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A Parent’s Guide to Swimmer’s Ear & Other Ear Infections

June 12, 2023

The weather is getting warm so bring on swimming, trips to the river or beach and for some kids, swimmer’s ear. While swimmer’s ear can be painful and inconvenient, it is just one type of ear infection that can make kids miserable. How do you know the difference between the two types of ear infections, otitis media (middle ear infection) and otitis externa (swimmer’s ear) and what to do if your child has one. 

Ear infections can be very painful and are the most common reason children are prescribed antibiotics. In fact, five out of six children experience at least one by the time they are three years old. The most common type of ear infection, acute otitis media, is located behind the eardrum, in the middle ear. With this type of infection, a child will likely experience a prolonged earache or pain among other symptoms such as preference to sit upright, fever, headache, difficulty hearing or sleeping and fluid secretion from ears. 

Middle ear infections typically start with an upper respiratory tract infection caused by viruses, including influenza viruses. Bacteria or viruses from the nose and throat move into the middle ear and to the eardrum, causing increased secretions, swelling, and pain. The virus or bacteria that led to the middle ear infection may be contagious but no more worrisome than other germs that cause the common cold.

Michael Abdelmisseh, MD

“When there is fluid in the middle ear, the eardrum cannot vibrate so the first symptoms you may notice are a feeling of fullness in the middle ear and a decrease in the ability to hear out of that ear,” said Michael Abdelmisseh, MD a pediatrician with West Tennessee Medical Group Primary Care in Dyersburg. “This fluid build-up can become more serious. Any time fluid sits still bacteria and viruses can start to increase in number and cause an infection.” 

Swimmer’s ear, on the other hand, is a bacterial infection of the skin in the ear canal that can lead to inflammation of the external ear canal. It earned its nickname because many cases are caused by water getting trapped after swimming. The infection is due to bacteria that resides in trapped water or moisture, which in many cases causes itchiness, redness, discomfort, pain when moving and sometimes a drainage of fluid.

Since children have a narrower ear canal, placing them at a higher risk of developing this type of infection. Swimming in water that has a higher bacteria level like lakes and rivers can also lead to this type of infection. Water activities are not the only thing that can cause it, anything that injures the skin of the ear canal can lead to an infection. Dry skin or eczema, scratching the ear canal, ear cleaning with cotton swabs, or putting things like bobby pins or paper clips into the ear can also increase the risk of this type of ear infection.

Ear pain is the main sign of swimmer’s ear. It can be severe and worsen when the outer part of the ear is pulled or pressed on. Most kids will not run a fever. Chewing may be painful. The ear canal may itch before pain begins. The outer ear may appear red or swollen, and lymph nodes around the ear can get enlarged and tender. Sometimes, there’s discharge from the ear canal. Hearing might be temporarily affected if pus or swelling blocks the ear canal. 

Ear infections should be diagnosed and treated by a doctor. If not, the ear pain will get worse, and the infection may spread. “Treatment depends on how severe the infection is and how painful it is,” said Dr.  Abdelmisseh. “Antibiotics are prescribed if fluid is seen behind the eardrum, the ear infection is painful, or the child has a fever and ear pain. Antibiotics are usually used for children who get recurrent ear infections; however, not all children need to be treated with antibiotics. Most ear infections can clear on their own and pain relievers such as acetaminophen can help with pain relief.” 

Preventing swimmer’s ear is easier than you might think. Most important is keeping the ears dry to prevent the chance of moisture buildup. After spending time swimming, make sure to carefully dry the outside of your child’s ears and have them tilt their head from side to side. To be even more precautious, they can wear ear plugs designed to prevent water from entering the ear canals while swimming. 

See a physician if symptoms last longer than two to three days, worsen or pain is uncontrollable with over-the-counter medication. West Tennessee Medical Group has pediatricians that can help diagnose and treat your child’s ear pain. To schedule an appointment, click here