What is “Surfers Ear”?


Image: Surf Transworld

Unlike “swimmers ear” or otitis externa, “surfers ear” also called exostosis is a buildup of abnormal bony growth in the form of lumps inside the ear canal.

Because surfers ear causes bony growth to build up in the ear canal, it starts to block the ear canal, making the passageway smaller. This can lead to difficulty hearing, and an increase of ear infections and swimmers ear.

Surfers Ear is caused by our ears having repeated contact with cold water and wind. It is more common in the surfing world – hence the name, but divers that repeatedly dive in cold water can also suffer from this condition.

In surfers it is generally more prevalent on one side (the side facing the prevailing winds when surfing), however with divers it generally occurs on both sides together due to the fact that both ears are in the cold water together.

Surfers ear is a progressive condition, meaning that it will start off slowly and become progressively worse over time with repeated exposure. This is why cold water divers must take preventative measures early on.

“But I only dive in warm tropical waters, I can’t possibly get surfers ear can I?” Even though the temperature of the water is warm, when you surface from the water into the “trade winds” that continually blow across the islands the water in the ear canal evaporates, causing a cooling effect inside the ear canal which could lead to surfers ear.

There are a couple of simple things that a diver can do to avoid getting surfers ear:

  1. Wear Vented Ear Plugs – I know you remember back in your Open Water Diver training that divers should never wear ear plugs because it prevents them from being able to equalize their ears. Vented Ear Plugs on the other hand prevent water from entering the ear canal but have a tiny hole in them to allow air equalization through them, but the hole is too small for water to pass through.
  2. Wear a Wetsuit Hood – Wetsuit hoods will keep our ear canals nice and warm, and prevent them from being chilled by evaporation from the wind.
  3. Wear a Stocking Cap or Beanie – After diving put a stocking cap or beanie on to cover the ears. This will keep you warm while preventing the wind from evaporating the water in your ear canals and cooling them too quickly.

“How can I tell if I already have surfers ear?” There are a few simple things to look for like:

  • Take notice of any pain, popping or crackling that originates in your ear.
  • Tilt your ear toward the ground and shake your head to see if you can hear water trapped in your inner ear.
  • Ask yourself if people are always telling you to turn down the music or the TV, or if they tell you that you talk loudly.
  • Think about whether you’re asking others to speak up, even when they are sitting right next to you.
  • Visit a doctor, preferably an ear specialist, and get a second opinion to verify any diagnosis.

If the condition is left untreated and becomes severe enough surgery may be necessary to alleviate it by drilling and cutting away the abnormal bony growth. This used to be done by making an incision behind the ear as well as going in with a drill through the ear canal.

There is a new process now where they will use chisels to remove the abnormal bony growth through the ear canal instead of making the traditional incision behind the ear. This new process also eliminates most of the use of the drill as well. The new process submits the patient to less noise during surgery that could damage hearing, and speeds healing afterwards.

By utilizing these simple steps outlines above, you can help prevent surfers ear from starting in the first place and the need for painful surgery.

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