Why Does My Child’s Ear Hurt After Swimming? A Parent’s Guide to Swimmer’s Ear
Swimming is one of the pleasures of childhood, particularly during summer holidays. But sometimes a day in the pool is followed by a child complaining:
“My ear hurts.”
Parents may immediately assume their child has developed another middle-ear infection. However, when ear pain starts after swimming—particularly when the ear feels itchy, blocked or tender to touch—the problem may actually be otitis externa, often called swimmer’s ear.
Swimmer’s ear affects the skin lining the ear canal, rather than the space behind the eardrum.
Water is an important trigger, but it is not the only one. Scratching, cotton buds, eczema, soap and shampoo can also damage or irritate the delicate skin of the ear canal.
Understanding the difference can help parents know what to do, what not to put in the ear, and when their child needs a medical assessment.
What exactly is swimmer’s ear?
The ear has several different parts.
The visible ear leads into the ear canal. At the end of this canal sits the eardrum. Behind the eardrum is the middle ear.
Swimmer’s ear—or otitis externa—is inflammation or infection of the skin lining the ear canal.
This is different from the typical childhood middle-ear infection, which occurs behind the eardrum.
NHS guidance explains that outer-ear infection can result from irritation of the ear canal caused by factors including eczema, water or earplugs, as well as bacterial or fungal infection.
Why can swimming trigger an ear infection?
Healthy ear-canal skin forms a protective barrier.
After repeated swimming, water can remain inside the canal. Prolonged moisture softens the skin and can make it easier for inflammation or infection to develop.
NHS paediatric safety-netting guidance describes otitis externa as particularly common after water enters the ear canal during swimming and notes that prolonged wetness creates conditions favourable for infection.
Swimming is therefore a trigger rather than simply a matter of “dirty pool water”.
Repeated exposure can matter too. A child swimming every day during a holiday may be more susceptible than after an occasional brief swim.
What does swimmer’s ear feel like?
Children may describe:
- earache
- itching inside the ear
- a blocked feeling
- reduced or muffled hearing
- tenderness around the ear
- discomfort when the outer ear is moved
- discharge from the ear.
The pain can sometimes become surprisingly intense because the inflamed skin sits within a narrow canal.
NHS paediatric information lists pain and tenderness, itching, foul-smelling yellow or green discharge, blocked/reduced hearing and tinnitus among possible features of otitis externa.
Why does touching the ear hurt?
This can be a useful clue.
With otitis externa, the inflamed area is the ear canal itself. Moving the outer ear or pressing around the entrance to the canal can therefore be uncomfortable.
Middle-ear infections behave differently because the infection is behind the eardrum.
This distinction is not perfect, however, and parents should not try to diagnose the type of ear infection themselves based on a single symptom.
An examination with an otoscope usually makes the situation much clearer.
Is swimmer’s ear the same as a middle-ear infection?
No.
A middle-ear infection, or acute otitis media, is particularly common in young children and often occurs alongside or after a cold.
Otitis externa affects the ear canal.
The treatments can therefore be different.
NHS guidance specifically distinguishes middle-ear infection from outer-ear infection and notes that otitis externa can be associated with water, irritation, eczema and bacterial or fungal infection.
This is why using leftover antibiotics or ear drops from a previous infection is not a good idea.
The correct treatment depends on which part of the ear is affected and whether the eardrum is intact.
Can cotton buds cause swimmer’s ear?
Yes, they can contribute.
Parents sometimes see water or wax in a child's ear after swimming and try to dry the canal using a cotton bud.
This can create two problems.
First, the cotton bud may push wax and debris further inside.
Second, it can produce tiny scratches in the ear-canal skin. Once the protective skin barrier is disrupted, inflammation and infection become more likely.
NHS guidance advises against inserting cotton buds, fingers or other objects into the ear.
The ear canal usually manages wax and moisture without needing mechanical cleaning.
What about children with eczema?
