The answer is three (3) times a clear NO!

Let’s clarify three huge misconceptions:

1. Surfer’s Ear is NOT an acute thing. Surfer’s Ear is developing slowly over the years. Even once you got it, it starts to progress slowly. Do not confuse Surfer’s Ear with an ear infection (Otitis), which is another topic we will cover another time.
2. Surfer’s Ear is NOT a disease, it is a condition. In other words: an anatomical special feature. But it might cost you a few surf sessions in the future.
3. Surfer’s Ear is NOT dangerous. But it is specific to the sport of surfing and it can be really annoying.

Learn how you can avoid it or slow it down in the Q&As below.

Answered by M. von Grote, MD and M. Goettinger, MD

Surfer’s Ear is a condition that develops slowly, usually over decades.

If not stoped or slowed down can lead to severe problems like hearing loss or reoccurring ear infections. Or it can be just annoying by trapping more water in your ear canals more often.

Surfer’s Ear is a narrowing of your ear canal (“auditory canal”) caused by bone growth of you skull.

This extra bone growth, also called exostosis (or “bony exostosis”) is caused when your ear canal is exposed to cold water. Even more than just cold water, in combination with wind creating a chill factor, this can really speed up bone growth.
In short:

Cold water & wind → cold ear canal → bone growth → narrowing of the ear canal → Surfer’s Ear

The problem is that once your bone has grown, it doesn’t shrink anymore when your ears get warm again. Surfer’s ear won’t ever disappear — but you can slow it down, or avoid it in the first place.

It is called Surfer’s Ear, because it is common among surfers. As surfers we are frequently exposed to water, wind and (depending on where and when you surf) cold conditions. Yes, also swimmers, triathletes, windsurfers or kiters can get it.

So, cold, water and wind, that’s it?
Not quite. How bad it gets varies from person to person as your genes also have a role in this. So, sometimes people seem to be more prone to develop Surfer’s Ear than others, even if the had the same water+wind+cold exposure. Thank your parents. 😉

Answered by M. von Grote, MD and M. Goettinger, MD

It is called Surfer’s Ear, because it is common among surfers. As surfers we are frequently exposed to water, wind and (depending on where and when you surf) cold conditions. Yes, also swimmers, triathletes, windsurfers or kiters can get it.

Not to be confused with Swimmer’s Ear, or Otitis externa, which is an inflammation of the ear canal. However, having Surfer’s Ear make your more likely to catch such an Otitis externa, which often presents with ear pain, swelling of the ear canal, and occasionally decreased hearing.

Answered by M. von Grote, MD and M. Goettinger, MD

You can’t.
(Without Surgery)

We get your thought: if cold causes it, then warmth will make it go away. Sadly that is not the case.

Once your bone has grown, it doesn’t shrink anymore when your ears get warm again. Think of it how your other bones grow — you start of as a small child, over the time bone grows but it will never shrink again. (Unless you break it, impacts it or because of diseases like osteoporosis occurring mostly in elderly people.)

Surfer’s ear won’t ever disappear — but you can slow it down, or avoid it in the first place.

So, there is this ONE way to make Surfer’s Ear go away: surgery. If your bone growth in the ear canal becomes severe, the only way to have it removed is by surgery. There are currently two major techniques, one where the extra bones get drilled, the other one got chiseled out. While chiselling sound more brutal, it turned out to be the more precise technique leading to better results.

So, yeah, surgery can make it go away, but that is definitely not the most pleasant way. And while surgery buys you time, it doesn’t mean your bone will never grow back when exposed to cold water afterwards. In short: Surgery is the last option! Hence our strong recommendation to avoid Surfer’s Ear as good and as early as possible.

Answered by M. von Grote, MD and M. Goettinger, MD

Not quite. How bad it gets varies from person to person as your genes also have a role in this. Some people seem to be more prone to develop Surfer’s Ear than others, even if the had the same amount of time off “water + wind + cold” exposure. Thank your parents if you are a slow grower. 😉

Answered by M. von Grote, MD and M. Goettinger, MD

1. Water in your ears
   When your ear canal gets narrower due to the bone growth (exostosis), it is harder to get the water out that has gotten in your ears during surfing. Hence, experiencing water stuck in your ears after surfing can be a first sign of developing Surfer’s Ear. (There are other reasons for stuck water too, so don’t freak out if you got water in your ears. Just get them checked.)
   
2. Acute ear infections
   With water being stuck in your ears more frequently and for longer, your ears get worse at drying. This “more humid climate” in your ear canal increases your risk of catching acute ear infections.Also, if the water you surf in is polluted, dirt, chemicals and germs can get stuck in your ear with the water. In healthy ears this nasty stuff gets out quickly again after the surf. If you have surfer’s ear, the nasty pollutants can work its magic for longer, causing increasingly frequent ear infections.
   
3. Hearing loss
   So, by now you know Surfer’s Ear is caused by bone growth in your ear canal. In other words the canal where the sound gets in get narrower and narrower until at some point you will notice a hearing loss. Usually this occurs at a very, very late stage of Surfer’s Ear. Or the other way round: if you start working about Surfer’s Ear when you start hearing less, your only option left is probably surgery.

You have some of those symptoms and wonder if you got Surfer’s Ear? Read on to find out how you can find out.

