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Q: I’m a keen swimmer and have recently begun to train in open water, with a view to competing in some open-water events later this year. However, over the last couple of months, I’ve been suffering with bouts of really bad earache. I’ve been to the doctor and he says the pain is due to a condition called “swimmer’s ear”. My ears are OK at the moment, but how can I prevent it from coming back? Is there anything I can wear in my ears while swimming to prevent water ingress? Lorna Stevens, by email

Andy HamiltonAndy Hamilton – Sports Performance and Nutrition Expert andrewmarkhamilton.co.uk 

A: Swimmer’s ear (more correctly known as “otitis externa”) is caused by an inflammation of the outer ear canal – the tube between the skin’s surface of the external ear and the eardrum – and is usually caused by an infection, which may be bacterial or fungal. Typical symptoms include redness and swelling of the skin of the ear canal and itchiness, especially in the early stages. As it progresses, the ear can become extremely sore and painful, and as the canal becomes more inflamed, hearing may also be affected.

Anyone can develop otitis externa and it often follows localised trauma to the skin of the ear canal, for example, if the canal is scraped by a cotton-tipped bud in an attempt to remove earwax (which you should not do – wax works its way out naturally, and cotton buds should only be used to sweep around your outer ear) or scratching the ear with fingernails in an attempt to relieve an itch. However, constantly getting the ears wet can also damage the normal immune defences in the ear leading to infection (hence the term swimmer’s ear). This risk is further increased if the water contains significant levels of bacteria.

Unfortunately, once you’ve suffered one episode of otitis externa, you’re more likely to suffer a subsequent one, which means extra care is required. To help prevent future episodes, wear a tight-fitting cap that completely covers your ears whenever you swim and plug the ears, where possible, with cotton wool coated in Vaseline. After swimming, dry any water in your ears using a hairdryer on a low setting and follow up with an acidifying ear spray product (such as Earcalm), which temporarily enhances the ear canal’s natural acidity, inhibiting any bacterial growth.