Acute Otitis Externa: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Acute Otitis Externa?
An ear, nose, and throat doctor (an ENT, also called an otolaryngologist) treats acute otitis externa. Many people start with a primary care doctor, who can treat most cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is acute otitis externa?
Acute otitis externa is inflammation, irritation, or infection of the outer ear and ear canal. Many people call it swimmer's ear. The ear canal is the tube that carries sound to the eardrum. Swimmer's ear may be sudden and short-term (acute) or long-term (chronic).
Symptoms
Symptoms include:
- Redness and swelling of the outer ear and ear canal.
- Pain when you touch your ear. The pain may get worse when you pull on the outer ear.
- Drainage from the ear canal. It may be yellow, yellow-green, pus-like, or foul smelling.
- Itchiness inside the ear.
You may have some hearing loss if your ear is swollen or draining. This hearing loss usually goes away after the infection is gone.
Causes and who gets it
Swimmer's ear is an infection of your outer ear canal. It can be caused by moisture trapped in the ear canal or an injury to the ear canal. Swimming in unclean water can lead to swimmer's ear. Bacteria often found in water can cause ear infections. Rarely, the infection may be caused by a fungus.
Anything that scratches the canal can make it easier to get an infection. Cotton swabs, fingernails, and pointed objects can scratch your ear canal. Some people with skin conditions may get swimmer's ear more easily. Long-term cases may be due to chronic skin conditions, such as eczema or psoriasis.
Swimmer's ear is more common among teenagers and young adults. It can happen to children or adults.
How doctors diagnose it
Your doctor will look inside your ears. The ear canal area will look red and swollen. Touching or moving the outer ear will increase the pain. A sample of fluid may be removed from the ear and sent to a lab to look for bacteria or fungus. This shows which medicine will work the best.
Treatment
Swimmer's ear is usually treated with ear drops from your doctor. In most cases, you will need antibiotic ear drops. Follow your doctor's instructions for using them. Your doctor may clean your ear canal first. If the canal is very swollen, the doctor may leave a piece of cotton soaked in medicine in your ear to fight the infection.
Your doctor may also recommend a pain reliever. Pain medicine, such as acetaminophen or ibuprofen, may help. Placing something warm against the ear may reduce pain too. Keep water out of your ear while it heals, and do not put cotton swabs or other objects in your ear. Swimmer's ear most often gets better with the proper treatment. People with chronic swimmer's ear may need long-term or repeated treatment.
When to see a doctor
If you think you have swimmer's ear, contact your doctor or an ENT right away. Contact your doctor if your symptoms get worse or continue despite treatment. Contact your doctor right away if you have a new fever. Call 911 or go to the emergency room right away if you have pain and redness behind the ear, or sudden weakness of the face. The infection may spread to other areas around the ear, including the skull bone. In older people, people with diabetes, and people with a weak immune system, it can become severe (malignant otitis externa).
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can look in your ear, prescribe ear drops, and check that the infection clears. Follow-up visits can happen right in the office.
Common questions
Is swimmer's ear the same as a middle ear infection?
No. Swimmer's ear is an infection of your outer ear canal. It may occur with a middle ear infection or a respiratory infection such as a cold, but it is a different problem.
Will I have hearing loss?
You may have some hearing loss if your ear is swollen or draining. This hearing loss usually goes away after the infection is gone.
How can I keep water out of my ears?
The best way to avoid an infection is to keep your ear canal dry. Dry your ears well with a towel after swimming or bathing. Tilt your head to drain water from your ears. Wear earplugs if you swim a lot.
Can it come back?
It depends. People with chronic swimmer's ear may need long-term or repeated treatment. Some people with skin conditions may get swimmer's ear more easily.
Sources
- MedlinePlus - Swimmer's ear
- American Speech-Language-Hearing Association - Swimmer's Ear (Otitis Externa)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
