Ear canal infections (otitis externa): quick, clear advice

A quick swim or a stray cotton swab can leave the ear canal sore, swollen, and painful. That's otitis externa, commonly called swimmer's ear. It lives in the skin of the ear canal, not the middle ear, and usually shows up with sharp ear pain and trouble hearing. Below you'll find simple ways to spot it, treat it, and prevent it from ruining your week.

What to look for

Pain is the most common sign — often worse when you tug the outer ear or chew. Other clear signs: itching inside the ear, a feeling of fullness, muffled hearing, and yellow or green discharge. If you have fever, spreading redness, or severe swelling of the outer ear, get medical help fast. People with diabetes or weak immune systems should treat any ear infection as urgent.

Treatment that actually works

Most ear canal infections respond well to topical ear drops. Doctors usually prescribe antibiotic drops (sometimes combined with a steroid) that reduce both infection and swelling. Apply drops exactly as instructed and keep the ear dry while you treat it.

If the eardrum is perforated or you're not sure, tell your clinician — some ear drops (especially aminoglycoside drops) can damage hearing if used with a hole in the eardrum. For severe cases with spreading redness or fever, oral antibiotics may be needed.

Home measures that help: control pain with ibuprofen or acetaminophen, use a warm compress against the ear, and avoid inserting anything into the ear canal. If a doctor cleans the canal in clinic, drops work better afterward because debris is removed.

Chronic or recurring problems need a different approach. If you keep getting infections, your clinician may check for eczema in the ear, narrow canals, or fungal growth (otomycosis). Treatment can include longer courses of drops, antifungal drops, or skin-focused therapies.

When to see a doctor right away: severe pain, fever, large amounts of pus, swelling that spreads beyond the ear, sudden hearing loss, or if you’re diabetic or immunocompromised. Also seek help if symptoms don’t improve within 48–72 hours of starting treatment.

Prevention is simple and effective. Dry your ears after swimming or showering — tilt your head, use a towel, or use a hair dryer on low a safe distance away. Don’t use cotton buds inside the ear; they push wax and damage skin. If you get swimmer's ear often, a few drops of a 50:50 mix of white vinegar and rubbing alcohol after swimming can help — but don’t use this if you think your eardrum is perforated.

Small changes make a big difference: avoid picking at the ear, keep earphones and hearing aids clean, and see a clinician early if you notice symptoms. With prompt care, most ear canal infections clear quickly and won’t come back.