside the ear canal becomes damaged, making it easier for bacteria to enter and cause infection. 

How Are These Conditions Treated?

Because swimmer's ear and middle ear infections occur in different parts of the ear, treatment is often very different.

Swimmer's ear is commonly treated with prescription ear drops that contain antibiotics, anti-inflammatory medication, or both. Patients are usually advised to keep the ear dry during the healing process and avoid swimming until symptoms improve.

Middle ear infections may be treated with observation, pain management, allergy treatment, or antibiotics depending on the patient's age, symptoms, and severity of the infection. Some infections resolve on their own, while others require medical intervention.

Attempting to self-diagnose can sometimes delay appropriate treatment and prolong symptoms. 

Can Swimmer's Ear Be Prevented?

Yes - fortunately, there are several simple steps that can help reduce your risk.

After swimming or bathing, gently dry your ears with a towel and tilt your head to allow water to drain. Avoid placing cotton swabs or other objects inside the ear canal, as these can cause irritation and damage the skin.

Additional prevention tips include:

• Dry ears thoroughly after swimming
• Use physician-approved drying drops when appropriate
• Avoid inserting objects into the ear canal
• Keep hearing aids and earbuds clean
• Consider swim earplugs if recommended by your physician

These simple habits can significantly reduce the likelihood of developing swimmer's ear, especially during the summer months. 

When Should You See an ENT Specialist?

While mild ear discomfort may occasionally improve on its own, certain symptoms should not be ignored.

You should seek medical attention if you experience:

• Severe ear pain
• Ear drainage
• Fever
• Hearing loss
• Symptoms lasting more than a few days
• Recurrent ear infections
• Significant swelling around the ear

An ENT specialist can examine the ear using specialized equipment to determine the exact cause of your symptoms and recommend the most effective treatment. 

Expert Ear Care in Hampton Roads

If you or your child are experiencing ear pain, drainage, hearing changes, or recurrent infections, the team at Advanced ENT & Allergy is here to help.

Dr. Timothy Queen is uniquely qualified to evaluate both allergy-related and ENT-related causes of ear problems. As a physician who is board certified in both Otolaryngology (ENT) and Allergy, he provides comprehensive care for ear infections, swimmer's ear, hearing concerns, allergies, sinus conditions, and other disorders affecting the ears, nose, and throat.

Don't let ear pain keep you out of the water this summer. Contact Advanced ENT & Allergy today to schedule an evaluation and get the answers, and relief, you need.

References:

• Centers for Disease Control and Prevention (CDC) – Preventing Swimmer's Ear
  https://www.cdc.gov/healthy-swimming/prevention/preventing-swimmers-ear.html
• National Institute on Deafness and Other Communication Disorders (NIDCD) – Ear Infections in Children
  https://www.nidcd.nih.gov/health/ear-infections-children
• American Academy of Otolaryngology – ENT Health: Swimmer's Ear (Otitis Externa)
  https://www.enthealth.org/conditions/swimmers-ear-otitis-externa/
• CDC – Ear Infection Basics
  https://www.cdc.gov/ear-infection/about/index.html