Air travel presents unique challenges for the human body, especially when managing an existing ear infection, such as Swimmer’s Ear, during a flight. The change in cabin pressure can transform a mild infection into severe discomfort. Understanding how altitude affects the inflamed ear is necessary for making an informed decision about flying.
What Swimmer’s Ear Is
Swimmer’s Ear, medically known as otitis externa, is an infection or inflammation of the outer ear canal, the tube running from the eardrum to the exterior opening of the ear. It is most frequently caused by water remaining in the ear canal, creating a moist environment conducive to the growth of bacteria or fungi. Trauma to the canal lining, often from cotton swabs or scratching, can also breach the skin’s protective barrier and lead to infection.
The common symptoms of otitis externa include itchiness, redness, and swelling of the outer ear. Pain is noticeable, particularly when the earlobe is gently tugged or the jaw is moved, such as when chewing. As the infection progresses, a feeling of fullness, muffled hearing, or a clear to yellowish discharge from the ear may occur.
How Altitude Changes Affect the Ear
The air pressure inside an airplane cabin remains lower than the pressure on the ground, creating a temporary imbalance that the ear must equalize. The greatest stress occurs during the ascent and, more acutely, the descent, triggering a condition known as barotrauma. The middle ear, separated from the outer ear by the eardrum, maintains its pressure balance through the Eustachian tube, which connects it to the back of the throat.
The Eustachian tube opens periodically, allowing air to move and balance the pressure between the middle ear and the cabin environment. When the outer ear canal is already swollen and inflamed from Swimmer’s Ear, this pressure equalization process is significantly compromised. Although otitis externa affects the outer ear, the swelling can indirectly impact the eardrum and the entire pressure regulation system.
An inflamed outer ear canal increases the sensitivity of the eardrum to pressure changes, leading to intense, sharp pain during ascent and descent. The inability to properly equalize pressure can cause the eardrum to bulge or retract, placing it under mechanical stress. Even in a mild case, the overall sensitivity and pain potential are dramatically increased compared to flying with a healthy ear.
Strategies for Pain Management During Flight
If travel is necessary with a mild case of Swimmer’s Ear, consulting a healthcare provider before the flight is the first step to confirm the infection is under control. A doctor may recommend continuing prescribed antibiotic or steroid ear drops right up until the time of travel. For general pain relief, taking an over-the-counter pain reliever, such as ibuprofen or acetaminophen, about 30 minutes before takeoff can help manage inflammation and discomfort.
To actively assist the ear in pressure equalization, stay awake during both the takeoff and landing phases of the flight. Swallowing and yawning are natural actions that help open the Eustachian tubes. Chewing gum or sucking on hard candy encourages frequent swallowing, which helps vent air and prevent a painful pressure differential from building up.
A technique known as the Valsalva maneuver can also be used gently to force air into the middle ear. This involves pinching the nostrils shut, closing the mouth, and then attempting to exhale softly through the nose. This action must be performed with minimal force to avoid damaging an already compromised eardrum. Using a decongestant nasal spray, such as oxymetazoline, before takeoff and again before descent can reduce swelling near the Eustachian tube opening, further aiding the equalization process.
Warning Signs That Require Delaying Travel
Certain symptoms indicate that the infection is too severe or complicated to risk flying, and travel should be delayed until a doctor has cleared the condition. A high fever, which is a systemic sign that the body is struggling against infection, is a clear contraindication for air travel. Similarly, experiencing severe, throbbing pain that radiates beyond the ear, potentially into the face, neck, or side of the head, suggests advanced inflammation.
Any indication of a spreading infection, such as visible redness or swelling that extends well beyond the immediate ear canal, may point toward cellulitis or a deep tissue infection. Furthermore, a sudden, severe reduction in hearing, the onset of dizziness or vertigo, or the presence of intense discharge are serious signs. These symptoms could suggest a complication like a perforated eardrum or an infection extending to the middle or inner ear, which would be severely exacerbated by cabin pressure changes. In these cases, the potential for complications outweighs the need to travel, and immediate medical attention is required.