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Ear Infection After the Hot Tub? Swimmer's Ear — Causes & How to Fix It

Sore, itchy, blocked ear a day or two after a hot tub session — and it really hurts when you tug your earlobe? That's almost certainly swimmer's ear, properly called otitis externa: an infection of the outer ear canal. It's a common companion to hot tub rash, and like the rash, it's a warning sign that the water you've been sitting in isn't as clean as it looks.

This guide covers how to tell it's swimmer's ear, how to ease and dry your ear safely, when to see a doctor, and — the part that actually stops it recurring — how to get the bacteria and biofilm out of the tub.

How to Tell It's Swimmer's Ear

Swimmer's ear symptoms are usually mild at first and get worse if untreated. Typical signs:

• Itching inside the ear canal — often the first symptom
• Pain that's worse when you tug the earlobe or press the little flap of cartilage in front of the ear canal (the tragus) — this is the classic giveaway
• A feeling of fullness or the ear feeling blocked
• Redness and swelling in the ear canal
• Fluid or pus draining from the ear
• Muffled or reduced hearing as swelling and debris block the canal

It usually comes on a day or two after being in the water. A handy distinction: swimmer's ear (outer ear) hurts more when you pull on the ear, whereas a middle-ear infection usually follows a cold and doesn't get worse when you tug the ear. As with hot tub rash, if several people who shared the same tub get sore ears, that points at the water — not at one person passing it on.

What Causes It

When you sit in a hot tub, water gets into the outer ear canal and can stay there. That warm, trapped moisture wears down the protective earwax and skin and creates an ideal environment for bacteria to multiply. The most common culprit is Pseudomonas aeruginosa — the same bacterium responsible for hot tub rash — though Staphylococcus aureus and occasionally fungi can be involved too.

Swimming and hot-tub use raise the risk of otitis externa several times over compared with people who stay out of the water, simply because of that retained-water effect. Two things tip the odds further:

• Under-sanitised or biofilm-laden water — if free chlorine is low or Pseudomonas is hiding in biofilm inside the pipes and filter, every soak exposes your ears to a far heavier bacterial load. (More on biofilm in our hot tub rash guide.)
• Poking the ear — cotton buds, fingers or anything else stripping the wax and grazing the canal removes the ear's natural defences and lets the infection take hold.

Easing Your Ear (and When to See a Doctor)

Mild swimmer's ear can settle on its own if you keep the ear dry, but it often needs treatment — so don't just wait it out if it's painful.

• Pain relief — over-the-counter ibuprofen or paracetamol eases the discomfort. A warm flannel held against the ear can help too.
• Keep the ear dry — no swimming or soaking, and keep water out when you shower (a cotton ball smeared with petroleum jelly over the outer ear works as a temporary plug).
• Don't put anything in the ear — no cotton buds, no scratching. It makes things worse.
• Don't go back in the tub until the ear has fully healed and the water's been cleaned.

This is general information, not medical advice — if you're worried about an ear infection, speak to a pharmacist, NHS 111 or your GP.

Drying Your Ears Properly (Personal Prevention)

The single biggest thing you can do is get the water out of the canal after every soak:

• Tilt and drain — tip your head to each side so the ear faces the ground, and gently pull the earlobe in different directions to help the water run out.
• Towel the outer ear dry — but never push a corner of towel or a cotton bud into the canal.
• Hair dryer on lowest — if water lingers, a hair dryer on its lowest heat and speed, held several inches from the ear, helps evaporate it.
• Optional drying drops — if you don't have a perforated eardrum, ear tubes or a current infection, a 50/50 mix of white vinegar and rubbing alcohol (a few drops after swimming, let it drain back out) helps dry the canal and discourage bacteria. Check with a pharmacist first if you're unsure.
• Don't dig out earwax — wax protects the canal. Removing it makes swimmer's ear more likely, not less.

Fixing the Tub (So It Stops Happening)

Drying your ears manages your risk; cleaning the tub removes the source. If the water carries a heavy bacterial load — because sanitiser is low or biofilm is seeding the water from the pipes — you're fighting a losing battle. The clean-up is the same biofilm-busting routine that fixes hot tub rash and musty smells:

1. Stop using the tub until both your ear and the water are sorted.
2. Test and balance — 6-in-1 strips. Bring pH to 7.2-7.6 first (chlorine is far more effective in range), then free chlorine to 3-5mg/L.
3. Shock the water — chlorine granules at the shock rate (~20g per 1000 litres), pre-dissolved, pump running, cover off for the first hour.
4. Flush the plumbing — add a spa pipe-purge / system-flush product, run all jets and the air blower for 20-30 minutes to scour biofilm out of the pipework, then drain it away. This is the step that clears the hidden Pseudomonas reservoir.
5. Deep-clean the filter — soak the cartridge overnight in cartridge cleaner, or replace it if it's over 12 months old or clogged.
6. Drain, refill and re-sanitise — fresh water, re-balance, free chlorine to 3-5mg/L. Only get back in once the water's balanced and your ear has healed.

Safe Water Levels: Quick Reference

Prevention: Stopping Ear Infections Coming Back

When It Keeps Happening — Get the Tub Checked

If you've shocked, flushed, replaced the filter and refilled, but people keep getting sore ears (or the rash) after using the tub, the biofilm may be entrenched in dead-leg pipework — sections where water barely circulates and sanitiser and flush can't reach. Weak circulation makes this far worse, because the system never gets properly cleaned.

• Weak circulation / flow faults — see our E02 flow-error guide.
• Itchy skin rash alongside the ear — same biofilm, different symptom; see hot tub rash (folliculitis).
• Musty or eggy smells — also point to biofilm; see hot tub water smells.

Products You'll Need

All available at B&Q Bournemouth, Amazon, or directly from Lay-Z-Spa.co.uk / a pharmacy:

• 6-in-1 test strips — chlorine, bromine, pH, alkalinity, hardness (~£8 for 50)
• Chlorine granules — for dosing and shock (~£8-12 for 1kg)
• Spa pipe-flush / system purge — strips biofilm from internal plumbing (~£8-12)
• Filter cartridge cleaner — overnight soak (~£6-9)
• pH Plus / pH Minus — to balance the water (~£6-8 each)
• Swim earplugs — keep water out of the canal in the first place (~£5-10)
• Ear-drying drops — pharmacy, if no perforation or infection (~£4-6)
• Hose pre-filter — reduces minerals on refill (~£20, reusable)

Frequently Asked Questions