Swimmer’s Ear vs. Ear Infection: What’s the Difference?

“Swimmer’s ear and an ear infection cause pain and discomfort, especially for young children,” said Derek Mattimoe, MD, Catholic Health Family Medicine Physician. “Although symptoms are similar, the causes and treatments are different, which is important for knowing when to get the right care.”

How is swimmer’s ear different than an ear infection?

Swimmer’s ear (otitis externa) occurs when the outer ear canal becomes infected. The outer ear consists of the visible part of the ear (pinna) and the external auditory canal that connects to the middle ear. Water remaining in the outer ear after swimming can cause swimmer’s ear; baths and showers can also cause it. The water creates a moist environment that breaks down the ear’s protective wax, allowing bacteria to grow.

An ear infection (otitis media) causes swelling in the middle ear cavity. It occurs due to a blockage in the eustachian tube, which connects the middle ear to the back of the throat. Ear infections often occur after a common cold.

What are the symptoms of swimmer’s ear and ear infection?

“You can tell if you have swimmer’s ear or an ear infection by where you feel pain,” said Dr. Mattimoe.

With swimmer’s ear, you feel pain near the ear opening. The pain increases when you pull on your earlobe.

If you have an ear infection, you feel pain in your inner ear behind your eardrum. The pain may get worse when you lay down.

Besides pain or discomfort, common symptoms of swimmer’s ear include:

• Fluid or pus draining from the ear
• Itchiness
• Muffled sound
• Redness or swelling

You may have more severe itching and increased pain if the infection worsens. You may also have excessive fluid drainage and decreased hearing.

The symptoms of an ear infection often start quickly and include:

• Fluid drainage from the ear
• High temperature
• Lack of energy
• Pressure inside the ear

Children may have ear pain when lying down, making it difficult for them to sleep. They may also pull or tug at their ear to relieve the pressure. Children are more likely to get an ear infection after a cold.

How are swimmer’s ear and ear infections diagnosed?

If you think you or your child have swimmer’s ear or an ear infection, contact your primary care provider (PCP) or pediatrician. Go to urgent care if the symptoms last more than two to three days, worsen or include a high temperature.

Your doctor diagnoses if you have swimmer’s ear or an ear infection by first asking about your symptoms and completing a physical exam.

They will then examine your ear canal with a lighted instrument called an otoscope. This instrument helps check your ears for redness or swelling and looks for fluid behind the eardrum or a hole in the eardrum.

How are swimmer’s ear and ear infections treated?

Contact your PCP if you have symptoms of swimmer’s ear or an ear infection.

Swimmer’s ear treatment

Your PCP may prescribe ear drops for swimmer’s ear, which contain antibiotics and steroids to fight infection and reduce inflammation. Over-the-counter pain relievers like ibuprofen can also relieve discomfort.

At home, a diluted solution of vinegar and hydrogen peroxide can help get rid of bacteria in your ear. Use an eye dropper or rubber bulb syringe to drop the solution into the ear. Do not do this if you know the eardrum has holes in it. You can also use a warm washcloth to relieve pain and help melt earwax.

Do not stick anything in your ear, such as cotton swabs, to try to clean it yourself. They can pack earwax into the ear canal, trapping water even further. Cotton swabs can also damage the lining of the ear canal. Your doctor may gently clean your ear out to help treatments work better.

Ear infection treatment

Viruses often cause ear infections, so antibiotics typically will not work. However, if bacteria is the cause, your PCP may prescribe antibiotics. Take antibiotics as instructed, even if you start feeling better. Your doctor may recommend an over-the-counter pain reliever if you have a fever.

You can ease the symptoms of an ear infection at home by gargling with salt water to clear the Eustachian tubes. The gargle washes out any blockages at the entrance of the tube. Gently pressing a heated compress against the infected ear can also provide relief.

“Call your PCP for a diagnosis before trying any at-home treatment for swimmer’s ear or an ear infection,” said Dr. Mattimoe. “The ear is a sensitive area that can easily get hurt.”

Can swimmer’s ear be prevented?

You can prevent swimmer’s ear by wearing ear plugs and drying your ears thoroughly after swimming or showering.

“Ear infections are not as easily preventable, often because they are caused by illnesses like a cold or flu or result from allergies,” said Dr. Mattimoe. “If you have a history of ear infections, your PCP can help you identify certain risk factors and provide helpful tips for safely enjoying activities like swimming.”