Understanding Swimmer’s Ear
What is it? Swimmer’s ear (also called external otitis) is an infection of the skin lining the outer ear canal — the tube that runs from the outside of the ear to the eardrum. It happens when water, moisture, or small irritations to the canal allow bacteria to grow. It’s very common in kids, especially in the summer or after a lot of pool time, but it can also happen even if your child hasn’t been swimming.
Common Signs
- Ear pain that gets worse with touch: Pain when you tug on the outside of the ear or press on the little bump in front of the ear (the tragus) is a classic clue.
- Itching or fullness: Kids may complain that the ear feels itchy, clogged, or ”underwater.”
- Muffled hearing: Sounds may seem quieter on the affected side because the canal is swollen.
- Drainage: You may notice clear, white, or yellowish fluid coming from the ear.
- Recent water exposure or ear-poking: Swimming, baths, earbuds, or cotton swabs can all set it off.
When to Manage at Home
✅ You can manage your child’s swimmer’s ear at home when:
- Your child has been started on prescription ear drops and is using them as directed.
- Pain is manageable with over-the-counter medication and warm compresses.
- Your child is otherwise acting like themselves — eating, drinking, sleeping, and playing.
- There’s no fever, stiff neck, facial weakness, or swelling behind the ear.
- Symptoms are slowly improving over the first 48–72 hours of treatment.
How to Treat at Home
🏠 Home care for swimmer’s ear:
- Use the prescription ear drops exactly as directed: Even if your child feels better in a few days, finish the full course to fully clear the infection.
How to give the drops:
- Have your child lie down with the affected ear facing up.
- Place the drops in the canal, then keep them in that position for several minutes so the medicine can reach where it needs to go.
- Gently press and release the tragus (the small bump in front of the ear) a few times to help the drops travel down the canal.
- Keep the ear dry for the full course of treatment: Moisture feeds the infection. Plan to keep water out of the ear for 7–10 days, or until your child has finished the drops and is fully pain-free.
- AVOID: swimming, dunking the head under bathwater, and getting the ear wet in the shower until your child has finished treatment and the ear feels completely back to normal.
- For brief showers or baths, place a cotton ball coated in petroleum jelly (Vaseline) loosely in the outer ear opening before water exposure, then remove it afterward. Don’t push it down into the canal — it’s meant to sit at the entrance.
- Skip the cotton swabs: Don’t insert Q-tips, fingers, earbuds, or anything else into the ear canal — this can worsen swelling and irritation.
- Manage pain with ibuprofen or acetaminophen: Swimmer’s ear can be really painful, especially in the first day or two. Ibuprofen (Motrin, Advil) is preferred for ear pain if your child is 6 months or older. Acetaminophen (Tylenol) can be used at any age. See the Safe Medications section below for dosing details.
- Warm compress for comfort: A warm (not hot) washcloth held against the ear can help ease pain, especially before bedtime.
Safe Medications
- Ibuprofen (Motrin, Advil) is preferred for ear pain and can be given every 6–8 hours for children 6 months and older.
- Acetaminophen (Tylenol) can be used every 4–6 hours as needed and is safe at any age.
- Always dose by your child’s current weight, not age. Reach out if you need help with dosing.
When to Contact Poppins
📱 Contact us again when:
- Symptoms aren’t improving after 48–72 hours of ear drops.
- Pain is getting worse instead of better, or pain medication isn’t helping.
- Drainage from the ear increases or changes color (becomes thick, bloody, or foul-smelling).
- A new fever develops.
- You’re having trouble getting the drops into the ear, or your child is refusing them.
- You have questions about medication, swimming, or returning to daycare or school.
When to Visit Your Pediatrician
🩺 Go to an in-person appointment when:
- Symptoms haven’t improved after a full course of ear drops.
- The ear canal is so swollen that drops can’t get in.
- Your child has had repeated episodes of swimmer’s ear.
- You’re noticing ongoing hearing changes or fullness even after the infection seems to clear.
- Your child has a condition that affects the immune system, or the infection just doesn’t seem to be improving as expected.
When to Go to the ER
🚨 Seek immediate emergency care if your child has:
- A stiff neck, severe headache, or strong sensitivity to light.
- Drooping or weakness on one side of the face.
- Redness, swelling, or pain behind the ear, or the ear starts to stick out from the head.
- Appears very sleepy, lethargic, or ”not themselves.”
- Sudden dizziness, spinning sensation, ringing in the ears, or noticeable hearing loss.
- A high fever paired with severe ear pain.
If your gut tells you something is wrong, don’t hesitate to reach out. Need help? Reconnect with our on-demand team of medical staff.
