Otitis Externa

(Swimmer’s Ear)


Otitis externa is an inflammation and/or infection of the ear canal. The ear canal is the tube leading from the outer ear to the eardrum. Because it is often found in swimmers, particularly in warm, humid climates, it is often referred to as swimmer’s ear.
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Otitis externa is caused by infection, chemical irritation, or trauma. Trauma causes damage to the ear canal, which may cause inflammation or allow infection to invade.

Risk Factors

Factors that may increase your chance of otitis externa include:
  • Frequent swimming in chlorinated water, stagnant water, or increasingly warm water
  • Not rinsing all of the soap from the ear canal while showering or bathing
  • Younger age with narrow ear canals
  • Insertion of any object into the ear canal causing damage to the lining
  • Skin conditions, such as eczema, that cause breaks in the skin of the ear canal
  • Eardrum rupture from a middle ear infection—otitis media
  • Diabetes
  • Medical conditions resulting in a compromised immune system
People with weak immune systems or who have a chronic illness, such as diabetes or HIV, may get an aggressive form called malignant otitis externa. Malignant otitis externa results in infection of the cartilage and bone around the ear, as well as between the ear and the brain (the skull base). The condition can be severe and difficult to treat, causing nerve paralysis.


Otitis externa may cause:
  • Redness and/or itching inside the ear canal
  • Pain in the ear, sometimes severe, that may worsen when chewing or talking, and with pulling on the ear
  • Hearing loss or a plugged-up or pressure sensation of the ear
  • Drainage from the ear

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