Swimmer’s ear is an infection of the outer ear canal. Usually a person develops such an infection after the ear is exposed to water for an extended period of time. Many readers have found ways of dealing with swimmer’s ear. Otolaryngologists have also offered recommendations for safe ways of dealing with swimmer’s ear.
We share some of these tips, but we have been roundly criticized by a physician who says some home remedies are a bad idea. You will read about his recommendation for using a hair dryer as alternative solution.
What to Do About Ear Infections from Swimming?
Q. My exercise of choice is swimming laps. I used to get occasional ear infections as a result. Once a doctor told me to put a drop of 50 percent alcohol in my ear after getting out of the pool. I never had another problem.
A. Years ago, an otolaryngologist recommended applying a solution of half white vinegar and half rubbing alcohol after getting out of the pool. It sounds similar to your approach. It is important that the drops be close to body temperature, neither too warm nor too cool.
Another option is chewing xylitol gum after swimming. According to a recent review, xylitol reduces the risk of ear and respiratory infections (Applied Microbiology and Biotechnology, Sep. 2020).
Q. Do you know of any good, safe ways of dealing with swimmer’s ear? I can usually feel it coming on (often within a couple days of clearing out ear wax or swimming in a lake or pond). I’d like to be able to clear it up before I need to see a doctor and get some antibiotic.
What Is Swimmer’s Ear?
A. When water gets trapped in the ear, it can lead to an infection in the outer ear. This is called otitis externa, or more commonly swimmer’s ear. It often occurs after getting water in the ear or injuring it with a cotton swab or fingernail. Bacteria in the water used for swimming may lead to such infections (Hlvasa et al, MMWR Morbidity and Mortality Weekly Report, May 18, 2018).
To tell if the pain is from the outer ear or from the middle ear (behind the ear drum), pull gently on the earlobe. This will increase the pain from swimmer’s ear but won’t change the pain from a middle ear infection (otitis media).
Doctor Spanks Us For Alcohol/Vinegar to Prevent Swimmer’s Ear:
This physicians says alcohol and/or vinegar is a big mistake!
Q. You have given your readers some very bad advice. As a practicing physician for 44 years, I advise my patients after they bathe, shower or swim to simply use a hair dryer to gently blow warm (not hot) air at a low speed for 20-30 seconds into their ears to dry them out. One can always find a hair dryer in hotels, gyms, health clubs and at home.
Instilling a cocktail of isopropyl alcohol and/or vinegar is much more complicated, not to mention messy. Furthermore, if you have a perforated eardrum, you risk additional potential complications. The hair dryer doesn’t introduce anything else into your external auditory canal.
A. Thank you for suggesting a hair dryer on low power and low heat settings. That is also the advice from the CDC. It should be kept about a foot from the ear. We do worry about someone casually using high heat and/or high power settings on their hair dryer. And hair dryers can be very noisy. If someone is not careful, your recommendation could also be hazardous.
The Mayo Clinic actually recommends vinegar and alcohol with a caveat:
“If you know you don’t have a punctured eardrum, you can use homemade preventive eardrops of 1 part white vinegar to 1 part rubbing alcohol. This solution promotes drying and helps prevent the growth of bacteria and fungi. Before and after swimming, pour 1 teaspoon (about 5 milliliters) of the solution into each ear and let it drain back out. Similar over-the-counter solutions might be available at your drugstore.”
Advice from the Children’s Hospital of Philadelphia is almost identical.
We recognize that people may not always know whether they have a punctured eardrum. The only way to be sure is to have an otolaryngologist examine the ears.
Many of the OTC swimmer’s ear preventive drops sold in pharmacies contain isopropyl alcohol and anhydrous glycerin. That includes brand names such as Debrox Swimmer’s Ear and Swim-EAR.
Safe Ways of Dealing with Swimmer’s Ear:
If you have pain from swimmer’s ear, you need to see a doctor. Prescription ear drops containing a corticosteroid and an antibiotic or an antifungal agent can clear up such infections quickly (Deutsches Artzeblatt International, March 29, 2019).
