An outer ear infection, also called otitis externa or swimmer’s ear, affects the ear canal between the outer ear and the eardrum. It can cause pain, itching, swelling and discharge. It is different from acute otitis media, which develops behind the eardrum and is especially common in children.
Symptoms
Symptoms may affect one ear and can develop over a few days. Common signs include:
- Pain or tenderness, especially when the outer ear is pulled or the small cartilage in front of the canal is pressed
- Itching inside the ear
- Redness and swelling of the ear canal
- Watery, cloudy or pus-like discharge
- A blocked feeling or reduced hearing
Severe swelling can narrow the ear canal. Pain that spreads into the face, neck or side of the head needs prompt assessment.
Causes and risk factors
Bacteria are a common cause, although fungi and skin conditions can also be responsible. Water that remains in the ear canal can weaken its protective surface and allow germs to grow. Scratching the canal or inserting cotton buds, fingers, earplugs or other objects can damage the skin.
Risk may also be higher with eczema, psoriasis, heavy earwax removal, hearing aids, narrow ear canals, frequent swimming or exposure to humid conditions. Outer ear infection is not usually contagious.
Diagnosis
A healthcare professional examines the ear canal and eardrum. They may gently clean away discharge so the canal can be seen and treatment can reach the affected skin. A sample may be taken if the infection is severe, keeps returning or has not responded to treatment.
Treatment
Treatment usually involves ear drops containing an antibiotic, an antifungal medication, a corticosteroid, an acidic solution or a combination, depending on the suspected cause. The full course should be used exactly as prescribed, even when symptoms improve early.
If the canal is very swollen, a clinician may place a small wick inside it to help the drops reach the affected area. Oral antibiotics are not routinely needed but may be used when infection has spread beyond the canal or the person has a greater risk of complications.
Using ear drops
- Wash your hands and warm the bottle in your hand.
- Lie with the affected ear facing upward.
- Apply the prescribed number of drops without touching the ear with the bottle tip.
- Remain in that position for a few minutes.
Do not use leftover drops or products bought for another ear problem. Some preparations are unsafe when the eardrum is perforated, so ask a pharmacist or clinician before putting anything into a painful or discharging ear.
Self-care
Keep the ear dry while it heals. Avoid swimming and try to keep water and shampoo out of the canal when showering. Wipe discharge from the outside with clean a cotton ball, but do not insert anything into the ear. Acetaminophen or ibuprofen may help pain when suitable for you.
Do not attempt to remove wax while the ear is inflamed. Avoid earbuds, earplugs and hearing aids in the affected ear until discomfort and discharge have settled, unless a clinician gives different advice.
When to seek medical help
Arrange medical advice if pain is severe, there is discharge or reduced hearing, symptoms are worsening, or they have not started to improve after a few days of treatment. People with diabetes, a weakened immune system or previous ear surgery should seek advice promptly.
Get urgent medical care for fever with rapidly increasing pain, spreading redness or swelling around the ear, facial weakness, dizziness, severe headache, confusion or a significant decline in general condition. Severe persistent pain in a person with diabetes or reduced immunity can indicate a rare but serious infection that needs urgent specialist treatment.
Prevention
Allow ears to dry naturally after swimming or bathing. Tilt the head to help water drain and dry only the outside with a towel. Do not insert cotton buds or other objects. People with repeated infections should ask a healthcare professional about safe ear protection and whether preventive drops are appropriate, particularly if they have ear tubes or a perforated eardrum.
Sources
- NHS: Ear infections
- Centers for Disease Control and Prevention: Preventing swimmer’s ear
- Centers for Disease Control and Prevention: Ear infection basics
Using this information
This information supports, but does not replace, an examination by a qualified healthcare professional. Ear pain and discharge can have several causes, and treatment depends on the condition of the ear canal and eardrum.
Reviewed: 28 August 2026