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Most divers call it swimmer's ear, but otitis externa is actually the technical term for this type of medical condition that affects the outer ear canal.
This guide contains expert tips for preventing otitis externa, how to recognise the symptoms, and the best first aid treatments for ear inflammation and infections.
It's fair to say some scuba diving rules are stricter than others. Having too much water in the external ear canal is one of the least dangerous - but still quite common.
So why is that?
Otitis externa is relatively common among swimmers and scuba divers because water can get trapped inside their ear openings.
If that happens, it can create the kind of warm and moist environment that encourages bacteria and fungi to grow.
As a consequence, prolonged or excessive exposure to water can lead to inflammation and sometimes infection of the external auditory meatus (the narrow pathway that runs from the outer ear to the middle ear).
In scuba diving, other recurrent causes may also include making multiple or repetitive dives in the same day, being submerged in contaminated water (e.g. harbours), excessive equalisation, or a failure to adequately dry the ears after the dive.
Generally speaking, keeping your ears as clean and dry as possible when you've finished diving is the best way to avoid getting otitis externa.
Even though some scuba divers use cotton swabs, the Divers Alert network (DAN) recommends not messing with the natural waxy hydrophobic barrier (cerumen) that helps to protect you from infection.
Instead, wash your ears with clean water and regular soap before you thoroughly dry them. You can also reduce earwax impaction by not inserting anything inside the auditory canal.
Key Takeaways:
Pro Tip: Always consult a doctor if you think there may be an excessive buildup of ear wax (cerumen). A medical professional may choose to perform a proper cleaning and prescribe appropriate medication, such as otic antibiotic drops and irrigation (ear syringing).
Unlike many of the scuba diving safety rules, the typical signs and symptoms of swimmer's ear do not manifest into dangerous conditions. But, the following may indicate some degree of otitis externa:
It's fair to say most divers are able to diagnose swimmer's ear by themselves. Nonetheless, there are cases when professional medical diagnosis (e.g. an ear exam with an otoscope) is needed.
It usually starts with mild pain or an itching sensation that often worsens overnight. However, applying the proper treatment usually means the symptoms will resolve within a few days.
It's always better to refrain from diving until the symptoms of swimmer's ear have gone away. Divers should know that pressure changes underwater can worsen any irritation, especially middle ear barotrauma (MEBT).
In some cases, an ear specialist may prescribe topical antibiotic drops, such as ciprofloxacin or ofloxacin to reduce the pain and swelling.
Pro Tip: Scuba diving with swimmer's ear (otitis externa) is likely to exacerbate the condition and could lead to increased infection. You could use this "dry period" to brush up on some non-diving courses, such as the Scuba Equipment Specialist Certification.