Prevention is your best medicine, though. Rinsing the ear with a few drops of a solution of half white vinegar and half rubbing alcohol can help dry out excess moisture after swimming…as long as there is no punctured eardrum!
How to Prevent Swimmer’s Ear:
Q. I am confused about how to prevent swimmer’s ear. A lot of websites suggest putting alcohol in the ears after swimming. But is it 50 percent or 90 percent? What about vinegar? Is the correct solution half alcohol and half vinegar? Please help me figure this out.
A. You can purchase over-the-counter ear drops to prevent swimmer’s ear. Most contain 95 percent anhydrous isopropyl alcohol and 5 percent anhydrous glycerin. By the way, anhydrous means it contains no water.
Here is what another reader wrote:
“I mix a solution of 1/2 isopropyl alcohol and 1/2 vinegar. I put it in the ear canal with a dropper after swimming, let it stand for a little while, and then empty the ear canal.
“The alcohol dries the water, and the vinegar leaves an acidic base for the ear canal, so fungus won’t grow. I have been using this solution for years, but I am careful not to use this too often so that I don’t get dry skin in my ears.”
Getting Water Out to Prevent Swimmer’s Ear:
Q. My brothers and sisters and I were all on a swim team for most of our young lives. The swim coach had us get out of the pool and lie on the warm pavement with one ear to the ground. We counted to 60 (one minute) and then turned the other ear down. I did this with my kids: no swimmer’s ears.
My father-in-law, who swam every day, used an eye dropper and put a couple of drops of vodka in his ears when he climbed out of the pool. He never had a bad ear either. These are safe ways of dealing with swimmer’s ear
A. With the start of summer, parents make it a high priority to prevent swimmer’s ear. Your approach has the advantage of being both free and easy, with no side effects.
Ear Drops to Prevent Swimmer’s Ear:
Ear drops such as Swim-EAR containing alcohol and glycerin can prevent infection by helping to evaporate water from the ear canal. You can also make your own ear drops.
One reader reported:
“I haven’t had swimmer’s ear for some time. I do use a home formula for drops. It’s 45 percent alcohol, 45 percent vinegar, 10 percent glycerin.”
A more common formula is half alcohol and half white vinegar.
Ear Plugs May Help Prevent Swimmer’s Ear:
Some swimmers find that customized molded ear plugs can keep water out of the ears and prevent the problem.
However, a reader cautioned:
“One must be very careful in using ear plugs when swimming. Any scuba diver will tell you that compensating for pressure is a very important aspect of underwater activity. As the diver descends below the surface, the outside pressure increases, The ear has a away of allowing pressure to equalize so that the ear drum does not become stressed, but if you block the ear canal with an ear plug the plug may be forced into the canal causing pressure on the ear drum and extreme pain. The plug may be forced far enough into the ear to make it difficult to remove. The takeaway: ear plugs should be used only for surface swimming.”
Chewing Gum to Help Prevent Swimmer’s Ear:
One mother wrote us:
“Otitis Externa: When my daughter started swimming with a league 15 years ago, she developed swimmer’s ear. I looked online and found a Finnish study that recommended chewing Trident gum with xylitol in it after swimming, as that opened up the Eustachian tubes and the xylitol had some small preventative effect. She tried it and it worked for the next 4 years!
“I myself started lap and lake swimming and I always had plenty of Trident gum handy to chew immediately after getting out of the water.”
Citations
- Benahmed AG et al, "Health benefits of xylitol." Applied Microbiology and Biotechnology, Sep. 2020. DOI: 10.1007/s00253-020-10708-7
- Hlavsa MC et al, "Outbreaks associated with treated recreational water - United States, 2000-2014." MMWR Morbidity and Mortality Weekly Report, May 18, 2018. DOI: 10.15585/mmwr.mm6719a3
- Wiegand S et al, "Otitis Externa." Deutsches Artzeblatt International, March 29, 2019. DOI: 10.3238/arztebl.2019.0224 Free PMC article
