Why Cold Water Can Cause Clogged Ears, Repeat Infections, and Hearing Problems

By Your Health Magazine Contributor

Your Health Magazine Contributor

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Why Cold Water Can Cause Clogged Ears, Repeat Infections, and Hearing Problems

You come out of the water, tilt your head, and the ear does not clear. It stays plugged for an hour, sometimes until the next morning. A few weeks later you are at urgent care with an ear infection, and it is the third one this year. Your hearing on that side seems slightly muffled, though not enough to mention to anyone.

Most people put this down to bad luck, or to the water quality, or to getting older. In swimmers, surfers, kayakers, paddleboarders and sailors, there is another explanation worth knowing about, because it develops silently over years and because the only effective response is prevention.

It is called external auditory exostosis, and almost everyone who has it calls it surfer’s ear.

What is actually happening in the ear canal

The ear canal is not a simple tube of soft tissue. Its inner portion is surrounded by bone, covered by a very thin layer of skin.

When cold water repeatedly enters that canal, particularly when wind then evaporates the moisture and drops the temperature further, the bone underneath responds the way bone often responds to chronic irritation: it lays down more bone. Over years, this produces small, smooth, rounded growths along the canal walls.

They are benign. They are not tumors, they are not cancerous, and they are not caused by infection. They are simply extra bone, in a place where the canal was already narrow.

The problem is purely mechanical. As the growths enlarge, the passage narrows. A narrowed, irregular canal no longer drains properly. Water, wax and debris get trapped behind the obstruction, sit in a warm dark space, and create close to ideal conditions for infection.

Why the symptoms arrive so late

This is the part that catches people out.

Exostoses develop slowly, typically over many years of exposure. In the early stages there is no pain, no hearing change, and no sign anything is happening. A person can have moderate growths and no complaints whatsoever.

Symptoms begin only when the canal has narrowed enough to interfere with drainage. By that point the changes have been accumulating for a decade or more, which means the first symptom is not the beginning of the problem. It is a fairly late milestone in it.

The usual sequence looks like this:

1. Water takes longer and longer to clear after swimming or paddling.
2. Episodes of outer ear infection become more frequent and more stubborn.
3. Wax builds up because the canal can no longer clear itself, sometimes requiring professional removal.
4. Hearing on the affected side becomes noticeably muffled, typically only once the canal is substantially blocked.
5. A sensation of fullness or pressure persists even when the ear is dry.

Both ears are usually involved, though rarely to the same degree, and the growth is generally slow enough that people adapt without registering the change.

This is not the same thing as swimmer’s ear

The two get confused constantly, including by people who have both.

Swimmer’s ear (otitis externa) is an infection of the skin lining the ear canal. It is acute, it is often painful, it responds to treatment, and it resolves.

Surfer’s ear is a structural change to the bone of the canal. It does not hurt by itself, it does not respond to drops, and it does not resolve.

The relationship between them is that the second causes the first. Recurrent swimmer’s ear in an adult who spends time in cold water is one of the most common ways exostoses are eventually discovered. If you have had several outer ear infections in a short period and you are regularly in open water, that pattern is worth raising with a physician rather than treating each episode in isolation.

Who is at risk

The name is misleading, because surfing is only one route to it. What matters is cold water in the ear canal, repeated over years, and wind on a wet ear.

That includes:

• Open-water and cold-water swimmers
• Kayakers, canoeists and paddleboarders, especially in spring and fall
• Windsurfers, kiteboarders and sailors, where wind exposure does much of the work even with less immersion
• Divers
• Anyone who spends long seasons on rivers, bays and lakes in a temperate climate

Two factors drive risk more than any others: water temperature and cumulative years of exposure. Colder water accelerates the process considerably, and the risk climbs steadily the longer someone has been at it. Published studies of long-term surfers in cold-water regions have found the condition to be very common, with prevalence rising sharply among those with the most years in the water.

For readers in the Mid-Atlantic, this is not a tropical-latitudes issue. Bay and Atlantic water here is cold for a good part of the year, and the spring and fall paddling seasons, which many people consider the best of the year, fall squarely in the risk window.

When to see an ENT

Consider making an appointment if you notice any of the following, particularly if you have several seasons of cold-water activity behind you:

• Water that regularly takes hours to drain from one or both ears
• Two or more outer ear infections within a year
• Wax impaction that keeps recurring
• Any change in hearing, however slight, on one side
• Persistent fullness, pressure or ringing after water exposure

An ear, nose and throat physician can see the canal directly with an otoscope and assess how much narrowing is present, usually in a single visit. Knowing where you stand is valuable even if nothing needs doing, because it tells you how seriously to take prevention from that point forward.

One practical warning: do not attempt to clear a narrowed canal with cotton swabs. In a canal that is already irregular, swabs push wax further in against the obstruction and can abrade the very thin skin covering the bone, which is a common trigger for the next infection.

What treatment involves, and why prevention matters so much

Exostoses do not shrink, dissolve or regress. There is no medication that reverses them.

When they cause significant problems, the treatment is surgical: an ENT surgeon removes the excess bone to reopen the canal, using a chisel or a drill, approached either through the canal itself or through a small incision behind the ear. It is a well-established procedure performed routinely, and outcomes are generally good.

It is also real surgery, with weeks of keeping the ear dry afterward, meaning time away from the water, and a set of risks that any surgeon will discuss in detail before proceeding. Most people who have been through it describe the same conclusion: they wish someone had told them about earplugs twenty years earlier.

That is the whole argument for prevention. The intervention costs very little, and the alternative eventually costs an operation and a season.

Steps That May Help Reduce Risk

The goal is simple: keep cold water and wind out of the canal, and get the ear dry afterward.

Wear earplugs designed for water sports. Ordinary foam plugs are not the right tool; they absorb water and fall out. Purpose-made swimming and surfing plugs seal the canal while allowing some sound through, so you can still hear people around you. Vented models are the usual compromise between protection and awareness. They cost a fraction of a co-pay and last for years.

Cover your ears in wind and cold. A neoprene hood or headband is at least as important as plugs in windy conditions, because evaporative cooling on a wet ear is a major part of the mechanism. This is the piece most people skip.

Dry the ears properly afterward. Tilt the head to each side, gently towel the outer ear, and let them air-dry fully before putting on a hat or hood. Some people use a few drops of an over-the-counter drying solution after sessions; ask your physician whether that is appropriate for you, especially if you have ever had a perforated eardrum or ear surgery.

Start young, or start now. The process is cumulative, so protection at any stage slows further growth. Nothing already formed will go away, but nothing more has to develop either.

For anyone getting properly equipped, ear plugs and neoprene hoods are commonly sold alongside other cold-water gear at watersports specialists such as EASY-surfshop. Parents outfitting a child for a swim, paddle or sailing season should treat them as standard equipment rather than an optional extra.

The takeaway

Surfer’s ear can develop silently over time, and preventive measures may help reduce further cold-water exposure to the ear canal. Those four facts together are unusual in medicine, and they make this one of the clearer cases where a small habit now avoids a real procedure later.

If you spend time in cold water and your ears have started behaving differently, have them looked at. And regardless of what an exam shows, put plugs in your bag before the next session.

This article is for general information and does not replace an evaluation by a qualified healthcare provider. If you have ear pain, drainage, or any change in hearing, contact a physician.