Swimmer's Ear: Otitis Externa Self-Care and Ear Infections in Spain

Ear pain after a swim in Spain is often swimmer's ear. Doctors call it otitis externa. It is an infection of the outer ear canal, the short tube between the outside of your ear and your eardrum. Water that stays in the canal softens the skin and lets germs grow. Warm summer weather makes this more likely.

For mild cases, otitis externa self-care is often enough: keep the ear dry and use simple pain relief. If the pain is strong, the ear is leaking or it is not getting better, see a doctor. You may need prescription ear drops.

Swimmer's Ear (Otitis Externa) Self-Care

1. Keep the ear dry. Stay out of the water until it settles and use a cotton-wool ball coated in petroleum jelly when you shower.
2. Do not put cotton buds, fingers or anything else into the ear canal.
3. Use simple pain relief such as paracetamol, or ibuprofen if it is safe for you.
4. Ask a pharmacist for advice. Antibiotic or steroid ear drops need a prescription in Spain.
5. To prevent it coming back, tilt your head to drain water after swimming and dry the outer ear gently with a towel.

See a doctor if the pain is severe, the swelling spreads to the outer ear or face, you have a fever or discharge, your hearing drops, you have diabetes or a weak immune system, or there is no improvement after two to three days.

What Is Swimmer's Ear?

Swimmer's ear is an infection or swelling of the skin inside the outer ear canal. It is most often a bacterial infection. Fungi cause it less often. It usually affects one ear, but it can affect both outer ear canals.

Common triggers are:

• Water that stays in the ear after swimming or a shower.
• Scratching the ear, or cleaning it with cotton buds, which can damage the skin.
• Skin problems such as eczema or psoriasis in or around the ear.
• Wearing hearing aids, which can irritate the skin of the ear canal.

Outer Ear or Middle Ear? How to Tell

Ear pain can start in the outer ear canal or in the middle ear, behind the eardrum. The cause changes the treatment.

• Swimmer's ear (outer ear, otitis externa): The pain gets worse when you pull or press the outer ear. You may also notice itching, a red and swollen ear canal, yellow or smelly discharge, and muffled hearing or a full feeling. A high fever is not typical.
• Middle ear infection (otitis media): A deep, throbbing pain, often after a cold or a blocked nose. Fever is common and your hearing may drop. Pulling the outer ear does not usually make the pain worse.

Why Early Treatment Helps

Swimmer's ear can get worse quickly. Mild itching can turn into strong pain that keeps you awake. Pain medicine eases the pain, but it does not treat the infection. When bacteria are the cause, prescription ear drops are usually needed. Without treatment, the swelling can close the ear canal.

In older adults, and in people with diabetes or a weak immune system, the infection can spread to the bone of the skull. This is called malignant otitis externa. It is rare, but it is serious and needs hospital treatment.

Who This Guide Is For

• Expats, digital nomads and retirees living in Spain who want care in English.
• Tourists and travellers with ear pain after the beach or the pool.

How an Online Doctor Can Help With Ear Pain

Dr. Pedro Yelamo offers 15-minute video consultations (€50) for urgent, non-emergency care, in English or Spanish. Consultations run every day, 07:30–20:30 (Spain time).

1. Your story first: He asks when the pain started, and about swimming, discharge, fever, hearing and health problems such as diabetes.
2. What the camera can show: He can see the outside of the affected ear and any redness or swelling around it. A video call cannot show the inside of the ear canal or the eardrum. If he needs to see them, he will refer you for an in-person check.
3. Treatment, if it is right for you: If clinically indicated after the video assessment, he can issue a private electronic prescription under Spanish law. It can be dispensed at pharmacies in Spain. For swimmer's ear this is usually antibiotic ear drops, sometimes combined with a steroid to reduce swelling (for example, ciprofloxacin with fluocinolone). A prescription is never guaranteed.
4. Ear care advice: How to keep the ear dry, why to avoid cotton buds (bastoncillos), and how to use pain medicine safely.
5. Referral when needed: If the canal is very swollen or blocked, an ENT specialist may need to clean it in person (microsuction).

