We’re stoked to team up with Moulded Earplugs and elevate awareness of Surfer’s Ear. Our members now receive 10% off custom plugs, and all ear health products available on the website. 2025 will see us hosting some clinics at our events, so stay tuned for further details.
Surfer’s ear: not just for surfers
Surfer’s ear or External Auditory Exostosis, to give it its medical name, has long been the bane of cold water surfers and it is more common than you might think and certainly not just restricted to the surfing community. The condition dates back to prehistoric people; it has been used by anthropologists to identify cultures with regular aquatic exposure. In the general population it was found in roughly 6.3 per 1000 people but that appears to be changing thanks to a growth in cold water pursuits and blue health having a positive impact on more and more people’s lives.
But what is it?
Surfer’s ear is a condition where abnormal bone growth occurs within the ear canal. This growth is typically a response to prolonged exposure to cold water and wind. An exact understanding of why exostoses occurs still eludes scientists but the most widely accepted theory is that the body’s natural defence mechanism is to protect the ear canal by forming bony growths, leading to a narrowing of the canal.
Whilst surfer’s ear is particularly prevalent in surfers, it is not just surfers who can suffer. Anyone who exposes their ear canals regularly to cold water or wind is at risk. Any water of 19°C or below is cold enough to promote exostoses growth – pretty much any open water in the UK at anytime of the year. The colder the water and the longer and more regular the exposure, the greater the risk.
Just how much time do I need to spend in the water before I should worry?
There have been a number of scientific studies focussed on surfers’ ear and its prevalence in watersports communities. They are often based on small sample sizes which means it is hard to give a really accurate answer to this question. Most seem to suggest however, that regular exposure to cold water (more than 50 sessions a year) over five or more years is needed before significant surfers’ ear develops.
There are a number of factors that effect the growth of surfer’s ear: genetics, sea temperature, regularity of submersion, length of time spent submerged, prevailing wind directions, the use and type of ear protection (more on this later) and probably a certain amount of luck. For example, the position of the growth within the canal can really effect how symptoms present; if the lumps are in the bottom of the canal and don’t allow water to drain naturally, the chances of suffering ear infections and deafness are greatly increased: if they are in the top of the canal then symptoms may be less common and less severe.
How do I know if I’ve got surfers ear?
The best way to find out is to have your ears checked by a medical professional. By visiting someone who offers video otoscopy, you can even see for yourself how things look in there. The condition is not reversible so it is definitely best to have this done before symptoms develop if your cold water habits mean you might be at risk.
A lot of people who live with mild and even moderate surfers ear most probably do not even know. The bony lumps and canal narrowing can be present for some time without causing symptoms. However, once the symptoms start there is no going back.
Symptoms can include:
- Sensations of fullness or blockage in the ear
- Increased susceptibility to ear infections
- Water trapped in the ear
- Deafness – often caused by wax, debris or water blocking the narrowed ear canal
- Pain or discomfort in the ear, especially when exposed to cold wind or water
So what do I do about it?
Once surfer’s ear has grown, it does not recede, even if the ear canal is never exposed to cold again. Without surgery, surfer’s ear is permanent, so prevention is key.
The best way to stop exostoses developing is to keep cold water out of your ear canals. The evidence on this is pretty clear, preventative measures are the way, ear plugs in particular. Wearing a hood helps but is not a complete answer as cold water will flush through a hood regularly.
There are a number of ear plugs on the market which can be effective preventative tools. Even earplugs that let some water in the ear canal may limit exostoses growth by slowing the flush effect and warming any water that remains in the canal in the same way that a wetsuit does.
I think I’ll just get the op!
It is possible to get exostoses surgically removed. After a significant wait on a list or after committing to a significant private health bill, surgeon’s will usually only operate on one ear at a time. Techniques have improved but the surgery is not without risk: The outcomes in most patients are good, but the rates of surgical complications to relieve the disorder are somewhat high. Landefeld; Ryan M. Bart; Henry Lau; Jeffrey S. Cooper (April 2023)
…and, of course, surgery does not stop the continued growth of surfer’s ear and will include at least a few weeks out of the water to allow your ear canals to heal.
What about my children? They love cold water!
With the great developments in wetsuit technology over recent years and the growth in popularity for cold water pursuits, experts like Claire Roynon from Moulded Ear plugs have seen an increase in the incidence of Surfer’s ear – “We used to see patients being referred for surgery in their 40s now we regularly see young people, even teenagers, with significant exostoses and regular symptoms. In my opinion, the danger years are the teenage years when the prevalence of growth/pubertal hormones appears to accelerate exostoses growth.
Getting young people educated about ear health is crucial to prevent future complications. We think ear protection should be as common as sunblock and sun-hats.”
Earplugs, earplugs, earplugs!
If you make surfing a habit (or any other cold-water pursuit) then you really should be thinking about protecting your ears. It is worth investing in protection that you find comfortable and many earplug brands supply protection that still allows you to hear the chatter in the line up or the hoots of your friends.
Claire Roynon from Moulded For Your Ears has extensive clinical experience and offers ear checks, ear health advice and high quality custom moulded earplugs. Moulded For Your Ears are Surfing England partners and offer 10% reductions to Surfing England members on their earplugs, accessories and ear health products.
Log into your membership portal here to access the code.
To find our more about Moulded Earplugs, click here.
