What should you know about swimmer's ear?

Also called otitis externa, swimmer's ear affects the passage between the outer ear and the eardrum. Water left in the canal can soften its protective skin. Scratching, cotton buds, earbuds or inserting other objects may then cause small breaks that allow irritation or infection to develop.

Typical symptoms include an itchy or blocked feeling, redness, discharge and pain that may worsen when the outer ear is touched or moved. Hearing can sound muffled when swelling or fluid narrows the canal. This is different from an infection deeper behind the eardrum, although an examination may be needed to tell the causes apart.

Keep the ear dry while it settles. During bathing, avoid directing water into the canal; do not swim until symptoms have cleared or a clinician has advised that it is safe. Let water drain naturally and dry only the outside of the ear with a towel.

Do not put cotton buds, fingers, oils or unprescribed drops into the ear. A pharmacist or clinician can advise whether pain relief is suitable for you and whether ear drops are needed. Drops are not appropriate for everyone, particularly when there may be a hole in the eardrum, so ask before using them.

Arrange a GP assessment if ear pain, itching, discharge or reduced hearing is worsening, does not settle, or makes it difficult to sleep or function. Assessment is also sensible if symptoms began after an object was placed in the ear, or if you are unsure whether the eardrum is intact.

Seek urgent medical help for severe pain, rapidly spreading redness or swelling around the ear, fever, marked dizziness, or new weakness of the face. People with diabetes or a weakened immune system should seek advice promptly because ear canal infections can sometimes become more serious.

You could ask: Is the problem in the ear canal or behind the eardrum? Are drops suitable for me? How should I keep the ear dry, and when can I swim again? If hearing remains muffled after treatment, should it be checked again?