After swimming in the sea or a pool, or even after taking a shower, it is common for a small amount of water to remain trapped in the external ear canal. The ear may feel blocked, sounds may seem muffled or there may be a distinctive sensation of water moving when the head is tilted. In most cases, this is a temporary irritation that resolves once the water drains or evaporates.

When moisture remains inside the ear canal, however, it can disrupt the skin’s protective environment and encourage microorganisms to grow. This can lead to otitis externa, commonly known as swimmer’s ear. The difference between simply trapped water and early inflammation is not always obvious at first. It is therefore important to recognise which symptoms require attention and which attempts to clean the ear may do more harm than good.


Why does water become trapped in the ear?


The external auditory canal is a narrow passage leading from the outer ear to the eardrum. It is not completely straight, so a small amount of water may temporarily remain trapped inside it, particularly after diving or spending a long time in the water.

Cerumen, commonly known as earwax, can also trap water, especially when it has accumulated or formed a blockage. This does not mean that it should be removed with a cotton bud. Earwax forms part of the ear’s natural defence system, helping to repel moisture, limit microbial growth and protect the delicate skin of the ear canal.

Water may become trapped more easily in people with narrow ear canals, excessive earwax or skin conditions affecting the ear. The same can happen in people who frequently use earplugs, hearing aids or in-ear headphones.


When is it probably only trapped water?


Trapped water usually causes a sensation of fullness or blockage, temporary muffling of hearing and, occasionally, a splashing sound when the head moves. It does not normally cause severe pain, significant itching, discharge or visible swelling.

In most cases, the discomfort gradually subsides within a short period. The ear may dry naturally, particularly when the head is tilted so that the affected ear faces downwards, allowing the water to drain more easily.

A persistent blocked sensation, however, does not necessarily mean that water is still present. It may be caused by swollen earwax, irritated skin, early otitis externa or another ear condition. If the discomfort persists or new symptoms appear, the ear should be examined instead of being subjected to repeated attempts at cleaning at home.


What is otitis externa?


Otitis externa is an inflammation of the skin lining the external auditory canal. It is often caused by a bacterial infection, although fungi, skin disorders and irritant or allergic reactions may also be involved.

Prolonged moisture softens and weakens the skin’s protective barrier. If small abrasions caused by cotton buds, fingernails or other objects are also present, microorganisms can enter the skin more easily and multiply. This is why otitis externa often develops after swimming, although it does not affect swimmers exclusively. It may also occur after bathing, showering, heavy sweating or prolonged exposure to a humid environment.

Otitis externa is not the same as otitis media, which develops behind the eardrum and is particularly common in young children. An examination of the ear is required to distinguish between them, as pain and a blocked sensation may occur in more than one condition.


Signs that inflammation may have developed


Otitis externa may initially cause mild itching, discomfort or a sensation of fullness. As the inflammation progresses, the following symptoms may appear:

- pain inside or around the ear;


- tenderness when the outer ear is gently pulled;


- pain when pressure is applied to the tragus, the small projection in front of the ear opening;


- itching inside the ear canal;


- redness or swelling;


- discharge of fluid or pus;


- temporary reduction in hearing;


- pain when chewing or moving the jaw.

Tenderness when the outer ear is moved is a characteristic finding in acute otitis externa, according to the American Academy of Otolaryngology. A single symptom is not, however, sufficient to establish a reliable diagnosis without examining the ear canal and eardrum.


How can trapped water be removed safely?


The safest first step is to tilt the head so that the affected ear faces downwards. Gently pulling the earlobe in different directions may help the water move towards the opening. The outside of the ear can be dried with a clean towel, without inserting anything into the ear canal.

The CDC advises that, if water remains, a hairdryer may be used at its lowest heat and fan setting, held several centimetres away from the ear. The air should not be hot or directed forcefully into the ear canal.

If the blocked sensation does not resolve, forceful or repeated attempts should be avoided. A healthcare professional can determine whether the problem is caused by impacted earwax, inflammation, a foreign object or another condition.


Why can cotton buds make the problem worse?


A cotton bud does not necessarily absorb water trapped inside the ear. It frequently pushes earwax and debris deeper into the canal and may cause microscopic injuries to its skin. These abrasions provide entry points for bacteria and increase the risk of inflammation.

The same applies to fingers, hairpins, keys, pencils and any other object used in an attempt to unblock the ear. Even if no immediate pain occurs, the skin can be injured or, if the object is inserted deeply, the eardrum may be damaged.

Removing too much earwax also deprives the ear of an important protective mechanism. The ear has a natural self-cleaning process and, in most cases, its interior does not need to be cleaned.


