Water sports expose enthusiasts to unique environmental risks, including a condition commonly known as Surfer’s Ear. This physical change is a slowly developing issue that affects anyone frequently in the water, not just surfers. The condition represents a biological response where the body attempts to protect itself from the persistent chill of the environment. Understanding this condition is the first step toward effective prevention and management for those who regularly participate in aquatic activities.
Defining Surfer’s Ear
Surfer’s Ear is the common name for external auditory canal exostosis (EACE). This condition refers to the abnormal, benign bone growths that form within the bony part of the ear canal. These growths appear as lumps of new bone tissue, typically arising from the walls of the ear canal. The physical change is progressive and irreversible without medical intervention, leading to a gradual narrowing of the passage to the eardrum. The constriction caused by these growths is the source of subsequent health issues.
The Mechanism of Bone Growth
The formation of external auditory canal exostosis is a protective reaction by the body to repeated exposure to cold water and wind. When the temperature inside the ear canal drops, the body attempts to warm the area to protect the eardrum and inner structures. This chronic thermal irritation stimulates the underlying bone tissue, specifically the periosteum, a membrane that covers the bone. The constant irritation triggers bone-producing cells, known as osteoblasts, to generate new bone growth.
This process results in the characteristic bony lumps, which can occur in one or both ears. Spending time in water below 64°F (18°C) significantly increases the risk of developing the condition. The overall risk rises by about 12% for each additional year of cold water exposure. The combination of cold water and evaporative cooling from wind chill accelerates this defensive bone proliferation.
Recognizing the Signs
The development of Surfer’s Ear is typically slow, often taking 10 to 15 years of frequent cold exposure before noticeable symptoms appear. One of the earliest and most common signs is the sensation of water becoming trapped in the ear canal after a session. As the exostoses grow and narrow the canal, this obstruction prevents water from draining normally. The trapped water, along with shed skin and earwax, creates a moist environment highly susceptible to bacterial overgrowth.
This environment leads to the advanced symptom of recurrent ear infections, medically termed otitis externa. As the condition progresses, the narrowing of the ear canal can also cause progressive conductive hearing loss, where sound waves are physically blocked from reaching the eardrum. Patients may also experience aural fullness, ear drainage, or tinnitus, which is ringing in the ears. Diagnosis is made by a healthcare professional using an otoscope to visually inspect the ear canal for the bony growths.
Medical Intervention and Prevention
If symptoms are mild, the condition may be managed non-surgically by keeping the ears dry and protected to prevent further bone growth. However, the bony growths are permanent. If the narrowing causes significant hearing loss or repeated, severe infections, the only definitive treatment is surgical removal. This procedure is called canalplasty, where a surgeon removes the excess bone to restore the ear canal to its normal width.
Canalplasty is typically performed as an outpatient procedure under general anesthesia. Surgeons use either a micro-chisel through the ear canal or a drill through an incision made behind the ear. Following surgery, patients must strictly avoid getting water in the ear canal for a recovery period lasting one to several months. A full return to water sports often takes up to eight weeks.
The most effective strategy against Surfer’s Ear is prevention, as the condition is entirely avoidable. Prevention involves wearing physical barriers to shield the ear from the elements. Custom-fitted earplugs are highly effective, creating a tight seal to keep cold water and wind out while allowing the wearer to hear their surroundings. Combining earplugs with a neoprene hood or warming headband provides additional protection in very cold or windy conditions.