Swimmer’s ear (Otitis Externa) is a common infection of the outer ear canal often caused by water exposure that allows bacteria or fungi to overgrow. When planning air travel, people with this condition frequently question whether the change in cabin pressure poses a danger to the inflamed ear. Flying with Swimmer’s Ear relates less to the infection itself and more to the secondary effects it has on the ear’s ability to manage altitude changes safely. Understanding the location of the infection and the mechanics of flight pressure is the first step in deciding whether flying is advisable.
Swimmer’s Ear: An Outer Ear Infection
Otitis Externa is an inflammatory condition that affects the skin lining the ear canal, the tube extending from the outer ear flap to the eardrum. It is triggered when moisture breaks down the protective layer of earwax, creating a warm, damp environment ideal for the proliferation of bacteria like Pseudomonas aeruginosa. Symptoms are localized to this outer area, beginning with mild itching and progressing to pain, which often intensifies when the outer ear or the small cartilage flap is tugged.
As the infection progresses, the skin of the ear canal swells and becomes red, sometimes producing a clear or foul-smelling discharge. This swelling can partially or completely occlude the ear canal, leading to a sensation of fullness or muffled hearing. Unlike middle ear infections, the primary source of the problem is external to the eardrum; however, the inflammation and swelling can still indirectly complicate the pressure dynamics of air travel.
Cabin Pressure Changes and the Ear
The discomfort associated with flying is primarily a function of the middle ear, not the outer ear where Swimmer’s Ear resides. Aircraft cabins are pressurized to an altitude equivalent of 6,000 to 8,000 feet. The rapid pressure fluctuations during ascent and, more acutely, during descent, stress the middle ear space. The Eustachian tube, a narrow passageway connecting the middle ear to the back of the nose and throat, is responsible for equalizing the pressure between the middle ear and the cabin environment.
When the Eustachian tube is unable to open correctly, the pressure difference creates a vacuum or bulge on the eardrum, a condition known as barotrauma or “airplane ear.” Swimmer’s Ear does not directly obstruct the Eustachian tube, but the severe swelling of the ear canal can create a physical barrier to the outside. This blockage can trap air or fluid against the outer surface of the eardrum, making the pressure imbalance more difficult to manage and magnifying the pain experienced during altitude changes.
Assessing Severity, Risk, and Necessary Precautions
The decision to fly with Swimmer’s Ear depends on the severity of the infection and whether it is being treated. Flying with a mild, diagnosed, and actively treated case is manageable, though increased pain is a common expectation. If the pain is severe, if a fever is present, or if there is suspicion of a burst eardrum, delaying travel until the infection is resolved is strongly recommended to prevent complications. Intense pressure changes can worsen an existing infection or, in rare cases, lead to a temporary rupture of an already compromised eardrum.
Consulting a healthcare provider before flying is a prudent step, particularly if symptoms are moderate or severe, as they may prescribe specific antibiotic or steroid ear drops. If flying is unavoidable, taking an over-the-counter pain reliever, such as an NSAID, approximately 30 minutes before takeoff and descent can help mitigate discomfort. Using pressure-equalizing techniques during these periods is also helpful.
Pressure Equalization Techniques
- Frequent swallowing, yawning, or chewing gum encourages the Eustachian tubes to open and equalize the pressure more effectively.
- The Valsalva maneuver involves gently blowing air out while pinching the nose and closing the mouth to force the tubes open.
- Perform the Valsalva maneuver gently to avoid further ear injury.
- Using specialized filtered earplugs designed for flying can slow the rate of pressure change against the eardrum, providing additional comfort during takeoff and landing.