Symptoms and complications of swimmer's ear

The main symptoms of swimmer's ear are severe pain or itching in the ear and tenderness in the earlobes. The tissue in front of and below the ear may become swollen and tender. There's often a lot of earwax and skin debris in the ear canal. More severe bacterial infection sometimes causes yellowish pus to drain out. This may have an unpleasant smell. Fungal infections can create a grey-white pus.

Pus, wax, and skin debris may block sound waves from reaching the eardrum, causing a temporary decline in hearing ability. This isn't a sign of ear damage. As a rule, you needn't worry about the infection spreading to the middle or inner ear, as the eardrum won't let fungus and bacteria pass. The middle ear is usually only infected through the tubes that connect it to the throat (the Eustachian tubes). The eardrum itself is a lot tougher than most people think.

Complications of swimmer's ear are extremely rare, except in people with diabetes or weakened immune systems. One of the ear's primary defences against bacteria is the acidity of earwax. Unfortunately, earwax in people with diabetes is often quite alkaline - not very acidic. This encourages particularly severe infections that can spread into the surrounding bone. This is called malignant otitis externa, and it's usually only seen in people with diabetes or weakened immune systems.