Swimmer’s Ear:What Is It and How Can It Be Prevented in Children?


Swimmer’s ear; what is it, why does it happen, and how can you prevent it in your children this summer. All, topics you are going to learn about in today’s edition of Portable Practical Pediatrics. Stay tuned!

Musical Intro

What is Swimmer’s Ear

To understand swimmer’s ear you need to start by understanding that it is an infection of your child’s ear canal skin. This specialized skin provides a barrier to the hostile world of the outer ear which is full of all sorts of bacteria and fungus. Without intact healthy skin providing a barrier to these microbes, trouble is inevitable. When the normal barrier function of the wax and surface skin cells breakdown, invasion into the skin by microbes begins, leading to swelling, pain, inflammation, and maybe fever and possibly and abscess or cellulitis–all from a simple skin infection in the outer ear. But why is it called swimmer’s ear you may be wondering? Good question…because the entire process is driven by moisture in the ear, most likely but not solely caused from swimming.

Science Drive

To understand how the swimmer ear ball get rolling, you need to know a few things about the special environment in the ear canal of children. When functioning well, the ear canal is self cleaning with dead skin and wax gradually and continually moving toward the opening and being discharged. Taking out of the trash of the ear canal so to speak. The canal is also kept healthy by maintaining a little acidic quality that slows down germ growth. And the wax and layers of skin cells serve as an effective barrier to keep germs from invading the skin.

But a child’s ear canal is often curved and sloped downward, allowing water to settle and supercharge the growth of bacteria and fungus. The canal is also a canal, a dead end path that again, promotes stagnation of anything entering.  And since your child’s ear canal has a light growth of bacteria and fungus all the time, if water gets trapped, especially if the skin barrier is broken, there we go with a painful case of swimmer ear, also known as otitis externa.

So what goes wrong that your child gets an outer ear skin infection?

As you know, summer is all about water for children. They often live in the pool, ocean, or lake which can promote an overgrowth of bacteria and fungus in the ear canal and possibly washing out the protective ear wax, and acids.  Think about your child swimming for a few hours, going underwater probably a thousand times, and you can see that their ear canal environment has changed drastically. Add to that some abrasions from cleaning with Q-tips, uses hard swim plugs, may have mild eczema in the ear canal, is swimming in high bacteria water like a lake or a warm swimming pool, who ends the day by washing their hair with shampoo that clogs up their ear, or a child who ends the day going to bed with wet hair, and you can see how a hot swimmer ear infection can easily get started.

So how do I prevent all this in your child?

Now that you understand what a otitis externa is, let’s get practical and talk about things you can do to prevent your children from suffering from a case this summer.

-The main thing is to keep their ear canals as dry as possible. Try and keep your child’s ear canals as dry as possible. Blow drying, shaking water out, towel drying, and putting a little rubbing alcohol in the ear just before bed.

-Avoid hard ear plugs, ear buds, q-tips, or any ear trauma.  All these things cause ear canal skin trauma.

-Don’t remove the wax from their ears unless you are instructed to do by your child’s pediatrician. It protects your child’s ear.

-If your child is prone to swimmer’s ear or is swimming daily, prophylaxis with 1/2 vinegar white and 1/2 alcohol at end of swimming day usually works to stop this process. Now you know that the alcohol dries your child’s ear and the vinegar and alcohol slows down the growth of germs. Do this every night until the swimming season is over. Some people simply use a dilute vinegar solution alone but i like the combination. There are also OTC drops for this at the pharmacy that will do the same thing.

-Be especially on guard for swimmer ear prevention when the pools get very warm in late July and August or if your child is swimming a lot in a lake (dirty). Sending some of these drops to camp with them may be a smart call.

-And this tip is especially for girls with thick hair…dry that hair before going to sleep otherwise their ear is damp all night. Perfect conditions for developing swimmer ear.

-And if your child is a competitive swimmer, soft water tight silicone ear plugs during swimming plus a special drop called Vosol HC or Acetasol HC once or twice daily during swim season can be helpful and is better tolerated than alcohol and vinegar.


Well, I hope those tips will keep your summer uninterrupted by a painful case of swimmer ear. By all means, let your children have a fun summer around water, but be smart about it. Swim lessons, adult supervision, and of course some attention to those delicate ear canals. If you find the information you get here valuable, please take a minute to rate this podcast where you get your podcasts and share an episode you like with family and friends. This is Doc Smo, hoping your children don’t have any tears, from summer sore ears. Until next time.