‘Tis the season…the swimming season that is.

Summer is here. Temperatures are warming, grills are firing up for a season of outdoor cooking, and pools are heating up for endless fun and entertainment. As a child growing up, I wanted nothing more than to spend time in the local pool after a long, cold Indiana winter.

As the temperatures warm, it is common for cold and flu season to settle down, and with that usually comes a drop in the number of ear infections we see. Summer is generally a time of good health outside of the allergies that are present here in Florida. In my ear, nose and throat practice, however, one of the most common questions I am asked is, “Doctor, if my child goes swimming, is he/she going to have ear infections or an increased risk of ear infections?

What is an ear infection?

Before we get into that issue, we should first discuss what an ear infection is. There are different types of ear infections. Frequently, the term “ear infection” is used interchangeably to describe really 2 or 3 different problems. The ear is divided into 3 parts: the outer ear, the middle ear, and the inner ear. Each part has a distinct function, and an infection in one part means something very different compared to the other parts.

Outer ear infections

An infection in the outer ear is called otitis externa, and it is commonly the infection people discuss when talking about swimming. It is called swimmer’s ear by some, but really can occur for many different reasons. The ear canal is a dark place, a warm place, and by getting water trapped in the ear canal, a moist place. This makes it the perfect environment for an infection. Otitis externa is frequently seen after swimming, but may also be associated with wax impactions, use of Q-tips, or a foreign body in the ear. The most common symptom is pain, sometimes severe, particularly with movement of the ear.

Diagram of the ear

Otitis externa is treated with pain control, usually in the form of ibuprofen, and ear drops. Occasionally, the swelling in the ear canal or debris in the ear canal prevents the drops from going into the ear. This is when your ear, nose and throat doctor may need to be involved. Children usually recover from this within a few days, but this may take up to a week. Uncommonly, oral or even intravenous antibiotics are needed to treat this infection.

Middle ear infections

Swimming is not usually considered a cause of middle ear infections. There is no evidence to suggest swimming causes, or places children at higher risk for, middle ear infections. In a middle ear infection, there is usually swelling in the middle ear space, behind the eardrum, which causes the eardrum to become red and even for fluid to collect behind the eardrum. These infections will routinely take care of themselves in a few days, but if symptoms last longer than a few days or if they are severe, they may require treatment. This treatment is usually in the form of oral antibiotics, the most common of which is amoxicillin. While ear infections are common in children, particularly in younger children, swimming this summer, whether in the pool, lake, river or ocean, is not likely to be a source of this problem for your child.

Inner ear infections

Inner ear infections are rare. They can cause hearing loss, dizziness and imbalance. Generally, children with inner ear infections are severely ill and should be tended to immediately either by your primary physician or your pediatric ear, nose and throat doctor. These are not caused by swimming and are something to be taken seriously if suspected, but fortunately aren’t very common.

So as you go swimming this summer, enjoy the warm weather and company of friends. Recognize the symptoms of otitis externa. Seek treatment if you are concerned.

Most of all, don’t worry about the risk of swimming and getting an ear infection and have a great summer!

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