What Surfer’s Ear is and Treatment Tips

23rd Jun 2020

Anyone who spends a lot of time in the water can get Surfer’s Ear, not only surfers. Surfer’s Ear or ‘exostoses’ is a medical condition that causes abnormal bone growth within the ear canal. Over time, this can result in the progressive closure of the ear canal and all the consequences thereof – from trapped water and repeated infections to hearing loss.

The ear canal is a cozy, warm hidey hole, with its own natural bacterial inhabitants and natural wax and canal skin. When it gets wet repeatedly, or someone fiddles there with earbuds etc, the bacteria can overwhelm the natural control mechanisms and take advantage of the heat and moisture, and then cause swelling, hearing loss and pain leading to Surfer’s Ear. This pain can be severe. We ENTs call this ‘otitis externa’ – OE = inflammation of the outer ear canal.


The main elements of TREATMENT of OE are to remove all the muck from the ear canal, to reduce the swelling, to treat the pain and to treat the infection. The first is usually done by an ENT using a microscope and microsuction, and is a vital step in the process of getting someone better. Skipping that step is usually the reason many infections linger on. See our Ear, Nose and Throat specialist.

Treating the pain implies use of analgesics, anti inflammatories and cortisone.

Reducing the swelling is done by inserting ribbon gauze with an antibiotic ointment, or a similar ear ‘wick’ that carries antibiotic eardrops. Cortisone also works towards this end.

Oral cortisone and antibiotics may be necessary in severe cases. Most infections are caused by a bacteria called pseudomonas, which does not respond well to penicillin. A class of antibiotics known as quinolones are better.


So, what can you do if you think you are getting an ear infection typical of ‘Surfer’s Ear?’

1. Stay out of the water – getting it wet repeatedly will only make things worse. A day or two of staying dry might allow the infection to settle down without treatment. Then use an ear plug to keep that ear dry when you do go back into the water.

2. Treat the pain – paracetamol or ibuprofen, or anything similar.

3. Remove the ear debris – usually an ENT does that for you, but you can do a bit of it yourself by flushing out your ear, using a big syringe if you have it, or a water bottle improvisation, using vinegar diluted 50-50 with cooled boiled water. This creates a mixture of roughly 2-3% acetic acid, and this has good antibacterial and antifungal properties. If that is not an option, rolled toilet paper gently twirled in the ear canal might help.

4. Reduce the ear canal swelling – to do this you need a fabric ribbon about 1cm wide and about 10cm long. Ribbon gauze is perfect, but if you do not have that, cut a strip from a t-shirt and sterilize it in boiling water. This ribbon, coated with ointment, must be inserted gently as deep into the affected ear as possible with tweezers, or any tool you can find, and left there for 24 hours. Remove and repeat as required.

5. Treat the infection by saturating the ribbon before putting it in – any antibiotic ointment is better than nothing. My preferences would be a combination ointment like Quadriderm (cortisone, antibacterial and antifungal) or mupirocin (Bacroban.) But any antiseptic is better than nothing. If you do not have even that, then garlic juice, onion juice, honey, vinegar are worth a try. Or gentian violet or mercurochrome… anything even remotely antiseptic safe for human use…

6. See an ENT as soon as possible.

Some people get OE so often that it is termed ‘chronic otitis externa.’ In many cases the cause is that their ear canals are narrowed at the outer end, and they cannot dry out naturally. To correct this there is a really neat procedure called an ‘m-meatoplasty’ that can be very successful.

If you suffer from any ear, nose or throat problems don’t hesitate to see our specialist unit.

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