Surfer's Ear. It's a sun of a beach, but it can be prevented.

What is it?

The medical term for Surfer's Ear is Auditory Exostosis. Exostosis is a series of benign bony growths that form in the ear canal following repeated exposure to cold water and wind.

What causes it?

When cold water and wind repeatedly enter the ear canal, the cold temperature stimulates bony growth. At first, small mounds of bone form, causing a narrowing of the ear canal. Over time these can form distinct nodules, blocking the ear canal and obscuring the view of the ear drum.

Who is at risk?

Surfers and other water sports enthusiasts. Exostosis is referred to as Surfer’s Ear colloquially because so many surfers suffer from it. However, it can affect anyone who swims outside or partakes in water sports. It also doesn’t necessarily have to be cold sea water either. Even in warmer water, the process of evaporation in the ears and the cooling temperature can also spur on the growth of the bone.

What are the side effects?

The main side effect of a narrow, blocked ear canal is infection of the outer ear – Otitis Externa. Water gets easily trapped in the ear canal and this leads to infection. It is often difficult to treat effectively and consequently can become chronic.

Wax build up. The exostoses impede the natural migration of wax making it harder for the ear to get rid of it. A smaller ear canal volume also means the ear is easily blocked with wax. It is also far more difficult to remove wax from an ear with Exostosis due to sensitivity and limited space to work in.

Hearing loss is also a side effect – normally it is in the form of physical conductive loss. If large and occluding enough, the exostoses physically prevent sound waves from reaching the tympanic membrane. Likewise, infectious mucous and ear wax also block sound. Chronic Otitis Externa, if not treated properly, can lead to permanent hearing loss.

How can it be treated?

Prevention is the best form of treatment. But if you develop exostoses, an operation can be carried to remove the growths if they are particularly bad and causing issues such as ear infections.

How can I prevent it?

Exostosis can quite easily be prevented by wearing ear plugs while in the sea. These can be custom fit or non-custom fit. Non-custom moulds are cheaper (£10 - £20) but they also sometimes don’t fit well, can be uncomfortable and are prone to falling out. A custom-made ear plug is based on an impression of your ear which is taken by an audiologist. The impression is used to create a perfectly fitting ear plug. These are naturally more expensive (between £70-£150).

Custom swim plugs are made out of soft silicone, are waterproof and are buoyant, just in case you drop one in the water. They fully protect the ears and are comfortable enough to be worn for long periods of time, but they also block out sound. While some people don’t mind this, there is a new iteration of the swim plug that has recently been created by a company called Surf Mould Pro. They’ve added a special filter into the mould that allows you to hear sound around you. These ear plugs have all the advantages of a traditional swim plug while allowing you to stay connected to the outside world.

Protecting your ears from the outset can save a world of discomfort, pain, and potential surgical intervention. If you're a surfer, or water sports enthusiast, then ear plugs should be just as important as your wetsuit and surfboard. Shell yeah.