Swimmer's ear (otitis externa) is an infection of the ear canal, the tube that runs from the outside of your ear to your eardrum. It causes pain, itching and ear discharge. Most cases get better within 7 to 10 days with ear drops.
Emergency
Go to your nearest emergency department if you have swimmer's ear and:
- you have diabetes or a weakened immune system, and your ear pain is severe or getting worse despite treatment
- one side of your face becomes weak or droopy
- you have a severe headache, or feel very unwell with a high fever
- redness and swelling are spreading from your ear to your face or neck
These signs can mean the infection has spread beyond the ear canal. This is uncommon but needs treatment straight away. Call triple zero (000) if you are very unwell.
Key points
- Swimmer's ear is an infection of the ear canal. It is also called otitis externa.
- It often happens after swimming, or when the skin of the ear canal is damaged, for example by cotton buds.
- The main symptom is ear pain that gets worse when you touch or pull your ear.
- Prescription ear drops are the main treatment. Most people improve within 7 to 10 days.
- Keeping your ear dry helps it resolve and stops it coming back.
- A Doccy consultation can help with medical certificates and ear drops for typical swimmer's ear, if appropriate.
What is swimmer's ear?
Your ear canal is lined with thin skin and a layer of ear wax. The wax protects the skin from water and germs.
Swimmer's ear happens when this protection breaks down. Water, scratching or cleaning can damage the skin. Germs can then get in and cause an infection. The skin becomes red, swollen and painful.
It is called swimmer's ear because water in the ear is a common trigger. But you can get it without swimming.
Swimmer's ear is different from a middle ear infection (otitis media). A middle ear infection happens behind the eardrum, often after a cold. Read more in our ear pain and ear infections in adults article.
How common is swimmer's ear?
Swimmer's ear is a common reason people see a GP in Australia. About 1 in 10 people get it at some point in their life.
It is more common in summer and in warm, humid places such as North Queensland. A 2024 Queensland study looked at nearly 1,700 ear swabs. Bacteria caused about 4 in 5 infections. Fungal infections were more common in adults (about 1 in 4) than in children (about 1 in 12).
Symptoms of swimmer's ear
Symptoms usually start within 2 days. They include:
- ear pain, which gets worse when you touch or pull your ear, or chew
- itching in the ear canal
- a blocked or full feeling in the ear
- discharge from the ear
- muffled hearing
- redness and swelling of the ear canal
In severe cases, the ear canal swells shut. The glands in your neck may also become swollen and tender.
When to see a doctor
If you have any of the signs in the emergency box at the top of this page, go to your nearest emergency department.
Get an urgent GP appointment, or call healthdirect on 1800 022 222 for advice, if:
- the outside of your ear is red, hot, swollen and painful
- you have severe ear pain with discharge, or a headache that will not go away
- your pain is getting worse after 3 days of ear drops
- your ear canal is so swollen that drops cannot get in
See a GP if:
- you think you have swimmer's ear
- your symptoms have not settled after 2 weeks of treatment
- you keep getting swimmer's ear
- your hearing has not returned to normal after the infection clears
Causes and risk factors
Swimmer's ear is usually caused by bacteria. The most common are Pseudomonas and Staphylococcus aureus. Fungi, such as Candida or Aspergillus, cause some cases. Fungal infections are more likely after a long course of antibiotic drops, or if you have a weakened immune system.
You are more likely to get swimmer's ear if you:
- swim often, or get water trapped in your ears
- use cotton buds, fingers or other objects in your ears
- wear hearing aids, earplugs or earbuds for long periods
- have a skin condition such as eczema or psoriasis
- live in a hot, humid climate
- have diabetes or a weakened immune system
How swimmer's ear is diagnosed
A GP can usually diagnose swimmer's ear by looking in your ear with a small torch (otoscope). They will check for redness and swelling, and whether your eardrum is intact.
You do not usually need tests. Your doctor may take a swab if:
- your ear does not improve with treatment
- they think you have a fungal infection
- you keep getting swimmer's ear
Sometimes the ear canal swells shut. If this happens, your GP will refer you to hospital to see an ear, nose and throat (ENT) specialist, who may put in an ear wick. If the GP is concerned the infection may have spread to the bone, you will be referred for an urgent ENT review and consideration of a scan.
