Chronic Swimmer's Ear Causes


Swimming is a popular activity that can be enjoyed by people. However, frequent exposure to water can sometimes result in a painful condition known as chronic swimmer's ear which can occur in all age groups.1 Chronic swimmer's ear is a persistent infection of the outer ear canal that can cause discomfort and hearing loss if left untreated.

Explanation of chronic swimmer's ear

Chronic swimmer's ear, also known as chronic otitis externa, is a condition that affects the outer ear canal. The outer ear canal is the tube-like structure that connects the outside of the ear to the eardrum. When the skin in the ear canal becomes irritated or damaged, it can lead to inflammation and infection.

Chronic swimmer's ear is called "chronic" as the condition can persist for weeks or months, and may recur even after treatment. The infection can cause significant discomfort, including itching, pain, and drainage from the ear. If left untreated, chronic swimmer's ear can lead to hearing loss or other complications.

Importance of understanding chronic swimmer's ear causes

Understanding the causes of chronic swimmer's ear is important for prevention and treatment. By identifying the underlying factors that contribute to the condition, individuals can take steps to minimize their risk of developing chronic swimmer's ear and seek prompt medical attention if necessary.

The most common causes of chronic swimmer's ear are prolonged moisture exposure, injury to the ear canal, and bacterial or fungal infections. 

Causes of chronic swimmer's ear2,3,4,5

Chronic swimmer's ear is caused by a combination of factors, including prolonged exposure to moisture, injury to the ear canal, and bacterial or fungal infections. Let's explore these causes in more detail.

  1. Prolonged moisture exposure

Prolonged exposure to moisture is the primary cause of chronic swimmer's ear. This can happen when water gets trapped in the ear canal, providing a damp environment for bacteria and fungi to grow. The following activities can increase your risk of chronic swimmer's ear:

  • Swimming: Swimming is one of the most common causes of chronic swimmer's ear. Water can easily enter the ear canal when you're swimming, and if it's not properly drained, it can lead to infection
  • Sweating: Sweating can cause moisture buildup in the ear canal, especially if you're not wiping your ears dry
  • Humid : Humid weather can make your ears feel moist and uncomfortable, increasing your risk of developing chronic swimmer's ear
  • Injury to the ear canal

Injury to the ear canal can also cause chronic swimmer's ear. Scratching the ear canal with your finger or a sharp object can cause tiny cuts, allowing bacteria and fungi to enter and infect the ear canal. In addition, cleaning your ears with cotton swabs or other objects can also cause injury to the ear canal, making it more susceptible to infection.

  1. Bacterial or fungal infection

Bacterial and fungal infections can also cause chronic swimmer's ear. The most common type of bacteria that causes swimmer's ear is Pseudomonas aeruginosa. This bacterium is commonly found in water and soil and can infect the ear canal when it enters through an injury. Fungal infections are less common but can also cause chronic swimmer's ear.

  1. Weakened immune system

Individuals with weakened immune systems, such as those with diabetes or HIV, are more susceptible to chronic swimmer's ear. A weakened immune system can make it difficult for the body to fight off infections, making it more likely for bacteria and fungi to cause chronic swimmer's ear.

It's important to note that chronic swimmer's ear can occur in anyone, regardless of age or overall health. However, there are certain risk factors that can increase your chances of developing chronic swimmer's ear.

Risk factors for chronic swimmer's ear5

  1. Age

Chronic swimmer's ear can occur at any age, but it's more common in children and young adults. This is because their ear canals are still developing, and they may spend more time in the water.

  1. Climate and environment

Living in a humid climate or working in a job that requires frequent exposure to water can increase your risk of chronic swimmer's ear.

  1. Skin conditions

Individuals with skin conditions such as eczema or psoriasis are more susceptible to chronic swimmer's ear because their skin is more prone to inflammation and infection.

  1. Swimming habits

Frequent swimming, especially in untreated water such as lakes or ponds, can increase your risk of chronic swimmer's ear.

  1. Foreign objects in the ear

Objects such as earplugs or hearing aids can trap moisture in the ear canal, increasing your risk of developing chronic swimmer's ear.

Symptoms of chronic swimmer's ear

One of the most common symptoms of chronic swimmer's ear is itching or pain in the ear. This pain can range from mild to severe and may be continuous or intermittent. Redness and swelling of the ear canal are also common symptoms, and there may be discharge from the ear, which can be yellow or green in color and may have an unpleasant odor. Another symptom is reduced hearing, which can occur if the inflammation and swelling of the ear canal obstruct the passage of sound waves.