What should not be poured into the ear without medical advice?


Numerous online recommendations involve rubbing alcohol, vinegar, hydrogen peroxide, oil or homemade mixtures. Some specially formulated preparations may be used to remove moisture or as part of a particular treatment, but they are not suitable for everyone.

Ear drops or other liquids should not be used without professional advice when there is:

- a known or suspected perforated eardrum;


- a ventilation or tympanostomy tube in the eardrum;


- a history of ear surgery;


- discharge or blood coming from the ear canal;


- significant pain;


- previously diagnosed otitis externa.

If it is not known whether the eardrum is intact, using a solution indiscriminately may cause irritation or may not be safe for the deeper structures of the ear. Old or leftover antibiotic drops should not be used either, as appropriate treatment depends on the condition of both the ear canal and the eardrum.


Who is at greater risk of otitis externa?


Frequent swimming and spending time in warm, humid environments increase exposure, but they are not the only risk factors. The risk may be higher in people with:

- eczema, psoriasis or seborrhoeic dermatitis;


- a very narrow ear canal;


- excessive or impacted earwax;


- a habit of cleaning the ears with cotton buds or other objects;


- frequent use of headphones, earplugs or hearing aids;


- previous episodes of otitis externa;


- allergic sensitivity to hair products or materials that come into contact with the ear.

Devices placed inside or around the ear should be cleaned regularly according to the manufacturer’s instructions. Poorly fitting devices and prolonged use may cause friction, trap moisture and irritate the skin.


How is otitis externa treated?


Diagnosis is usually made by examining the ear canal and eardrum. In persistent, severe or recurrent cases, a sample of the discharge may need to be taken to determine whether bacteria or fungi are involved.

Treatment depends on the cause and severity of the condition. For uncomplicated acute otitis externa, the main treatment usually consists of topical ear drops, which may contain an antimicrobial, antiseptic or anti-inflammatory agent. If the canal is significantly swollen, the doctor may insert a small ear wick to help the medication reach deeper into the canal.

The clinical guidelines of the American Academy of Otolaryngology–Head and Neck Surgery Foundation recommend topical treatment as the first-line option for uncomplicated acute otitis externa. Oral antibiotics are not usually required unless the infection has spread beyond the ear canal or the patient has an increased risk of complications.

During treatment, the ear should be kept dry and swimming should be avoided until the doctor advises otherwise. Treatment should not be stopped as soon as the pain improves but should be followed exactly as prescribed.


When is medical assessment necessary?


Pain or discharge developing after swimming requires medical assessment, as these symptoms do not usually correspond to simply trapped water. Medical advice is also necessary when there is severe or increasing swelling, fever, significant hearing loss or symptoms that do not improve.

More urgent assessment is required if any of the following develop:

- very severe or disproportionate pain;


- pain that wakes the person during the night;


- redness or swelling spreading around the ear;


- fever or marked malaise;


- dizziness, balance problems or neurological symptoms;


- weakness or asymmetry of the face;


- discharge of blood or pus;


- sudden or severe hearing loss.

Particular caution is necessary for people with diabetes, immunosuppression or chronic kidney disease. In these groups, persistent or severe ear pain should be assessed promptly because, in rare cases, a serious infection can develop and spread to the surrounding tissues.


How can swimmer’s ear be prevented?


The main preventive measure is to remove moisture safely without damaging the ear canal. After swimming or bathing, the outer ears can be dried gently and the head tilted to either side to allow the water to drain.

People who experience recurrent otitis externa can ask their doctor whether specially fitted earplugs or another protective measure may be appropriate. Standard earplugs should fit properly and be kept clean, as poor fitting may irritate the skin or trap moisture.

Preventive drying drops are not suitable for everyone and should only be used after confirming that they are safe for the individual ear. Avoiding cotton buds and other objects remains one of the most important preventive measures.


From temporary discomfort to inflammation


Water trapped in the ear after swimming is usually harmless and temporary. Pain, worsening itching, tenderness when the outer ear is moved, swelling or discharge may indicate that otitis externa has developed and should not be treated with improvised home remedies.

The most important step is to allow the ear to dry using gentle methods and to avoid anything that could injure the ear canal. When symptoms persist or signs of inflammation appear, examination by a healthcare professional is safer than repeatedly attempting to unblock the ear at home.


Sources and further reading

- CDC: Preventing Swimmer’s Ear


- American Academy of Otolaryngology: Swimmer’s Ear


- Clinical Practice Guideline: Acute Otitis Externa


- American Family Physician: Acute Otitis Externa – Rapid Evidence Review


- NHS: Ear Infections https://healthpont.com/water-trapped-in-ear-swimmers-ear/