Doctors explain that most ear infections—but not swimmer's ear—affect the middle ear

Explore why swimmer's ear will not go away on its own

This infection is typically treated with ear drops to reduce inflammation and fight the bacteria or fungus that led to the issue. But without treatment, complications can arise, including a deep tissue infection, bone or cartilage damage, or—very rarely—spreading beyond the ear into the skull bones and surrounding areas.

Learn about swimmer's ear, which sickens 1 in 10 Americans

This outer ear infection—in the tube leading from the ear opening to the eardrum—is usually caused by bacteria. Formally called otitis externa, this condition is commonly called swimmer's ear because microbes can enter the ear canal while swimming.

Swimmer's ear is not contagious

Though a lot of people may have symptoms of swimmer's ear at the same time at the same pool, that's because they are all swimming and the moisture is remaining in their ears—not because they are passing this bacterial or fungal-caused infection to each other. People of any age swimming in a pool, lake, or other body of water are all at risk, though children are considered particularly vulnerable.

Swimming boosts the risk of contracting swimmer's ear by fivefold

The term swimmer's ear is a bit of a misnomer since other factors including scratches to your ear from Q tips, trapped perspiration inside the ear when you sweat, and living in tropical climates can elevate the risk of contracting this outer ear infection. But swimming poses the greatest risk: widely cited research has found that swimming elevates the risk of contracting this infection fivefold.

Ear infections can arise from chlorinated water, too

Any water remaining in the ear can lead to swimmer's ear. Chlorinated water, however, can also strip the skin of the oils and wax that would otherwise protect the ear.

Children are at increased risk of contracting swimmer's ear

Kids may be more likely to spend time at the pool so they have that water exposure. They also tend to have narrow ear canals, a prime location for water to get trapped. Frequently wearing earbuds or excessively trying to rid ears of earwax, however, can also increase the chances of painful swimmer's ear infections at any age.

Exactly who coined the term 'swimmer's ear' remains unknown

There is no record of anyone being the first person to call otitis externa by its most commonly known name, swimmer's ear. The earliest known use of the term was in a 1917 news article, according to the Oxford English Dictionary. The article in Connecticut's The Day stated that the illness was appearing among swimmers and bathers that summer.

Swimmer's ear is America's most common waterborne illness

Federal government analysis of the roughly 7 million waterborne illness cases that occur annually in the US found that swimmer's ear comprises some 4.7 million, or 65%, of the annual waterborne illnesses and 20% of hospitalizations. Norovirus infection comes in second place.

Listen to why extensive ear rinsing can create problems

The clinician who hosts this podcast discusses how his patient developed swimmer's ear after he flooded his ears with water during his daily showers, ostensibly to clean them. The resulting itchy, painful ears were the result of removing protective earwax in the ear and also altering the typical pH of the ear.

See why wearing earbuds—instead of over-the-ear headphones—can cause ear infections

Earbud headphones can heighten the risk of ear infections. They can lead to earwax buildup and create a dark, moist environment as you sweat—ideal conditions for germs to thrive. Wearing external over-the-ear headphones or ones that don't enter deep into the ear canal can help.

Watch how to safely remove water from your ears

Do not stick a Q-tip into the ear canal—it can cause microtears of the delicate skin there and elevate infection risks. Instead, try tapping on the side of your tilted head after swimming to break the surface tension so water will drip out, or pulling your earlobe in different directions while the ear is pointed downwards. Another suggested approach is to place a few droplets of isopropyl alcohol or over-the-counter eardrops inside the ear to speed evaporation. If those approaches don't work, consider contacting your physician.

Surfer's ear, from repeated cold water exposure, leads to new bony protrusions in the ear

Frequent exposure to icy cold water, typical in surfing, can cause tiny bony growths to develop in the ear canal, informally called surfer's ear. While the exact cause for these growths is unknown, it may be the body's protective response to shield the ear drum from the cold. These protrusions can heighten the risk of swimmer's ear, lead to wax buildup, and result in hearing loss.

Infants are particularly at-risk for ear infections

The Eustachian tubes, which connect the middle ear to the upper throat and help to drain fluids and equalize pressure, are relatively flat at birth, making it hard for gravity to assist with drainage. The angle of these tubes changes and becomes steeper as we age, making fluid buildup in the ear canal less common.

Q-tips can cause more problems than they solve

Swabbing the ear with a Q-tip can disrupt the ear wax that naturally protects the ear from dirt and bacteria. It can also tear the delicate skin of the ear drum, causing permanent hearing loss and constant discomfort that's similar to the symptoms of swimmer's ear. (Some users may encounter a paywall.)

If kids have ear tubes, over-the-counter ear drop solutions to clear buildup shouldn't be used

Mixes of acetic acid or alcohol to help speed water evaporation in the ears shouldn't be placed into children's ears if they have a hole in the eardrum or if they had ear tubes inserted—hollow cylinders made of plastic or metal that are inserted into the eardrum by a doctor to help drain fluid and improve airflow in the middle ear. Alcohol or acids can cause irritation to the middle ear and intense pain as they pass through the hole or tube.

We hear because soundwaves are converted into electrochemical signals in our ears

This science teacher video systematically walks through the biology of the outer, middle, and inner ear. The explanation starts with the auricle, an external part that funnels sound through the auditory canal, and the tympanic membrane (the ear drum), which vibrates when sounds hit it. Beyond that, as the video details, is the eustachian tube, which is connected to the back of our throats and allows air to pass in and out to equalize ear pressure.

Tinnitus is a rare side effect of COVID-19

The infection can affect inner ear cells, and a review of the literature across multiple studies concluded that hearing loss occurred in 3.1% of patients with the virus and tinnitus in 4.5%.

Ménière's disease is a long-term, inner ear disorder that causes vertigo

This severe vertigo-causing disorder may involve long and recurrent episodes of vertigo. Symptoms of this disease include balance issues and hearing loss, tinnitus, and a feeling of fullness in the ear. It typically affects only one ear and is linked to a buildup of excess fluid in the inner ear.

Ancient Egyptian papyrus from 16th century BCE seems to reference tinnitus

Ancient Egyptians wrote that they treated "bewitched ear" with herbal concoctions that involved frankincense and other ingredients, which were placed in the ear.

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Learn how cholera bacteria sicken humans

Once a person has ingested large amounts of the bacteria, typically through contaminated water, cholera bacteria begin producing and releasing a toxin inside their host. It attacks the mucosal lining of the intestine, making it hard to absorb liquids. This process leads to cholera's characteristic symptoms, like voluminous, watery diarrhea.

Typhoid smells like freshly baked brown bread

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Erythema migrans rash is common in Lyme—but it often doesn't look like a bull's-eye

The US Centers for Disease Control and Prevention states that this rash occurs in roughly 70% or more of Lyme disease patients, and typically occurs at the site of a tick bite. The rash may expand slowly over several days and feel warm to the touch, but it's rarely itchy or painful. As it grows, areas of it may clear—creating a target or "bull's-eye" appearance.

Changes in vision or eye pain can be early MS symptoms

This occurs due to myelin degradation around the optic nerve, impairing its ability to transmit visual information to the brain. Individuals may especially experience eye symptoms after exercising or taking a hot shower because boosted body temperatures slow down nerve function in nerves already damaged by MS.

The most common type of arthritis is osteoarthritis, or age-related cartilage loss

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