Otitis externa, or swimmer’s ear, is inflammation and irritation in the outer ear. People can treat mild cases with antibiotic drops, but infectious cases may need oral antibiotic medication.

Swimmer’s ear can cause inflammation anywhere between the eardrum and the outermost portions of the ear. This can cause pain and itching.

Otitis externa may be noninfectious or infectious. In the case of the latter, it means there is an underlying bacterial infection. If a person has noninfectious swimmer’s ear, it is usually mild, and they can resolve it with home treatments. However, infectious cases can be harder to treat.

In some cases, it can spread to surrounding structures. Doctors call this malignant otitis external.

Read on to learn about treatments for otitis externa, home remedies, prevention strategies, and more.

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People with mild cases of otitis externa usually respond well to antibiotic drops. The American Academy of Family Physicians offers the following treatment guidelines:

  • Doctors should rule out other conditions that may mimic otitis externa and check to ensure the eardrum is intact.
  • They should ask an individual about their pain and offer pain relief options.
  • Antibiotic drops are the best first-line treatment option — most people do not need oral antibiotics.
  • If the eardrum is not intact, doctors should prescribe treatments that will not harm the ear or eardrum. Fluoroquinolones are a group of antibiotics that are safe for the middle ear and eardrum.
  • Doctors should only prescribe oral antibiotics if there is evidence the infection has spread beyond the ear canal.

Many people can manage mild otitis externa with home treatments.

Some potentially effective home remedies include:

  • over-the-counter (OTC) swimmer’s ear drops
  • a warm washcloth or heating pad to ease the pain
  • OTC pain relievers such as acetaminophen or ibuprofen

Thoroughly drying the ear with a towel or hair dryer can also help. A person can also apply swimmer’s ear prevention drops before and after swimming.

If home remedies do not improve symptoms, a person can contact a doctor.

Doctors may prescribe the following medications for people with otitis externa:

If a person’s infection spreads, they may need oral antibiotics. In severe cases, they may also need to stay in the hospital for monitoring.

The Pseudomonas bacteria cause most cases of otitis externa, so doctors will prescribe an antibiotic that can kill them. However, in some cases, a doctor may take a culture of the ear to determine which antibiotic will most effectively treat the infection.

Swimmer’s ear is usually a mild condition that resolves on its own or with topical treatment. However, severe infections may spread, damaging bone and surrounding tissue.

Without treatment, otitis externa can cause osteomyelitis. This is an infection in the bone, and some people with this may need surgery.

During surgery, a doctor will drain any abscesses, clean the ear, and remove dead bone tissue.

A person can apply swimmer’s ear prevention drops before and after swimming. Some people use a combination of vinegar and alcohol to dry the ear after swimming and prevent bacteria from growing.

Some other techniques to prevent swimmer’s ear include:

  • avoiding getting water in the ear when a person has an active infection
  • using ear plugs while swimming
  • drying the ears after swimming
  • keeping the ears out of the water as much as possible

If a person has recurrent swimmer’s ear, they should talk with a doctor about additional strategies to prevent further infection and inflammation.

A person should contact a doctor if:

  • they develop a fever, severe pain, swelling, or signs of severe illness
  • they have pain, swelling, or itching in the ear
  • they have frequent ear infections
  • their symptoms do not go away within a few days of treatment
  • they are immunocompromised and develop ear pain or an ear infection

Otitis externa can cause itching and moderate to severe ear pain. In most cases, people can manage mild cases with ear drops and home remedies.

However, severe cases may spread beyond the ear, especially in those with weakened immune systems. If a person has symptoms of a severe infection or their infection does not resolve, they should speak with a doctor.