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Surfer's Ear: How to Treat and How to Prevent It

Exostoses can really suck. Photo: screenshot


The Inertia

I’ve enjoyed a solid dose of unfounded medical anxiety since the early aughts, but my 2024 resolutions found me stripped down and sitting back on that strange scratchy paper in front of a brand-new doctor. After confessing he was a lifelong surfer, the doc checked my heartbeat, then went for the ears. His face darkened, I prepared for the worst.

“You’ve got exostoses,” he said, flashing me a mildly reassuring shaka. “Not to worry, man. I’ve got it, too.

The doc moved from telling me how he set up his residences to coincide with tasty waves all over the world to filling me in on the very un-dude knobs growing in my ears like wildflowers. Exostoses is also known as – you guessed it – surfer’s ear.

My case didn’t surprise the doctor, but it surprised me. As a lifelong musician and live music devotee, I thought it would be screaming amplifiers that dismantled my ear holes. Plus, I surf 3-5 times a week now, but I wasn’t always such a die-hard. Yet there I sat, facing the tragic, lumpy truth. So, what was the good doctor talking about?

What is Surfer’s Ear?

According to University of California Irvine’s School of Medicine, surfer’s ear, also known as swimmer’s ear, diver’s ear, and stand-up paddle – who are we kidding, we don’t care about those guys – technically refers to abnormal growths within the external part of the ear canal. 

My doctor explained that these growths are a result of our bodies struggling to protect their valuable technologies from the damage of cold water and air. The small, rocky lumps are thin layers of bone, stimulated into action by cold water and air like plants sucking down Miracle Grow. 

Is Surfer’s Ear Serious?

Many consider surfer’s ear more of a nuisance than anything else, but it can create serious complications. When the ear canal thickens with these bony protrusions, there’s not as much space for ear wax and other debris to sift through. This random collection of detritus becomes trapped, creating blockages and infections. In extreme cases, unchecked exostosis can lead to thickening of the ear canal, constriction, pain and sensitivity, and hearing loss. 

Who is at Risk?

According to the National Library of Medicine, exostosis is more common in coastal regions with cool climates and colder water temperatures. In the general population, the rate of surfer’s ear hovers around 6.3 out of 1,000 people, but that figure spikes to anywhere between 26 percent and 73 percent in at-risk populations. There’s a reason it’s called surfer’s ear – wave riders are more inclined to the affliction than other cold-water sports enthusiasts.

The disease is also more common in males. Men who surf for more than 20 years have over a 50 percent chance of developing exostoses that obstruct more than two-thirds of the ear. For females who surf, it is still a significant issue, but hovers closer to 40 percent.

Even more staggering, approximately 80 percent of surfers who ply their cutbacks in cool to cold conditions develop surfer’s ear after approximately 10 years of water activity or 3,000 hours of surfing. 

Surfer's Ear: How to Treat and How to Prevent It

Love cold-water tubes? You’re at risk for surfer’s ear. Hoods can help. Photo: Keith Luke

What Are the Symptoms?

One thing surfers, swimmers, and unsuccessful kayakers should be aware of is the way exostoses symptoms present. Early signals can be tough to distinguish, and could include water getting trapped in the ear, ear pain that is not related to being forced to listen to Taylor Swift, repeat infections and a decrease in hearing sensitivity.

Since it takes years for these small lumps to become larger, many of us (ahem) don’t do squat about them. I suspect that if these bones popped out of our foreheads and made us real-life unicorns, humans’ tendencies towards vanity would lead us to act more quickly. 

In fact, looking back, however, I’m not sure how I didn’t put two and two… forget that, not a math guy and I’m already confused. But over the last few years, I’ve had enough nagging pain and clogs to stock up on more bottles of over-the-counter relief than CVS. Last winter, I spent many mornings lying on my side on the floor, pouring white vinegar and rubbing alcohol into my ears while questioning my life decisions.

Let’s talk solutions, though, since it is possible to prevent surfer’s ear. Seeing as my doctor has surfed Cloudbreak, Waimea, and Pipeline, and less importantly, has over a decade of medical experience, I’ll defer to him.

  • Earplugs

Probably the most effective and popular solution are silicon earplugs. There are tons to choose from at different price points, so do as deep a dive as you want. Some are crafted to let sound in, some get molded to your ear, and some have wires to ensure a big set doesn’t knock them out.

While myself and my doc both agreed we don’t love wearing earplugs while surfing, he admits that in terms of prevention, plugs are the number one choice for keeping surfers’ ears dry and safe.

I’ve only logged 10 or 12 sessions with my chosen plugs, and while they work great, something about not being able to hear until I shake my head still throws me off. However, I’m also reportedly a huge pain in the ass, based on testimony from my fiancée, so take that with a grain of sea salt, and know that many endorse earplugs as the best solution.

  • Hoods

The thing is, I told the doctor, I like to wear a hat to block out the sun, so a hood is not really going to work for me, either.

As my new doctor subtly filled out a form requesting that I not be his patient going forward, he suggested that next to plugs, hoods are great for keeping ear drums dry. They’re also keeping you warm if it’s a cold day, based on the whole heat/head paradigm. 

Many suits come with hoods attached, or grab a detachable hood and it can double as a dope hat when you’re out at the club.

  • Ear Drops

Research tells us that using ear drops post-session kills bacteria and dries the ears out in ways that a towel or your finger cannot. The key is to opt for drops that are lower in alcohol content, because too much ear booze can over-dry the drums and cause infections. You can make your own solution of equal parts rubbing alcohol and white vinegar, but something like this might also make sense.

  • Blow Dryer

Many swear by the ol’ daily-driver daily-dryer trick to rid ears of moisture out after a cold paddle.  Some surf shops even now sell portable dryers specifically designed for ears, just put it on a low setting and don’t get too carried away with how fluffy your hockey mullet looks these days.

What About Surgery? 

Some of us (ahem) are prone to putting off medical stuff and ignoring symptoms, figuring they’ll deal with it later. This is never a good idea, and while the process of exostosis surgery has improved over the years, it remains a complicated and painful option when faced with an evolved case of exostosis (gulp). 

Rob Jones, owner of Drift Surf Shop in Rhode Island, has been in the surf industry longer than you’ve been doggy paddling, but his 40-year love affair with riding waves put him under the knife a few years back. Jones had reached the point where the overgrown exostoses made water unable to leave his ear, creating painful surface tension. Even worse, it had to be vacuumed out regularly, which feels about as good as it sounds. 

Jones, who was also suffering early stages of hearing loss, cheerfully describes the surgery as “not brutal, but not at all pleasant,” and uses comforting verbs like “slicing,” “whacking,” and “chiseling” to describe the surgeon eliminating the growths. Afterwards, he says, it felt like it had water in his ears for a while, and even worse: he couldn’t surf or spearfish for over two months. 

Jones’ recommendation is to deal with present cases of surfer’s ear ASAP, and work to prevent it by wearing protection. He now throws plugs in before every session, and uses ear drops afterwards. “I’m not a doctor,” he says, laughing, “but people who surf frequently and are not just weekend warriors should wear ear plugs all the time.”

I’m planning on taking Jones’ advice, though it might already be too late for me. Hopefully, though, it’s not too late for you! Pony up for some quality plugs, stick them in before you leash up, and continue to rip apart waves to your heart’s content – your ears will thank you.

 
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