Answered by M. von Grote, MD and M. Goettinger, MD

First of all: Relax! Surfer’s Ear is not dangerous. It is not a disease, it is a condition. In other words: an anatomical special feature. But it might cost you a few surf sessions in the future. And this is what we are concerned about as your ‘Surf Docs’ and this is why Surfing Medicine International is working on this project.

Protect yourself

Depending on how severe your Surfer’s Ear is and how old you are you should consider wearing ear plugs and/or a hood. If you keep surfing in cold water the bone will keep growing. And if you surf in dirty water you will get infections way easier then surfers without Surfer’s Ear. So, get surgery and be done with it once and for all? Nope, sorry. Surgery is no easy solution since once the bone has been drilled or chipped away it will grow back if you don’t protect your ears in the water.
With the current knowledge about Surfer’s Ear these are the advantages and disadvantages of earplugs and a hood:

Ear Plugs

We do not sell any. So we have no interest in talking you into wearing them. Except for the fact that they seem to do a great job:

• Good wind protection
• Good protection from cold water
• No major change of your looks
• Injury protection (Owen Wright busted his eardrum in competition 2007 in Portugal, Sally Fitzgibbons 2015 in Fiji)

Many surfers choose not to wear them. Because no matter which brand you buy: You have to remember to bring them, put them in, take them out, not loose them, clean them every once in a while. It is a pain. And with many of them your hearing is impaired. People feel disconnected from their environment and many surfers say it affects their equilibrium. For the good ones that feature a membrane and promise less hearing impairment you have to pay around 60 Dollars, check out Doc’s Proplugs / Surfears or EQ Ear Plugs for good quality. Loosing them is pretty annoying. For cheap ones that will keep the water out just as good but the sound as go to Home Depot or a drugstore.

Neoprene Hood

• Good wind protection
• Keeps the whole head warm
• Injury protection
• Sun protection for your eyes and face

Why nobody wears them unless it is freezing? Probably because of the Kook-Look. Yes, even Julian Wilson doesn’t seem that pretty anymore with a hood on. People might drop in on you. From a medical point of view we think they protect you better against Surfer’s Ear than ear plugs because they keep the whole head warm. Let’s see if the data we are collecting supports this theory. A famous hood wearing surfer is Dr. Renneker from Ocean Beach California. He usually wears two hoods (a thin short one and a normal one with a neck part) and is probably the only surfer who spent over 40 Years surfing cold water and does not have Surfer’s Ear!

Other things that work

Care

Ear plugs and hoods are not your thing? There is still something you can do. Just like some people have drier skin than others and use lotion to take care of it, every person’s ear canal hat a different anatomy and you should look after it.

Glycerol/Alcohol (aka ‘Swimmer’s ear drops’)

Most common is the mixture with glycerol and ethanol. It fits well into the natural environment of your ear canal, especially the PH level. Depending on the country you can get the drops in drugstores, supermarkets and pharmacies. Some pharmacists can even mix them themselves. You can put a couple of drops in your ears after every surf especially when the water is dirty. They might not delay the growth of the bone but they will certainly avoid infections and blockage of your ear canal. If you do not like them (some people say they sting) talk to your pharmacist. There are other options.

Hydrogen peroxide/ agua oxigenada/ H202

This solution is easy to buy all over the world. And it is not bad to clean your ears either. However, it is more aggressive than the drops mentioned above. Most important is that you never use a mixture with more than 3% H2O2 and if your ear canal is sensitive it is better to use other drops and to dry your ear gently (for example with a blow-dryer). So if your ear is fully blocked or you surf really dirty water once a month this is a great option. If you need to use drops several times a week use the drops above.

Blow-dryer

You have water stuck in your ear and you can not get it out? This is not only irritating. Bacteria love it when it is moist, the odds to get an ear infection increase. Take a blow-dryer to get rid of the water in your ear canal. It is a simple and effective solution, you will feel the difference. Just don’t hold it too close to your ear and don’t take an extra hot one.

Answered by M. von Grote, MD and M. Goettinger, MD

Just like many ‘therapies’ out there, some are better than others. Few even can worsen the healing, like toothpaste on burns (Nope, don’t do that) or pee on jellyfish stings (Nope, don’t do that either).

Also for Surfer’s Ear there as some Urban Myths, proven to either be ineffective or even causing more harm than doing good.

Here some examples we advise you NOT to do:

• Vinegar
  We met quite a few surfers who put vinegar in their ears to clean them. This is ok, you will not destroy your eardrum doing it once. But honestly, your ears deserve better. So some of the drop recommended above are better.
  
• Pure alcohol
  Alcohol is another effective fluid against germs but not the best care for your eardrum. It is a sensitive region and even if there are not enough vessels in your ear canal to get you drunk pure alcohol is too aggressive for this part of your body.
  
• Oil
  Olive oil is a cure for everything? Not quite. Due to Surfer’s Ear your ear canal is very tight. It will be harder to get the olive oil out of there than the sea water. We are not saying it harms you. It might even have a good effect if you put some drops of oil in your ear before the surf since a fatty surface rejects water. But good luck getting it back out. Olive oil can be put to one very good use (besides in the kitchen): to get insects out of your ear. Sometimes small insects get trapped in the canal. If you pour olive oil in your ear canal they will drown and slide right out.
  
• Limes / Lemons
  Just a clear ‘No’!. It won’t help in Surfer’s Ear, nor in Swimmer’s Ear. “But if it doesn’t harm…?” Well, that’s exactly the point. Just forget about it.

Answered by M. von Grote, MD and M. Goettinger, MD