Oreille du nageur

© Stephen Frink

DAN Medics and Researchers Answer Your Dive Medicine Questions

Q: I frequently get swimmer’s ear while diving. Can I do anything to fix it? 

A : Swimmer’s ear (otitis externa) is an infection of the external auditory canal that frequently occurs in divers and swimmers. Lingering moisture in the skin of the ear canal results in an alkaline shift of the pH balance, which provides a good environment for bacteria proliferation. Any number of bacteria and other microscopic organisms can contaminate the water where we dive. 

Antibiotics are the most common treatment for the condition, and you shouldn’t dive or swim until you’ve completed the treatment and your symptoms have fully resolved. As with many disorders, prevention is the best treatment. Keep your ear canals clean, dry, and free of waxy debris or buildup. We do not recommend cleaning your ears with cotton swabs, which often push earwax further in and can cause tiny abrasions, making you more prone to infection.  

You can dry your ear by putting your head sideways so gravity can assist with draining or by using a fan or a hairdryer on a low setting. Some commercial eardrops can help, but a mixture of equal parts household white vinegar (not acetic acid) and rubbing alcohol or equal parts vinegar, alcohol, and distilled water can also create an environment less suitable for bacteria to proliferate. 

If none of these conservative measures work, an otic acetic acid and aluminum acetate solution is another alternative but requires a physician’s prescription. A drying measure paired with an eardrop solution may be the most beneficial. 

— Leandra Lynn, NREMT


Q : Can I dive with herpes?

A : Herpes is a common infection — up to about 80% of people have oral herpes, which causes cold sores or fever blisters, and about 17% of people 14 to 49 years old have genital herpes. A herpes outbreak can be painful and a source of infection. 

The pain associated with oral herpes can interfere with your ability to hold a regulator in your mouth, and a tight-fitting wetsuit’s constriction can exacerbate the pain and discomfort of genital herpes. Any restriction to regular physical activity caused by an outbreak can potentially put you or your dive buddy at risk. The discomfort could force you to end a dive early, which can also affect your dive buddy or group. Any physical restrictions during an emergency or strong current could increase your risk of serious injury. 

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All bodies of water are full of microorganisms, and any break in the skin provides a passageway for those microorganisms to enter the body and cause an infection. Diving in remote locations can be especially concerning if medical care is limited or unavailable. An infection left untreated or significantly delayed from appropriate health care can lead to serious illness or even death. 

Generally, herpes is most contagious for seven days before and after an outbreak. Sharing a regulator or touching gear and other surfaces during an active herpes outbreak can put others at risk of contracting the virus, so communication with your dive buddy is important. 

While herpes is not an absolute contraindication, we recommend not diving when experiencing an active herpes outbreak or any time you are not feeling completely healthy.

— Jevon Monaghan, EMT-P


© Alert Diver – Q3 2024

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