Diagnosis and treatment of chronic swimmer's ear


Chronic swimmer's ear is diagnosed through a physical examination by a healthcare provider. During the examination, the outer ear and ear canal are examined for signs of inflammation, discharge, or damage. Microscopic examination and culture tests may also be done to confirm the diagnosis.

During the physical examination, the healthcare provider will examine the outer ear and ear canal for signs of inflammation, discharge, or damage. The ear may also be gently cleaned to remove debris and assess the extent of the infection. small sample of the discharge or debris from the ear are examend under a microscope to identify the type of bacteria or fungus causing the infection. Culture tests are done to determine the specific type of bacteria or fungus causing the infection. This helps to guide the selection of the most effective antibiotics or antifungal medications for treatment.


The treatment of chronic swimmer's ear typically involves the use of ear drops that contain antibiotics or antifungal agents. Antibiotics may also be prescribed in the form of oral medication for severe or complicated cases. Pain relief medications such as acetaminophen or ibuprofen may also be recommended to manage the pain and discomfort associated with the infection. Ear drops containing antibiotics or antifungal agents are applied directly to the infected ear and should be used according to the prescribed dosage and duration.

In addition to medical treatments, there are also several home remedies that can help alleviate symptoms and promote healing. Warm compresses can be applied to the affected ear to reduce pain and inflammation. It is also important to avoid getting water or moisture in the ear, which can worsen the infection. Over-the-counter pain relievers may also be used to manage pain and discomfort.

However, external ear infection can lead to two main complications: Periauricular cellulitis and malignant external otitis. Periauricular cellulitis causes redness, swelling, and warmth around the ear, while malignant external otitis is a severe and potentially life-threatening complication that occurs when the infection spreads from the skin to the bone and marrow spaces of the skull base. It is more common in older adults with diabetes or other immune system problems. Symptoms of malignant external otitis include severe ear pain and discharge, with visible tissue damage in the ear canal. If suspected, a patient should see an ear, nose, and throat specialist for prompt referral and diagnosis.

Prevention of chronic swimmer's ear

Prevention is always better than cure, and this is especially true when it comes to chronic swimmer's ear. Here are some simple steps you can take to prevent this condition:

  1. Drying the ears properly

Make sure to dry your ears thoroughly after swimming or showering. Use a soft towel or a hair dryer on the lowest heat setting. Tilt your head to one side and gently tug on your earlobe to help the water drain out.

  1. Use of earplugs or a swim cap

Wearing earplugs or a swim cap can help keep water out of your ears while swimming. There are several types of earplugs available, including foam, silicone, and custom-fitted earplugs. Choose the type that fits your ears comfortably and provides a good seal.

  1. Avoidance of ear trauma

Avoid inserting objects into your ears, including cotton swabs, hairpins, or even your fingers. These can cause trauma to the ear canal and increase the risk of infection. If you need to clean your ears, use a soft washcloth or tissue.

  1. Maintenance of good ear hygiene

Keeping your ears clean and dry can help prevent chronic swimmer's ear. Avoid using Q-tips or other objects to clean your ears. Instead, use a damp washcloth to gently clean the outer ear.

  1. Prompt treatment of ear infections

If you develop an ear infection, seek prompt medical treatment. The sooner the infection is treated, the less likely it is to progress to chronic swimmer's ear.


Chronic swimmer's ear is a common condition that can cause significant discomfort and hearing loss. It is important to understand the causes and risk factors of this condition, as well as how to prevent and treat it.

If you experience symptoms of chronic swimmer's ear, such as itching, pain, redness, or discharge from the ear, seek prompt medical attention. Your doctor can diagnose the condition and recommend appropriate treatment, which may include ear drops, antibiotics, pain relief medication, or home remedies.

By taking simple steps to prevent chronic swimmer's ear, such as drying your ears properly, using earplugs, and maintaining good ear hygiene, you can reduce your risk of developing this condition. Remember, prevention is always better than cure.


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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Beste Selen Arikan

Medical Doctor- Master’s Degree in Drug Sciences, University of Basel, Switzerland

Beste is a Medical Doctor with a deep understanding of AI in Healthcare and extensive experience in managerial positions within the healthcare sector. With a substantial track record as a project/product manager, she has also excelled in advisory and management roles. Currently, Beste is dedicated to furthering her expertise by pursuing a Masters degree in Drug Sciences in Switzerland, with a vision to make a significant impact in the pharmaceutical industry and improve the lives of countless individuals. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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