Children with eczema or other skin conditions may be more susceptible to ear canal inflammation.
The skin inside the canal can become dry, itchy and irritated. The child scratches it, creating further trauma, and then water exposure adds another trigger.
Some children therefore experience recurrent episodes rather than a single infection.
When otitis externa keeps returning, it is important to consider the underlying cause rather than repeatedly treating each episode in isolation.
Potential contributors include:
- eczema
- repeated swimming
- scratching
- cotton-bud use
- earplugs
- retained wax
- narrow ear canals
- hearing devices
- sensitivity to products entering the ear.
What should parents do if ear pain starts after swimming?
Keep the ear dry until it has been assessed and symptoms have settled.
NHS advice recommends avoiding swimming during an active ear infection and preventing water or shampoo from entering the ear.
For pain, age-appropriate paracetamol or ibuprofen may be used according to the child's instructions, provided they can normally take these medicines.
A pharmacist can assess many children aged 1–17 with suspected ear infection and can advise whether further medical assessment is needed.
Should I put olive oil or shop-bought drops in the ear?
Not automatically.
Different ear conditions need different treatments.
Some preparations should not be used when the eardrum is perforated, when a child has grommets, or in other specific circumstances.
NHS advice for childhood earache says not to put oil, ear drops or cotton buds into a child's ear unless advised by a healthcare professional.
If there is pain, discharge or uncertainty about the eardrum, have the ear assessed rather than experimenting with different preparations.
How is swimmer’s ear treated?
Treatment depends on what the clinician finds.
The ear canal may be:
- red
- swollen
- narrowed
- filled with discharge
- covered by debris
- affected by eczema or fungal infection.
Treatment can include appropriately selected ear drops. NHS guidance notes that treatment for ear infections may include antibiotic, antifungal or steroid ear drops depending on the cause.
Correct technique matters.
After putting drops into the affected ear, keeping the ear facing upwards for several minutes helps the medicine remain in the canal rather than immediately running out.
If swelling or debris prevents the drops reaching the infected skin, further ear care may sometimes be required.
Why might an ENT specialist clean the ear?
A heavily infected ear canal may contain discharge, wet debris and swollen skin.
This can make examination difficult and prevent medication reaching the area where it is needed.
Under appropriate circumstances, an ENT clinician may carefully clear the canal using microsuction or other ear-care techniques.
This is very different from parents attempting to clean deeply inside the ear themselves.
Can my child continue swimming?
Usually it is sensible to avoid swimming while an active infection is being treated.
NHS advice specifically recommends not swimming during an ear infection.
Once the infection has resolved, most children can return to swimming.
A child who repeatedly develops otitis externa may benefit from personalised advice about water protection.
Guy's and St Thomas' NHS guidance suggests options such as a well-fitting swimming cap and, in recurrent cases, consideration of individually fitted swimming plugs after appropriate assessment.
What if my child has grommets?
This requires slightly different advice.
NICE recommends keeping ears dry for two weeks after grommet insertion. For children who develop isolated discharge after grommet surgery, water precautions are advised while discharge is present; children with recurrent otorrhoea after grommets may be advised to use earplugs or headbands when in contact with water.
Parents should follow the specific instructions provided by their child's surgical team, as recommendations may depend on the individual situation.
How can swimmer’s ear be prevented?
Some straightforward habits can help:
- do not put cotton buds into the ear canal
- discourage scratching or poking inside the ears
- allow ears to dry naturally
- avoid repeatedly getting shampoo and soap into sensitive ears
- treat underlying ear-canal eczema appropriately
- consider a swimming cap if infections repeatedly follow swimming.
Guy's and St Thomas' advises against using cotton buds or other materials in the canal to dry moisture and suggests that a hairdryer on its lowest setting, held appropriately away from the ear, can sometimes be used after swimming to help the ears dry.
Routine preventive ear drops should not simply be started in every child without individual advice.
When should parents seek medical help?
