Red flags & when to go in person for Swimmer’s Ear (Otitis Externa) in Children

Audience: pediatric

Swimmer’s ear, or otitis externa, is an infection of the outer ear canal common in children who swim often. It can cause ear pain, redness, and sometimes discharge. Many cases can be managed with home care and telemedicine visits, where a healthcare provider can guide treatment and symptom relief. However, some signs need prompt in-person care to prevent complications. These include severe pain, spreading redness or swelling around the ear, fever, or hearing loss. If your child shows these signs, seek medical attention quickly. Telemedicine can help assess mild cases, provide advice on ear care, and recommend treatments like ear drops. Always keep the ear dry and avoid inserting objects into the ear canal. This guide helps you understand when telemedicine is appropriate and when to see a healthcare provider in person for your child's swimmer’s ear.

Red flags — go in person / ER

• Severe or worsening ear pain — seek in-person medical care promptly.
• Fever above 38°C (100.4°F) with ear symptoms — visit a healthcare provider.
• Spreading redness, swelling around the ear, or hearing loss — urgent evaluation needed.

What telemedicine can do

• Mild ear pain and itching without fever.
• Providing guidance on ear care and hygiene.
• Recommending over-the-counter pain relief and ear drops.
• Assessing symptoms via video or phone consultation.

What telemedicine cannot do

• Severe or worsening symptoms needing physical examination.
• Signs of spreading infection like swelling beyond ear.
• High fever with ear symptoms.
• Hearing loss or discharge with blood or foul smell.

What is Swimmer’s Ear (Otitis Externa)?

Swimmer’s ear is an infection of the skin lining the ear canal. It often happens when water stays trapped in the ear after swimming, creating a moist environment where bacteria or fungi can grow. Children may feel itching, pain, or fullness in the ear. The outer ear may look red or swollen, and there might be some discharge.

Common Symptoms to Watch For

Typical symptoms include:

These symptoms often develop over a few days and may worsen if untreated.

When to Use Telemedicine for Swimmer’s Ear

Telemedicine can help if your child has mild symptoms without severe pain or fever. A healthcare provider can:

Keep the ear dry and avoid inserting cotton swabs or fingers into the ear.

Red Flags: When to Go In Person

Seek in-person care if your child has:

These signs may mean the infection is serious or spreading and needs prompt treatment.

Preventing Swimmer’s Ear

To reduce the risk:

Good ear hygiene helps keep infections away.

How to prepare for your tele-visit

• Have a quiet, well-lit area for the telemedicine visit.
• Prepare to describe your child’s symptoms clearly, including when they started.
• Have a way to show the child’s ear via video if possible.
• List any medications your child is currently taking.
• Note any allergies or previous ear infections.

After your tele-visit

• Follow the healthcare provider’s instructions carefully, including medication use.
• Keep the child’s ear dry and avoid swimming until healed.
• Watch for any worsening symptoms or new red flags.
• Schedule follow-up care if symptoms do not improve as advised.
• Use pain relief methods recommended during the visit.

FAQs

Can I put anything in my child’s ear to relieve swimmer’s ear?

It is best to avoid putting anything into your child's ear canal unless recommended by a healthcare provider. Inserting cotton swabs or other objects can worsen irritation or push infection deeper.

How long does swimmer’s ear usually last?

With proper care and treatment, swimmer’s ear often improves within 7 to 10 days. If symptoms persist or worsen, seek further medical advice.

Can swimmer’s ear cause hearing loss?

Swelling and fluid in the ear canal may cause temporary hearing difficulty. This usually resolves once the infection clears. Persistent hearing loss should be evaluated by a healthcare provider.

Is swimmer’s ear contagious?

Swimmer’s ear is not contagious. It results from irritation and infection inside the ear canal, not from person-to-person contact.

How can I prevent swimmer’s ear in my child?

Dry your child's ears thoroughly after swimming or bathing, avoid inserting objects into the ear, and consider using ear plugs during swimming if your child is prone to infections.

Sources

1. Otitis Externa — MedlinePlus, U.S. National Library of Medicine.
2. Swimmer's Ear (Otitis Externa) — Centers for Disease Control and Prevention (CDC).
3. Otitis Externa (Swimmer's Ear) — Mayo Clinic.
4. Otitis Externa — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or red flags, please seek immediate medical attention.