What surfer’s ear is
The inner part of the ear canal is lined by very thin skin directly over bone. Repeated exposure to cold water and wind irritates this bone, which responds by laying down new layers. Over many years, smooth, rounded bony lumps (exostoses) form, usually on both sides and in both ears. They are different from osteomas, which are single bony growths not linked to cold water.
Studies of surfers show that exostoses are very common in people who surf in cold water for many years, and that their severity increases with time spent in the water.
Who is at risk
- Surfers, bodyboarders, kitesurfers and windsurfers.
- Open-water and cold-water swimmers, divers and free divers.
- Kayakers, sailors and others exposed to spray and wind.
- People who spend more than five to ten years in cold water, especially without ear protection.
- Cold water and windy conditions increase the risk more than warm water.
Symptoms
- No symptoms in the early years.
- Water trapped in the ear after surfing or swimming, taking longer to drain.
- A blocked or full feeling, often on one side first.
- Muffled hearing, especially when water or wax blocks the narrowed canal.
- Recurrent outer ear infections with pain, itching and discharge; see swimmer’s ear.
- Wax build-up that is hard to clear; see earwax blockage.
How it is diagnosed
An ENT specialist sees the bony lumps when looking into the ear with an otoscope or microscope and estimates how much of the canal is blocked. A hearing test checks whether hearing is affected. A CT scan is sometimes requested before surgery to plan the operation and assess the relationship with the eardrum and facial nerve.
Treatment
- Prevention and monitoring: mild exostoses need no treatment beyond protecting the ears to stop progression.
- Ear care: regular microsuction by a specialist to remove wax and debris trapped behind the lumps.
- Treating infections with ear drops and keeping the ear dry until they settle.
- Surgery (canalplasty or exostectomy): removal of the bony growths through the ear canal or behind the ear, using a drill or small chisels, when the canal is severely narrowed, hearing is affected or infections recur. Recovery usually takes several weeks, with no water in the ear until the canal has healed.
Surgery is effective, but without ear protection the bone can grow back in people who keep surfing in cold water.
How to prevent surfer’s ear
- Use well-fitting surf earplugs designed to let some sound through, every session.
- Wear a neoprene hood or headband in cold water and windy conditions.
- Dry the ears gently after sessions by tilting the head and using a towel; a hair dryer on a low, cool setting at a distance can help.
- Avoid cotton buds, which push wax and debris deeper.
- Have ears checked periodically if you surf or swim in cold water regularly.
Getting back in the water after surgery
After surgery, the ear canal must stay dry until the skin has healed completely, which often takes four to eight weeks. The surgeon confirms when it is safe to return. After that, earplugs and a hood are strongly recommended to protect the result.
Choosing earplugs for surfing and swimming
- Look for plugs designed for water sports, which block water and cold wind but let some sound through so you can hear waves and other surfers.
- Custom-moulded plugs made from an impression of your ear fit best and are comfortable for long sessions.
- Rinse them in fresh water after use and let them dry.
- Replace them when they lose their shape or seal.
- Combine plugs with a hood or headband in winter.
Using earplugs from your first years of surfing or open-water swimming is the most effective way to prevent exostoses.
When to see an ENT specialist
- Recurrent ear infections or water that stays trapped after every session.
- Muffled hearing or a blocked ear that does not clear.
- Ear pain with discharge, swelling or fever.
- Sudden hearing loss, dizziness or facial weakness: urgent assessment.
Key points to remember
- Surfer’s ear is bony narrowing of the ear canal caused by cold water and wind.
- It leads to trapped water, wax build-up and recurrent infections.
- Earplugs and hoods prevent it from developing or progressing.
- Surgery is used when the canal is severely blocked.
Questions about surfer’s ear
These answers are general information and do not replace an examination or individual medical advice.
Can surfer’s ear go away on its own?
No. The bony growths do not shrink, but protection stops them getting worse.
Is surfer’s ear the same as swimmer’s ear?
No. Swimmer’s ear is a skin infection of the ear canal. Surfer’s ear is bony narrowing, which makes infections more likely.
Do earplugs prevent surfer’s ear?
Yes, they reduce cold water exposure and are the main prevention, ideally together with a hood in cold conditions.
How long does it take to develop surfer’s ear?
Usually years of regular cold-water exposure, often more than five to ten.
Can I surf after surfer’s ear surgery?
Yes, once the canal has healed, usually after several weeks, and with ear protection.
Does surfer’s ear cause hearing loss?
It can cause muffled hearing when the canal is blocked by water or wax, which usually improves with treatment.
Sources
- NHS · Ear infections: otitis externa
- NHS · Earache
- Deleyiannis FW, et al. Exostoses of the external auditory canal in Oregon surfers. Am J Otolaryngol. 1996
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.