What are the Causes of Swimmer’s Ear or Outer Ear Infection?

(OTITIS EXTERNA aka Swimmer’s ear or Outer Ear Infection)
The external ear canal is the part of the ear that connects the outer ear to the eardrum. This outer ear infection takes place in the external ear canal and usually presents a sudden painful condition usually caused by bacterial infection, inflammation or sometimes fungal infection.
People who are predisposed to outer ear infection includes the young and adolescent group, people with skin conditions like eczema or psoriasis, and people with excessive ear wax production.

The natural defence mechanism of the ear canal

  • The narrow ear canal serve to reduce entry of contaminants
  • The sticky nature of the ear wax helps to maintain a harsh environment for bacteria, helping to trap fine debris and also repel water.


What are the Causes of Swimmer’s Ears or Outer Ear Infection?

A moist ear canal can serve as a reservoir for bacterial (most common cause) or fungal infection to seed on.
Other factors that contribute to outer ear infection:

  • Exposure to contaminated water, swimming pool or hot tubs
  • Contact with allergic or corrosive chemicals such as hair dye or spray
  • Excessive ear canal cleaning with cotton buds
  • Skin barrier impairment over the ear canal secondary to eczema/ psoriasis or abrasions secondary to scratching
  • Using ear canal devices such as earphones, hearing aids, diving caps
  • Complication from water irrigation during ear wax removal procedures

Concurrent infection which causes inflammation and swelling of the skin. This leads to obstruction, itch and scratching of the ear canal which will create further injury, thus worsening the condition.

What are the Signs and symptoms of Swimmer’s Ears or Outer Ear Infection?

  • Ear pain
  • Itch
  • Discharges from ear
  • The feeling of blocked ear
  • Reduced hearing


What are the treatments for Swimmer’s Ears or Outer Ear Infection?

The treatment goal is to control pain and treat the infection.

  • Careful cleaning of the ear canal using specialized equipment
  • Eardrops to reduce inflammation and hinder the growth of bacteria and fungus

With the removal of debris in the ear, this will facilitate the absorption of ear drops in the ear canal.
In addition, the doctor can place a sponge or wick in the canal if it is swollen. This will increase the delivery of ear drops into the ear canal.

How to take care of your ears?
It is important to avoid the ear canal from getting wet during treatment. Extra precautions should be taken while showering. Avoid swimming 7-10 days during infection is of great importance.
If you swim regularly, consider

  • Shake your ears dry after swimming
  • Blow dry the ears with low setting dryer held from a distance away
  • Use earplugs during swimming

Are there any Follow-ups?
A patient needs to be follow up 36-48 hours after treatment initiation to monitor symptoms. Sometimes, the ear may need cleansing again using specialized equipment by a doctor in addition to the installation of ear drops.

Most external ear infection improves within 7-10 days.

If you think you have outer ear infection, please speak to any of our friendly doctors at any of our clinics to discuss further, or drop us an email at

5 Objects Found In Ear Where It Should Not Belong!

#1 Impacted Earwax

The production of ear wax can be excessive in some people. This can happen when water gets trapped in the ear, or when the ear is injured or occurs for no particularly obvious reason.

#2 Small insects

A myriad of insects may reside temporarily in the external auditory canal.  Amongst all, small cockroaches are most commonly found in the ear canal as they prefer the warm, dark environment. A crawling and moving insect can be uncomfortable and may risk injuring the inner ear and the eardrum. Mineral oil is used to kill the insects before one attempting to remove it.

#3 Cotton bud

It is a common routine for some to attempt cleaning their ears using cotton buds. This can actually push the wax deeper into the ear instead of getting it out. As a consequence, leading to ear wax impaction, resulting to discomfort and decreased in hearing ability. Also, repetitive friction may cause skin tear in the ear causing bacteria to set in. This might result in an ear infection.

#4 Beads and plastic toys

This occurs in toddlers and children who place items in their ears out of curiosity.


#5 Button Batteries

Button batteries can be found in toy or hearing aids. They can cause destruction to the ear canal because of electrical currents and pressure exerted by the battery in the small ear canal. There have been reports of injury to the eardrum and skin of the ear canal.


Looking after your ears (Water Precaution)

It is imperative to keep water out of the ears and keeping them dry.  Water can be a vehicle for germs and bacteria growth when present in the ear canal. Interestingly, the worst water is bath water; even soap or shampoo water can potentially carry a large number of germs.
It is advisable for the below products when swimming or washing head and hair:

  • Cotton wool plug covered in Vaseline
  • Earplugs during swimming
  • Shower cap


Tips for good ear care and prevention of ear infection

  • Keep the ears dry especially bathing or swimming.
  • Earplugs at all time during swimming. Earplugs need to be regularly cleaned and changed.
  • Keep ears dry after swimming
  • Dry the ears using a dry towel.
  • Avoid using cotton buds or sticking metal ear pick into your ears.
  • Regular cleaning and nightly removal of hearing aid
  • Clean the ears regularly by a doctor if you have excessive earwax

Who should be more concerned?
Preventive interventions should be considered in people with a recurrent ear infection or patients with a skin condition involving the ear.

Have You Heard of Ear Toliet?

Ear Toliet Procedure is using Instrumentation and Microsuction to Remove Ear Wax

While microsuction and instrumentation carries some inherent risks, this is one of the safest wax clearing procedure when used with direct visualization by the medical practitioner.
This enables the medical practitioner to clean the ear canal with greater precision and reduced patient discomfort whilst concurrently enabling the medical practitioner to inspect the ear canal and tympanic membrane are in detail.
As an ancillary benefit, this method allows 2-handed working which further minimizes the risks of human error.
Due to the increased precision and stability, microsuction is often used in situations where ear irrigation is inappropriate or for patients with a deficiency in the ear drum (eg hole in the ear) or having previous ear surgeries.

  • Patients with an ear infection will benefit as ear irrigation will not be safe in this group of patients
  • Patient with build- up of ear wax causing symptoms
  • Patient with anatomical variations of the ear canal
  • Patient wearing hearing aids
  • Children who able to understand instructions and willing to cooperate

We provide Earwax removal with Painless Microsuction, it is offered currently only in Robertson branch and is subject to the doctor’s availability.

If you are interested in this service and wish to find out more, please call the clinic (+65 6238 7810) to make an appointment. Unfortunately for this service we are unable to accept walk-ins.

Speak to one of our friendly doctors today if you would like to address your blocked ear discomfort symptoms! – ear wax removal singapore
Take Care!