Read more about ear infection treatment online, or book a video consultation.

Can I Fly With an Ear Infection?

It depends on which part of the ear is infected.

Swimmer's ear (outer ear). The pressure changes in a plane mainly affect the middle ear, behind the eardrum. The outer ear canal is open to the cabin air. So swimmer's ear alone is less likely to cause pressure pain when you fly.

Keep using your treatment and keep the ear dry. If the ear is very painful, swollen shut or leaking, speak to a doctor before you travel.

Middle ear infection, or a heavy cold. Flying can hurt, mostly when the plane comes down to land. The small tube that balances pressure in your ear (the Eustachian tube) may be blocked. Rarely, the pressure change can damage the eardrum.

The CDC, the US public health agency, says travellers with ear, nose or sinus infections may choose to put off flying. The same goes for a badly blocked nose.

If you do fly:

• Stay awake as the plane starts to come down.
• Swallow, yawn, chew gum or suck a sweet to help your ears "pop".
• Babies and young children can feed or take sips of a drink.
• Ask a pharmacist or doctor whether a decongestant is safe for you.

Get checked before you fly if you have severe pain, discharge with fever, sudden hearing loss or dizziness. If your airline asks for a medical certificate, see our guide to fit-to-fly certificates in Spain.

Red Flags: When to Get Urgent Care

Some ear symptoms need an in-person check the same day, at a hospital emergency department (urgencias) or with an ENT specialist. In an emergency, call 112.

• Redness, warmth or painful swelling behind the ear, over the mastoid bone (possible mastoiditis).
• Weakness or drooping of the face on the affected side.
• High fever over 38.5°C with severe dizziness or loss of balance (vertigo).
• Sudden, major hearing loss, or bloody discharge after a head injury.
• Severe ear pain if you have diabetes or a weak immune system, as the infection can spread to the bone.

Not sure where to go? Read when to go to the ER or see an online doctor in Spain.

Which Care Do You Need?

Your symptoms	Where to go	When	Spanish health card needed?
Water stuck in the ear, no real pain	Self-care: tilt your head to drain it and dry the outer ear gently	Now	No
Pain when you touch the ear, swollen ear canal	Online GP video consultation	Any day, 07:30–20:30	No
Swelling behind the ear, high fever, vertigo or weakness of the face	Call 112 or go to hospital urgencias	Immediately	No

Frequently Asked Questions

Is swimmer's ear disease contagious?

No. You cannot catch swimmer's ear from another person, and you cannot pass it on. It comes from water in the ear, damage to the skin of the ear canal, or both.

Do antibiotic ear drops need a prescription in Spain?

Yes. Antibiotic ear drops (for example, drops that contain ciprofloxacin or polymyxin B) are prescription-only medicines in Spain. This helps prevent antibiotic resistance.

Can an online GP prescribe ear drops in Spain?

Sometimes. After a real video assessment, and only if clinically indicated, a doctor licensed in Spain can issue a private electronic prescription under Spanish law. It is never guaranteed: some ear problems need an in-person examination first.

How can I prevent swimmer's ear?

Wearing earplugs or a swimming cap helps keep water out. After swimming or a shower, tilt your head so each ear faces down, then dry the outer ear with a towel. Do not put cotton buds or anything else in the ear, and do not try to remove ear wax. Wax helps protect the ear canal from infection.

Can I swim while using antibiotic ear drops?

No. Keep the ear canal dry, including in the shower. Avoid swimming for at least 7 to 10 days, until the treatment is finished and the symptoms have gone. Your doctor will tell you when it is safe to swim again.

Your Next Step

If you have ear pain in Spain and no warning signs, book a video consultation for urgent, non-emergency care. Have a list of your symptoms, your medicines and any health conditions ready.

This content is educational and not a substitute for medical advice. For emergencies in Spain, call 112.