Arrange assessment if your child has:
- significant ear pain
- ear discharge
- swelling of the ear canal
- reduced hearing
- symptoms that are worsening
- recurrent episodes after swimming
- persistent itching
- symptoms despite treatment.
NHS guidance advises medical assessment for hearing changes, fluid coming from the ear or swelling around the ear.
Red flags: when is ear pain more urgent?
Seek urgent medical advice if your child develops:
- swelling or redness behind the ear
- the ear beginning to stick out
- severe or rapidly worsening pain
- high fever with a child who appears very unwell
- significant dizziness
- persistent vomiting
- facial weakness
- severe headache
- sudden marked hearing loss.
Swelling and tenderness behind the ear are different from tenderness of the ear canal and can indicate a more significant infection such as mastoiditis.
If a child becomes extremely unwell, difficult to wake, develops facial weakness or has other significant neurological symptoms, seek urgent/emergency medical help.
When should my child see a paediatric ENT specialist?
Most straightforward episodes of otitis externa can be managed in primary care.
ENT assessment becomes particularly useful when:
- infection does not settle despite appropriate treatment
- episodes repeatedly return
- the canal is very swollen or blocked
- there is persistent discharge
- hearing remains reduced
- the diagnosis is uncertain
- the eardrum cannot be adequately examined
- there are grommets or previous ear surgery
- an underlying skin or structural ear problem is suspected.
Mr Gaurav Kumar advises specialist ENT assessment when otitis externa does not settle following treatment.
Paediatric ear care in London and Essex
Swimming should remain an enjoyable activity for children rather than something families fear.
The key is recognising when post-swimming discomfort represents simple trapped water and when symptoms suggest inflammation or infection of the ear canal.
Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children with recurrent outer-ear infections, ear pain, discharge, hearing concerns and wider paediatric ENT problems from London, East London, Romford, Ilford, Redbridge, Brentwood, Chelmsford and surrounding areas of Essex.
A careful examination can establish whether the problem is swimmer's ear, a middle-ear infection, wax, an eardrum problem or another cause—and guide appropriate treatment.
The key message for parents
Ear pain after swimming is not always a middle-ear infection.
Pain, itching, tenderness when the outer ear is touched, hearing loss or discharge after repeated water exposure may point to swimmer's ear (otitis externa).
Keep a painful or discharging ear dry, avoid swimming temporarily and do not put cotton buds or unadvised preparations into the ear.
Most cases can be treated effectively once the cause is identified.
But severe worsening pain, swelling behind the ear, facial weakness, significant dizziness or a child who appears seriously unwell requires prompt medical assessment.
Frequently asked questions
Can swimming really cause an ear infection?
Yes. Prolonged moisture can irritate and soften the ear canal skin, making otitis externa more likely.
How do I know whether it is swimmer's ear?
Pain, itching, canal tenderness, blocked hearing and discharge after water exposure are typical clues, but an ear examination is needed to confirm the diagnosis.
Why does it hurt when I touch my child's ear?
Because otitis externa affects the ear canal, moving the outer ear can aggravate the inflamed skin of the canal.
Should I use cotton buds to dry the ear?
No. Cotton buds can damage the canal skin and push debris deeper.
Can my child swim while being treated?
NHS guidance recommends avoiding swimming while an ear infection is active.
Does swimmer's ear always need antibiotic drops?
No. Treatment depends on whether the problem is bacterial, fungal, inflammatory or related to another cause.
What if my child has grommets?
Follow the child's surgical team's advice. NICE recommends water precautions for two weeks after grommet surgery and while post-grommet ear discharge is present.
When should we see ENT?
Persistent, recurrent or severe infections, continuing discharge, hearing loss, a blocked canal or failure to respond to appropriate treatment may warrant ENT assessment.
Disclaimer: This information is intended for general educational and regional SEO purposes only and does not replace personalised clinical advice. For a definitive structural evaluation, a face-to-face consultation with a registered specialist is required.
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