My Child’s Ear Hurts or Itches After Swimming — Could It Be Swimmer’s Ear?
Swimming lessons are finished, and your child seemed completely well when they left the pool.
Later that evening—or perhaps the following day—they start rubbing one ear.
They may say:
“It feels itchy inside.”
“My ear hurts when I touch it.”
“It feels blocked.”
Sometimes there is even a small amount of watery or unpleasant-smelling discharge.
Parents naturally wonder whether water is simply trapped in the ear or whether their child has developed an ear infection.
One possibility is otitis externa, commonly called swimmer’s ear.
The important point is that swimmer’s ear is not the same type of ear infection as the middle-ear infections commonly seen after childhood colds.
Understanding the difference helps parents know what to do—and what not to put inside the ear.
What exactly is swimmer’s ear?
Swimmer’s ear is inflammation or infection of the skin lining the ear canal.
The ear canal is the short passage that carries sound from the ear opening to the eardrum.
Guy's and St Thomas' NHS Foundation Trust describes otitis externa as inflammation of the ear-canal skin and notes that the condition is commonly called swimmer’s ear.
This is different from acute otitis media, where infection and fluid develop behind the eardrum in the middle ear.
That distinction matters because the symptoms, examination, and treatment can differ.
Why can swimming cause an ear-canal infection?
Healthy ear-canal skin forms a natural protective barrier.
After prolonged exposure to water, that skin can become damp and softened.
If water remains within the canal—particularly behind wax—it can create conditions that encourage inflammation and infection.
Current Hertfordshire and West Essex NHS guidance explains that otitis externa occurs more often when water enters the canal and stays there for long periods.
Swimming is therefore a common trigger.
But despite the name, you do not have to be a swimmer to develop swimmer’s ear.
What else can cause otitis externa?
Several factors can disturb the delicate skin of the ear canal.
These include:
- shampoo or soap entering the ear
- scratching the canal
- cotton-bud use
- eczema
- psoriasis
- wax accumulation
- water becoming trapped behind wax
- hot or humid conditions.
Guy’s and St Thomas’ NHS guidance specifically identifies these factors.
Chelsea and Westminster NHS also notes that earplugs, hearing aids or headphones can sometimes reduce ventilation and contribute to irritation in susceptible ears.
What does swimmer’s ear feel like?
One of the earliest symptoms can be itching.
The child may repeatedly put a finger towards the ear or complain that something feels irritating inside.
As inflammation increases, symptoms can include:
- ear pain
- tenderness
- itching
- watery discharge
- yellow or green discharge
- a blocked sensation
- temporary reduction in hearing
- discomfort when chewing or moving the jaw.
These features are described across current NHS otitis externa guidance.
Swimmer’s ear is commonly one-sided.
Why does the ear sometimes hurt when touched?
This can be a useful clue.
Because otitis externa affects the outer ear canal, movement or pressure around the outer ear may irritate inflamed canal skin.
A child may therefore complain when the outer ear is touched or manipulated.
That differs from many uncomplicated middle-ear infections, where the infection sits behind the eardrum.
However, parents should not repeatedly pull or press the ear trying to diagnose the problem.
An otoscope exam provides much more useful information.
Is swimmer’s ear the same as a middle-ear infection?
No.
Swimmer’s ear — otitis externa
The problem is mainly in the ear canal skin.
Itching, tenderness around the canal and pain when the outer ear is moved can be prominent.
Middle-ear infection — acute otitis media
The problem is behind the eardrum.
It frequently occurs around a cold or upper respiratory infection and is especially common in younger children.
A child may have fever, general irritability and a deeper earache.
Children can occasionally have features of both, so symptom comparison cannot replace examination when the diagnosis is unclear.
Can swimmer’s ear make hearing seem worse?
Yes.
Inflamed ear-canal skin can swell.
Discharge or debris may also be present in the canal.
If sound cannot travel efficiently down the canal towards the eardrum, hearing may temporarily become muffled.
Current NHS sources list blocked or reduced hearing as possible symptoms of otitis externa.
Hearing usually improves when the swelling and debris settle.
A significant hearing problem that persists after the infection has resolved deserves reassessment.
What if fluid or pus is coming out?
Ear discharge should not automatically be labelled swimmer’s ear.
Discharge can arise from an inflamed external canal, but it can also occur when fluid from a middle-ear infection passes through a perforation in the eardrum.
Hertfordshire and West Essex NHS guidance advises that a child with pus coming from the ear should be medically assessed so the source can be determined.
This is particularly important before using non-prescribed ear products.
Should I put ear drops in immediately?
Be cautious about choosing ear drops yourself.
Different drops have different purposes, and not every product is suitable when there is a possibility of a perforated eardrum, grommet or previous ear surgery.
Current NHS-linked otitis externa guidance specifically advises against using over-the-counter ear products if there is a possibility of an eardrum perforation.
A pharmacist, GP, nurse or ENT clinician can advise which treatment is appropriate for the individual child.
How is swimmer’s ear treated?
Treatment depends on the severity and appearance of the canal.
A clinician may recommend topical treatment such as:
- antiseptic preparations
- antibiotic drops
- steroid-containing drops
- combination drops.
Guy’s and St Thomas’ notes that prescribed preparations commonly combine treatment for infection with medication to reduce canal inflammation.
The important principle is that treatment needs to reach the ear-canal skin.
What if the ear canal is completely swollen?
Sometimes the canal becomes so inflamed that drops cannot penetrate adequately.
