Swimmer's ear vs ear infection: Four ways to spot the difference

It's summer, and the Land of 10,000 Lakes is a great place to swim and play. As your family enjoys the pools and lakes, make sure you know the difference between swimmer's ear and a middle ear infection.  

Swimmer's ear is an infection in the outer ear canal. It's often brought on by water in the ear canal that remains after swimming, creating a moist environment where bacteria can grow. While it can affect anyone, swimmer's ear is most common in children (because their ear canals are narrow) and during the summer months (because of the increased use of swimming pools and lakes). Swimmer's ear is not the same as a middle ear infection, which occurs behind the eardrum and is most often caused by a viral infection.  

Spot the symptoms of swimmer's ear or a middle ear infection

1. Determine where the pain is. With swimmer's ear the pain is located in the outer ear canal, or the area near the ear opening, and increases when you pull on the earlobe. In a middle ear infection, pain is located in the inner ear, near the ear drum and will often increase with lying down, which can also cause trouble sleeping.
2. Look for visible symptoms. If your child is experiencing ear pain, these signals are especially helpful: With swimmer's ear, the outer ear may appear red and swollen and have a rash-like appearance. You may see your child frequently scratch at his ear or complain of an itchy ear. Also watch for a foul-smelling drainage coming from the ear(s) that bother him. Symptoms to watch for with a middle ear infection include fever, pulling or tugging on the ear, decreased appetite, diarrhea or vomiting.
3. Check for difficulty hearing. Temporary hearing loss is a telltale sign for both a middle ear infection and swimmer's ear, but it may be one of the first signs you notice.
4. Consider contributing factors. Did the ear pain start after a recent swim in a lake, pool or hot tub? Despite its name, you don't have to swim to pick up swimmer's ear. Simply cleaning your ears with a cotton swab or taking a shower or bath can also cause this condition. With a middle ear infection, your child may exhibit signs of an upper respiratory infection, such as congestion, runny nose and watery eyes, in the days before the inner ear pain began.

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How to treat ear pain

For pain relief, it's OK to take an over-the-counter pain reliever like ibuprofen or Tylenol^® to help relieve the pain associated with swimmer's ear or a middle ear infection (be sure to follow the manufacturer's directions for taking over-the-counter medication). A warm compress placed over the affected ear can also relieve the pain from swimmer's ear. You should consult with an expert to treat the cause of the infection.

Swimmer's ear can usually be treated in children and adults with an online visit, like Allina Health Everyday Online. This is especially convenient if symptoms start while you're away from home, after clinic hours or over the weekend, since most online clinics have 24-hour access. Whether you're seen online or in person, your provider will likely prescribe antibiotic ear drops to treat swimmer's ear.

With a middle ear infection, it's best to have a provider examine your ear with an otoscope to look for signs of infection or blockages. For this reason you should be seen in person at urgent care, at a convenient care or walk-in clinic, or at your primary care clinic. If your provider believes that bacteria may have caused the infection, she'll prescribe an antibiotic. However, if a virus is causing the infection, an antibiotic won't help, and you'll have to treat the pain and wait for the infection to get better on its own.