Otitis externa in pregnancy

Overview

Otitis externa, also called swimmer's ear, is an infection of the outer ear canal – the tube that runs from the ear opening to the eardrum. During pregnancy, hormonal and immune changes may make you slightly more prone to infections, but the condition itself is the same as for anyone else.

Yes, otitis externa is a very common condition, especially in warm or humid climates and after swimming. It can affect people of all ages, including pregnant women.

Anyone can get otitis externa, but it is more common in people who swim often, wear hearing aids, have narrow ear canals, or have skin conditions like eczema. During pregnancy, changes in the immune system may slightly increase your risk, but the condition remains manageable.

Symptoms

Common symptoms

• Itching in the ear canal
• Pain that gets worse when you touch or pull on your ear
• A feeling of fullness or blockage in the ear
• Watery or pus-like discharge from the ear
• Mild hearing loss or muffled hearing

Symptoms in children

• Tugging or rubbing the ear more than usual
• Irritability or crying when the ear is touched
• Difficulty sleeping or hearing
• Fever (less common)

Symptoms in older adults

• Same as common symptoms
• May have more intense pain or discharge
• Hearing loss may be more noticeable

Causes

Main causes

• Bacterial or fungal infection – often from water staying in the ear canal after swimming or bathing
• Damage to the skin inside the ear canal, for example from scratching or using cotton buds

Risk factors

• Swimming, especially in pools, lakes, or the sea
• Living in a humid or warm climate
• Using hearing aids or earplugs that trap moisture
• Having a narrow ear canal
• Skin conditions such as eczema or psoriasis
• Pregnancy-related immune changes (mild increase in risk)

When to see a doctor

See a doctor urgently if:

• If you have severe pain, high fever, or swelling around the ear

Book a routine appointment if:

• If you have mild discomfort, itching, or discharge for more than a few days

Diagnosis

A doctor will look inside your ear with a lighted instrument called an otoscope to check for redness, swelling, discharge, or damage to the ear canal.

Tests that may be done

• In most cases, no tests are needed. The doctor can diagnose just by looking.
• If the infection is severe or not improving, they may take a swab to identify the bacteria or fungus.

What to expect at your appointment

The examination is quick and painless. The doctor may gently clean your ear canal if needed. They will then discuss safe treatment options for pregnancy.

Treatment

Treatment focuses on clearing the infection and relieving pain. During pregnancy, medications are chosen carefully to be safe for you and your baby. Most cases are treated with ear drops and self-care measures.

Self-care at home

• Keep your ear dry by using a shower cap or a cotton ball coated with petroleum jelly when bathing.
• Avoid swimming until the infection has completely cleared.
• Do not insert anything into your ear, including cotton buds, fingers, or earplugs.
• Apply a warm cloth or a warm, dry compress to the outside of the ear to soothe pain.
• Ask your pharmacist which painkillers are safe to take during pregnancy (such as paracetamol) if needed.

Medical treatments

Your doctor may prescribe ear drops that contain a mix of antibiotics and sometimes a steroid to reduce inflammation. These are chosen to be safe during pregnancy. In rare severe cases, oral antibiotics may be needed. Always follow your doctor's instructions and finish the full course of treatment.

When is surgery considered?

Surgery is almost never needed for otitis externa. Only in very rare cases of severe infection that spreads to surrounding tissue might a doctor consider drainage.

Living with this condition

While you have otitis externa, avoid getting water in your ear and protect it from dust and wind. Most people feel better within a few days of starting treatment. The discomfort can be annoying but is temporary.

Lifestyle tips

• Use a shower cap or earplugs designed for swimming when washing your hair or showering.
• If you wear hearing aids, remove them while the infection heals, or ask your audiologist for advice.
• Avoid flying or sudden pressure changes until your ear has healed.

Diet and exercise

No special diet is needed. You can continue gentle exercise as long as you keep your ear dry. Avoid swimming until cleared by your doctor.

Mental health and emotional wellbeing

Ear pain and itching can be frustrating, especially when you are already coping with pregnancy. It is normal to feel a bit low. Remind yourself that this is temporary and treatable. Talking to your healthcare provider can help.

Prevention

Yes, you can reduce your risk by keeping your ears dry, not inserting objects, and treating any skin conditions like eczema. After swimming, tilt your head to drain water and gently dry the outer ear with a soft towel.

Vaccines

No vaccine prevents otitis externa.

Screening programmes

No routine screening is needed. If you have symptoms, see your doctor.

Complications

If left untreated

• The infection can spread to the cartilage of the ear or deeper tissues (cellulitis).
• It may become chronic, causing long-term itching and discharge.
• Temporary hearing loss can occur from swelling or discharge.

Long-term outlook

With proper treatment, otitis externa usually resolves within a week or two and rarely causes lasting problems. During pregnancy, the outlook is just as good – your healthcare team will choose treatments that are safe for you and your baby.

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