Swimmer's Ear is an inflammation or infection of the outer ear canal.

Contributing factors include: moisture, local trauma, canal occlusion and allergic disease. These factors lead to a loss of the protective wax layer, causing edema of the squamous epithelium with plugging of the glandular secretory ducts. Consequent scratching induces local trauma, allowing bacteria to invade through the skin, leading to inflammation and production of exudate.

It is often caused by a variety of common organisms, including some types of fungi and bacteria. Water sometimes remains trapped in the ear canal, allowing the skin gets soggy. Then the bacteria and fungi grow, flourish and infect the outer ear. However, it can also have purely physical causes. When it occurs among swimmers, three elements are usually present:

• an infectious agent is present
• the ear canal is damp or wet
• the ear canal is alkaline, (rather than acidic)

Many of the organisms often involved in ear infections are typically present in the ear canal, at least in small quantities. Between the pool and the ear, all minimum requirements for an infection are met. Since some of the causative organisms (such as varieties of Psuedomonas) are quite resistant to most pool sanitizers, swimmers often get an extra helping from some pools, including some that are otherwise well sanitized.

Individuals may experience any combination of the following:

• The ear canal becomes red and swollen.
• Blockage of the eustachian tube.
• The ear may itch.
• Runny milky liquid and/or blood drains from the ear.
• Neck glands may become swollen.
• May have enlarged adenoids.
• May experience hearing loss.
• May have a sense of fullness in the ear.
• The ear may become very painful and tender to touch
  (especially on the cartilage in front of the ear canal.)
• Sufferer may have a fever.
• May experience dizziness.
• There may be loss of appetite.
• There may be ringing in the ear (tinnitus).
• May have a stiff neck.

The time needed for the infection to clear up varies from person to person; a typical timeframe is 5 - 7 days. If you experience severe symptoms, then you should consult a doctor.

While the obvious (and unhelpful) answer, "don't get your ears wet", is often provided in literature from medical sources, most swimmers find the following measures sufficient:

• Wear ear plugs.
• Use ear drops before swimming.
• Use ear drops after swimming.
• Dry your ears after swimming.
• Combinations of the aforementioned

Rubbing alcohol is often recommended for use as ear drops. However, rubbing alcohol burns or stings at best, especially on young swimmer's skin, and may hurt like the devil if the ear canal is already slightly inflamed or irritated. (Some other, less common, types of alcohol are NOT irritating, and are used in commercial ear drops.)

Lest drastic -- and possibly more effective -- is a mixture of 1/2 vinegar and 1/2 hydrogen peroxide. Once the peroxide is added, the mixture is perishable, so don't mix more than you'll use in a week or so. The peroxide can lose its strength rather quickly once mixed. Vinegar alone is a good preventative since it restores the ear canals acidity.

A laboratory wash bottle, filled with this mixture, and used routinely on swim team members (line 'em up, squirt it in!) is cheap and seems to eliminate problems almost completely. But check with parents: there are some bizarre sensitivities out there -- and some bizarre parents! But, please be careful. Don't jab the bottle nozzle in some wiggly kid's ear! You may want to trim and round the nozzle so it's less 'pointy'. And, though this mix doesn't irritate most peoples ears, it feels pretty AWFUL in EYES! Having the kids hold a towel over their eyes, as you squirt, is a good idea.

You may be advised to take one or more of the following:

• Antibiotics - These medicines help to fight the infection. It is most important that you take all the medication provided, even if you are feeling better in two or three days. Depending upon your diagnosis, you may be prescribed an oral antibiotic or antibiotic ear drops.
• Decongestants and/or antihistamines - These medicines may help relieve the swelling of the eustachian tube and drain the fluid from the ear.
• Other medications - Your health care provider may prescribe medications, such as a pain reliever, to help with some of the problems that go along with the ear infection.

Steps you can also take are:

• Drink extra fluids, preferably water up to 6-8 glasses each day to prevent dehydration.
• When pain is present, take acetaminophen or ibuprofen (as directed on the package).
• Rest is important in helping the body cope with the infection process.
• Keep the affected ear(s) dry until topical therapy is completed.