​Otitis Externa (Swimmer’s Ear)

Otitis Externa, also known as Swimmer’s ear is a painful disorder caused by infection and inflammation in the outer ear canal. It is called swimmer’s ear as it is often caused due to water remaining in the ear after swimming, providing a moist environment for bacteria to grow. The bacteria penetrate the skin inside the ear canal, leading to inflammation and irritation. Otitis externa may also be caused by fungal infections.

Even though swimmers who spend a lot of time in water are more prone to developing this disorder, especially children and teenagers, you may not necessarily get affected by swimming only. Moisture trapped in the ear after a bath or shower can also cause otitis externa. It can also be caused by any other disorder which can cause a break in the skin of the ear canal, such as dry skin, eczema, vigorous scratching or cleaning of the ear canal with objects like bobby pins, paper clips or other foreign objects. In case someone has middle ear infection, pus can drain into the ear canal through a hole in the eardrum, causing otitis externa.

Pain in the ear is the most common symptom of otitis externa, with the sensation of pain worsening upon tugging or pulling the ear. Though it starts off as mild, the pain often gets very severe if the infection is left untreated. Other symptoms of otitis externa besides ear pain include:

  • Difficulty chewing because of ear pain

  • Itching in the ear, which increases progressively if the infection is left untreated

  • Fluid drainage or pus discharge from the ear

  • Feeling of fullness or blockage inside the ear

  • Decreased or muffled hearing

  • Uncomfortable feeling in the ear

  • Intense pain that extends to the neck, face or side of the head

  • Fever

  • Swollen lymph nodes around the ear

  • Redness and swelling of the skin around the ear

Symptoms such as fever and intense pain extending to the neck are signs that the infection has advanced. It is important to seek medical advice even if you notice mild symptoms of otitis externa.​

If left untreated, otitis externa can lead to further complications, including recurring ear infections, hearing loss and spread of infection to the skull, brain or cranial nerves, which can be quite serious.

Therefore, it is essential for you to visit an ENT (Eye-Nose-Throat) specialist working with the Eye and ENT Service Line of The Aga Khan University Hospital even if you experience mild signs of otitis externa. If you experience serious symptoms such as fever, intense pain in the neck, decreased hearing or pus discharge from the ear, you must see your doctor immediately.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

To diagnose swimmer’s ear, your doctor will ask you questions, such as whether you swim regularly or have been exposed to a moist environment in the recent past or whether you have been diagnosed with dry skin or eczema. This will help the doctor make an initial diagnosis. An examination of the ear will also be conducted to check for signs of redness and swelling in the ear canal, and identify the site of the infection. For this purpose, a special instrument with light and a microscope, called an otoscope, will be used.

A test of any fluid discharge from the ear (ear culture) may also be requested to test for the presence of bacteria or fungus, especially if you have recurring infections or your symptoms are very severe. In some cases, additional lab tests may also be requested.

The Aga Khan University Hospital, Karachi offers multidisciplinary healthcare under one roof from diagnosis to treatment. You can discuss your symptoms in complete confidence with your doctor to enable the correct diagnosis to be reached for your disorder.
The treatment for otitis externa will be focused on curing your infection and allowing your ear canal to heal. The first step towards treatment is to clean all the debris, pus, flaky skin or clumps of earwax. This is necessary so that the prescription eardrops can reach all the affected areas inside the ear. In case you are suffering from severe pain, prescription pain medications will also be prescribed.

The doctor will also prescribe steroid-antibiotic eardrops to clear up the infection and reduce the inflammation. If your infection has advanced and become very serious, oral antibiotics may also be prescribed. You must follow the complete course of treatment advised to you for antibiotic eardrops to avoid bacteria from developing resistance towards the antibiotics. You may also be asked to keep the ear protected from water till the infection has cured, for example with the help of a shower cap when bathing.

Preventive measures can be also be taken to avoid a repeat episode of otitis externa. After swimming, you should dry your ears with a towel and allow water to come out of the ears by turning the head from side to side.

Make sure you discuss your treatment options thoroughly with your doctor, including advice on how to use the eardrops. Our team of ENT specialists at the Eye and ENT Service Line at The Aga Khan University Hospital is internationally trained in diagnosing and treating ear, nose and throat disorders, and you will be prescribed the treatment plan best suited to your individual symptoms.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.


​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.