Fungal Otitis Externa: What It Looks Like and How to Fix It

Think an ear infection is always bacterial? Not true. Fungal otitis externa — often called otomycosis — is a common outer-ear infection caused by fungi like Aspergillus or Candida. It pops up most in warm, humid climates and in people who swim a lot, wear hearing aids, or have diabetes. The good news: with the right steps it usually gets better fast.

How to recognize it

Signs are usually clear: itching inside the ear, flaky or thick discharge (sometimes black, white, or yellow), mild hearing drop, and discomfort that gets worse when you touch the outer ear. It may sting or feel blocked rather than causing sharp ear pain the way some bacterial infections do. If you’ve been swimming a lot or using cotton swabs, think fungal causes.

Doctors confirm otomycosis by looking in the ear with an otoscope. They may take a swab for culture if the infection keeps coming back or treatment isn’t working.

Quick treatment steps that help

Step 1 — Keep the ear dry. Stop swimming and avoid water entry until healed. Step 2 — Get the ear cleaned. A clinician often needs to remove fungal debris; home attempts with cotton buds usually push the mess deeper. Step 3 — Use topical antifungals. Drops or creams with clotrimazole or miconazole are common and effective. Your provider may also prescribe acetic-acid drops (vinegar diluted for the ear) to create an environment fungi dislike.

If the ear canal is swollen and drops won’t reach the fungus, a tiny wick can be placed by a clinician to let medication soak into the canal. Oral antifungals are rarely needed but may be used for long-standing infections or in people with weak immune systems.

For pain, simple OTC pain relievers help. Avoid inserting cotton swabs or ear candles — they do more harm than good.

Most people see big improvement in a few days with proper cleaning and drops. If symptoms last more than a week, come back, or if you have fever, severe pain, or significant hearing loss, see an ENT specialist.

Prevention tips that work

Dry ears after water exposure — tilt your head, use a towel, or use ear-drying drops (alcohol plus vinegar mixes are often recommended). Don’t use cotton buds inside the canal. Clean and dry hearing aids and ear devices regularly. If you have diabetes, keep blood sugar under control; high sugar levels raise the risk of fungal infections.

Fungal otitis externa can be stubborn, but with proper cleaning, the right drops, and simple prevention, most people recover quickly. If you’re unsure, a quick clinic visit will get the right diagnosis and speed up healing.