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Kids Health Info

Outer ear infection (otitis externa)

  • Go to middle ear infection (otitis media)

    Key points

    • An outer ear infection happens when the skin of the ear canal gets infected – usually due to bacteria or fungus.
    • Outer ear infections are also called swimmer’s ear.
    • Both outer ear and middle ear infections are types of ear infections, but they need different treatments.
    • Doctors often prescribe antibiotic ear drops to treat outer ear infections. Sometimes, they will insert a wick to help medicine get to the infected area.

    What is an outer ear infection?

    An outer ear infection happens when the skin of the ear canal (auditory canal) gets infected. Most outer ear infections are caused by bacteria or fungi. The condition can cause the skin inside the ear canal to get irritated and swell up; together with a build-up of debris like dead skin, it can make the canal look closed-over.

    Outer ear infections are commonly known as 'swimmer’s ear' because water can get trapped inside while swimming and create an environment that allows bacteria and fungi to grow. This can cause infection.

    Outer_Ear_Infection_Swimmers_Ear_Diagram

    Figure one: Diagram showing an outer ear infection (swimmer's ear or otitis externa).

    Signs and symptoms of outer ear infections

    Common signs and symptoms of outer ear infections include:

    • Feeling of ‘fullness’ in their ear
    • Itching
    • Pain
    • Discharge leaking from the ear
    • Fever (temperature of 38°C or more)
    • Swollen skin inside the canal that makes it look smaller or closed over.

    Some of these can also occur in middle ear infections.

    How to care for outer ear infections

    See a doctor

    It is best to take your child to see their doctor if you think they have an outer ear infection. This is because outer ear infections need treatment with antibiotic ear drops.

    Care at home

    Once your child has seen a doctor, you can usually care for them at home.

    • To give your child ear drops, it is usually best for them to lie down with the affected ear facing the ceiling. Put the drops in and try to keep your child in the same position for a few minutes so they can absorb.
    • If your child is in pain, you can offer them pain-relief medicine, such as paracetamol or ibuprofen.
    • Children with an outer ear infection should avoid swimming for one week so the ear can heal.
    • Bathing and showering your child are both safe while your child has an ear infection, as long as their ear stays above the water in a bath or out of the direct stream of a shower head.

    Your child’s doctor may insert a ‘wick’ into their ear. This is a tiny sponge that helps medicine get to the infected area. Simply drop the antibiotic eardrops onto the wick tip sticking out of the ear – it will expand to fill up the whole ear canal. If the wick falls out while the infection is still recovering, continue to drop the antibiotics straight into the ear canal.

    How to prevent outer ear infections

    Keeping your child’s ear canals dry is the key to preventing outer ear infections.

    • Your child could wear earplugs when swimming.
      • It is best to use earplugs that fit into the main part of the ear, not into the ear canal. These are available at most pharmacies, sports stores, and even swim centres.
    • Some over-the-counter drops containing an alcohol or acetic acid solution can help dry the ear canal and prevent bacterial growth.
    • If your child is not using earplugs, dry the ear canal thoroughly after each swimming/bathing session with the corner of a towel, or with a hair dryer on a low-heat setting.
      • Take care to avoid burns if using a hair dryer.
    • Do not clean the ear with cotton buds as they can damage the ear canal and will push wax further in.
    • Do not insert anything into the ear to scratch it if your child says it feels itchy.

    When to get help

    Call an ambulance (000) if:
    • your child is lethargic and not waking up properly or interacting – for example, they seem very drowsy.

    Go to a hospital if:
    • your child has swelling building up behind the infected ear on the head itself.
    • your child has a fever (temperature of 38°C or more) and is lethargic or drowsy.
    • your child’s infected ear is red and swollen.
    • your child is very irritable, and pain-relief medicine like paracetamol or ibuprofen does not help.

    See a doctor or health professional if:
    • your child is still in pain or has a fever (temperature of 38°C or more) after 48 hours.
    • your child gets ear infections often.
    • your child still has hearing problems two weeks after an outer ear infection.
    • your child is still acting irritable two weeks after an outer ear infection.

    Look after your child at home if:
    • pain-relief medicine helps with their pain, and they start to recover within 48 hours.

    Common questions about outer ear infections

    What causes outer ear infections?

    Outer ear infections often happen when the ear canal is moist, such as in humid places or when water gets trapped while swimming. This is because it creates an environment that allows bacteria and fungi to thrive. Damage to the ear canal can also cause outer ear infections, as tiny cuts allow germs to enter the skin. Scratching or cleaning the ears is one common culprit.

    Are outer ear infections contagious?

    Outer ear infections are not contagious.

    How long do outer ear infections usually last?

    In most cases, outer ear infections will heal in one to two weeks with proper treatment. Some may take longer.

    Can my child go swimming with an ear infection?

    If your child has an outer ear infection, wait until one week after treatment before letting your child swim. This will give the ear time to heal. Speak to your child’s doctor if you are not sure.

    Should I clean my child’s ears to prevent a build-up of wax?

    There is no need to remove the wax in your child’s ears. The body can do this by itself. You can remove large clumps of wax that you can see at the opening of your child's ear canal, but do not use a cotton bud. It is best for a doctor to remove the wax if you are not sure how to get it out safely.

    Can my child still go to childcare or school if they have an ear infection?

    Your child can go to childcare or school with an outer ear infection if they are otherwise well. However, if they are in pain or have a fever (temperature of 38°C or more), they should stay home to rest. You may need to organise for their educators or carers to give them their antibiotics.

    For more information


    Developed by The Royal Children’s Hospital Emergency department, with input from Otolaryngology. We acknowledge the input of RCH consumers and carers.

    Reviewed March 2026

    Please always seek the most recent advice from a registered and practising clinician.


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

Updated July 2025

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