By: Sarah Almasalkhi, RPh, PharmD

Otitis externa, also known as swimmer’s ear, is inflammation of the external ear canal often caused by bacterial infection. Swimmer’s ear is most prevalent during the summer when swimming and high humidity are more common. The warm, dark and moist environment in the ear canal creates the perfect environment for bacterial and fungal growth.


Water entering the ear after swimming or bathing is the most common cause of swimmer’s ear. Water raises the pH inside the ear, allows bacteria to easily enter the ear, and creates a moist environment for bacterial growth. Other causes of swimmer’s ear include wax buildup on hearing aids, chronic skin conditions (such as eczema) resulting in infected lesions in the ear, and excessive cleaning of the ear.

Signs and symptoms

The main signs and symptom of bacterial swimmer’s ear is pain that worsens when chewing or tugging on the outer part of the ear. Difficulty hearing, itchiness, feeling of fullness or discomfort in the ear are additional symptoms that may precede ear pain.  The outer ear may appear red, swollen, tender, or purulent with clear or cloudy discharge.  Fever is not a common sign of swimmer’s ear fever may be a sign of middle ear infections.


Polysporin ear drops are available over-the-counter for treatment of mild acute swimmer’s ear. Gently moving the ear up and backward and lying on one side for a few minutes can help administer the drops properly. Symptoms usually improve within 48-72 hours of treatment; however, it’s important to continue the treatment for three days after symptoms have resolved (usual duration is 7-10) to prevent worsening of the infection. If pain continues, adding acetaminophen (Tylenol) or ibuprofen (Advil) can be used.  Seek medical attention when pain is not improving within 2-3 days, or if there is a fever and/or any other systemic symptoms.


There are a variety of ways to help prevent swimmer’s ear from occurring. Wearing ear plugs or a swimming cap helps prevent water from pooling in ears. Thoroughly drying the ears with a towel after swimming or showering. Mixing diluted isopropyl alcohol (rubbing alcohol) with equal parts water and adding a few drops to each ear can be used to dry out water after showering or swimming. Similar commercial product are available such as Auro-Dri ear drops.