In selected cases an ENT clinician may need to clear discharge and debris using microsuction.
If the canal is very swollen, a small wick may occasionally be inserted so medication can reach the affected skin.
Chelsea and Westminster NHS describes microsuction and medicated wicks among treatments that may be required for more troublesome otitis externa.
This is not necessary for every child.
Does swimmer’s ear need oral antibiotics?
Not routinely.
Because uncomplicated otitis externa affects the ear-canal skin, topical treatment is generally more important than oral antibiotics.
NHS Greater Glasgow and Clyde guidance specifically states that there is no role for oral antibiotics in simple otitis externa.
Oral antibiotics may be considered when infection is extending into surrounding tissues or in other selected clinical circumstances.
Can my child continue swimming?
If your child has active otitis externa, keeping the ear dry while the canal heals is generally sensible.
Repeatedly exposing inflamed canal skin to pool water can prolong irritation.
Guy’s and St Thomas’ NHS advice emphasises keeping the ear dry during treatment.
The timing of return to swimming depends on how quickly symptoms settle and whether there is another ear problem, such as a perforation or grommet.
Should I use cotton buds to dry the ear?
No.
Cotton buds are one of the common factors that can cause or worsen otitis externa.
They can scratch the delicate canal skin, push wax deeper and interfere with the ear’s natural cleaning mechanism.
Both Guy’s and St Thomas’ and Chelsea and Westminster advise against inserting cotton buds or other objects into the ear canal.
The same applies to tissues, hairpins and fingers.
How should I dry my child’s ears after swimming?
Start simply.
Allow water to drain naturally.
Your child can gently tilt their head to each side.
Dry the outside of the ear with a towel, but do not push material into the canal.
Guy’s and St Thomas’ suggests that, for people prone to otitis externa, a hairdryer may be used briefly on its lowest setting, kept away from the ear, to help evaporate residual moisture.
Do not use hot air close to a child's skin.
Do children need swimming earplugs?
Not every child needs them.
For a child who swims comfortably and has never developed otitis externa, routine plugs are not automatically necessary.
For children with recurrent swimming-associated otitis externa, water protection may be useful.
Guy’s and St Thomas’ notes that customised swimming plugs may sometimes be considered for people with frequent episodes.
A well-fitting swimming cap or headband may also help reduce water entry.
The advice can be different for children with grommets or previous ear surgery, so follow the guidance given for that child's specific ear condition.
What if my child has eczema?
This is particularly relevant.
Eczema does not stop at the entrance to the ear. The skin around and within the canal can also become dry, itchy and inflamed.
A child then scratches the ear, damaging the skin barrier and making secondary infection more likely.
NHS guidance identifies eczema and psoriasis as recognised risk factors for recurrent otitis externa.
Repeated episodes may therefore require attention to the underlying skin problem as well as treatment of each infection.
What if swimmer’s ear keeps coming back?
Recurrent otitis externa deserves a closer look at why the canal keeps becoming inflamed.
Possible contributing factors include:
- regular swimming
- eczema
- narrow ear canals
- retained wax
- habitual cotton-bud use
- scratching
- repeated inappropriate ear products
- persistent moisture.
If episodes continue despite sensible prevention, ENT assessment can help identify underlying canal disease or debris requiring treatment.
When should my child be seen?
Arrange medical assessment if:
- ear pain is significant or worsening
- there is pus or persistent discharge
- the canal appears markedly swollen
- hearing has noticeably reduced
- symptoms are not improving
- the skin around the ear becomes red or swollen
- you are uncertain whether the child has swimmer’s ear or a middle-ear infection.
A child with persistent symptoms despite appropriate treatment may need ENT review.
Red flags: when should parents seek urgent help?
Most swimmer’s ear is uncomfortable rather than dangerous.
However, seek same-day medical advice through your GP or NHS 111 if your child develops:
- fever with worsening otitis externa symptoms
- increasing redness or swelling around the ear
- pain, redness or swelling behind the ear
- significant dizziness or loss of balance
- worsening illness or unusual drowsiness
- severe headache or neck stiffness.
Current Hertfordshire and West Essex NHS paediatric guidance specifically highlights fever, post-auricular swelling, dizziness/balance problems and deterioration as reasons for prompt assessment.
Swelling behind the ear is particularly important because it may indicate a problem different from uncomplicated swimmer’s ear, including mastoiditis, which was covered in yesterday's parent guide.
Seek emergency help if your child becomes extremely drowsy or confused, has a seizure, develops severe breathing difficulty or appears critically unwell.
Paediatric ear assessment in London and Essex
Many uncomplicated cases of swimmer’s ear can be managed in primary care.
ENT assessment may be useful when infections are recurrent, severe, the ear canal is very swollen, treatment repeatedly fails, there is significant debris requiring microsuction, or the diagnosis remains uncertain.
Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children with recurrent otitis externa, ear discharge, hearing concerns and other paediatric ear conditions across London, East London, Romford, Ilford, Redbridge, Brentwood, Chelmsford and surrounding areas of Essex.
The key message for parents
An itchy or painful ear after swimming may be swimmer’s ear—but the problem is usually the skin of the ear canal, not water trapped behind the eardrum.
Keep the ear dry while it is inflamed.
Do not use cotton buds.
Do not repeatedly scratch or probe the canal.
And be cautious about putting non-prescribed products into a child's ear when you do not know whether the eardrum is intact.
If there is significant discharge, worsening pain, hearing loss, surrounding swelling or recurrent episodes, arrange appropriate medical assessment.
Frequently asked questions