Treatment for swimmer's ear
Ear drops are the main treatment. Most contain an antibiotic, and some also contain a steroid to reduce swelling. They need a prescription. Your doctor will choose drops that are most appropriate for you. If you have a hole or absent ear drum, this may affect the antibiotic drop they choose. Your doctor will direct you how frequently to use them and for how long, depending on the degree of infection. Most courses are 7 to 10 days long.
Ear wick. If your ear canal is too swollen for drops to get in, your GP may refer you to an ENT specialist to have a small sponge (ear wick) put in your ear canal. The drops soak into the wick. It is usually removed after about 3 days or falls out as the canal swelling decreases.
Ear cleaning. If your ear canal is full of discharge or debris, a GP or ENT specialist may clean it gently with suction. This helps the drops reach the site of the infection.
Antifungal drops may be used if a fungus is the cause.
Pain relief, such as paracetamol or ibuprofen, can ease pain while the drops work.
Antibiotic tablets are not usually needed. They are used if the infection spreads beyond the ear canal, or if you have diabetes or a weakened immune system.
Self-care and prevention
While your ear heals:
- Keep your ear dry. Wear a shower cap, or put cotton wool coated in petroleum jelly in your ear when you shower.
- Do not swim until your ear has healed.
- Do not put anything in your ear, including cotton buds.
- Take a break from hearing aids or earbuds if you can.
To stop it coming back:
- Wear earplugs when swimming. A little petroleum jelly around the earplug helps it seal.
- Dry your ears after swimming or showering. Tilt your head to drain water, or use a hair dryer on the lowest/cool setting held away from your ear.
- Ask your pharmacist about drying ear drops to use after swimming. These are not suitable if you have a hole in your eardrum.
- Clean hearing aids and earbuds regularly.
- Keep skin conditions such as eczema under control.
Outlook
Most people with swimmer's ear get better within 7 to 10 days of starting ear drops. Some people get it again, especially if they swim often.
Rarely, the infection spreads to the bone around the ear canal. This is called necrotising (or malignant) otitis externa. It is not cancer. It mainly affects older people with diabetes or a weakened immune system. It needs hospital treatment.
How Doccy doctors can help
A Doccy consultation can help if you have typical swimmer's ear and none of the warning signs on this page. The doctor may ask you to send a photo of your outer ear. A Doccy consultation can:
- provide a medical certificate if you need time off work or study, or a carer's certificate if you are looking after someone who is unwell
- provide a special consideration letter if swimmer's ear has affected a university assessment or deadline
- prescribe antibiotic ear drops for typical swimmer's ear, if it is appropriate
- continue a prescription for medicine you already use, if it is appropriate
A Doccy consultation is not suitable if you have any of the signs in the emergency box. A doctor cannot look inside your ear remotely. See a GP in person if you have diabetes or a weakened immune system, your ear canal is very swollen, or you are not improving after 3 days of drops.
Resources and support
healthdirect: information on swimmer's ear and a 24-hour nurse advice line on 1800 022 222.
Hearing Australia: advice on caring for hearing aids and protecting your ears.
These services and websites can provide extra information, but they do not replace advice from your own doctor.
- Lee J, Yau S. Approach to otitis externa in Australian general practice. Aust J Gen Pract. 2024;53(12). https://www1.racgp.org.au/ajgp/2024/december/approach-to-otitis-externa-in-australian-general-p
- Wijesekera A, Chiam Xu Wen A, Walker A, Cervin A. Effects of seasonal, geographical and demographic factors on otitis externa microbiota in Queensland, Australia. Aust J Gen Pract. 2024;53(11 Suppl). https://www1.racgp.org.au/ajgp/2024/supplement-november/effects-of-seasonal-geographical-and-demographic-f
- healthdirect. Swimmer's ear (otitis externa). https://www.healthdirect.gov.au/conditions/ear-diseases/swimmers-ear
- Wiegand S, Berner R, Schneider A, et al. Otitis externa. Dtsch Arztebl Int. 2019;116(13):224-234. https://pubmed.ncbi.nlm.nih.gov/31064650/
- Victorian Department of Health. Statewide referral criteria: discharging ear. 2025. https://www.health.vic.gov.au/statewide-referral-criteria/discharging-ear