Solving Surfer’s Ear

You might call Surfer’s Ear the epidemic of cold water surfers. Like a strange twist of payola for cold water stoke, Surfer’s Ear or “exostosis” occurs in those of us who surf consistently in water with temperatures below 60 degrees.

Studies from around the world have confirmed that after ten years of cold water surfing more than 80% of surfers will have exostosis while over 90% will have it after 20 years of cold water surfing. Large population ear exams have revealed that even a fair amount of warm water surfers have moderate cases.

Not to be confused with Swimmer’s Ear-an infection caused by trapped water and bacteria or fungus-Surfer’s Ear is a painless, creeping bone growth that can eventually close down the ear canal. The bombardment of cold water and wind chill causes the bones just under the thin skin of the canal to enlarge. Knobs begin to form halfway into the canal to the eardrum in what seems an effort to protect the eardrum. Over time the knobs can grow together, choking off the canal. This may leave a space between the knobs and the eardrum where wax and water can get trapped, leading to infection and pain.

If you surf cold water and notice increasing earwax or water blockages, your knobs are probably getting bigger. If you wear a hood your knobs may grow a bit slower because your ears are warmer. However this won’t prevent the growth. The evidence points to both water and wind chill as combined culprits.

Ear plugs are a good call as plugs block the cold water. Drugstores carry various foam, plastic and silicone plugs. Foam and plastic disc plugs can irritate the canal lining and shove wax in. Putty plugs can slide around, separate and get stuck-especially if rolled into cylinders. Swim plugs work, but don’t count on hearing someone else on your wave.

Vented plugs like’s Doc’s Proplugs will let sound in while keeping water out. Robert Scott, MD invented and patented these vented plugs in the 1970s. Get your local surf shop to size your ear and if you can hear yourself hum on the side with one plug in you’ve got a water seal.

Best bet is a hood and plug combo, keeping the head warmer while holding your plugs in.

Other preventive measures occur between sessions. Drying ears out is critical. A few drops of rubbing alcohol, a sun dry or even low-heat blow dry can work. Ear docs suggest a 50/50 white vinegar/alcohol solution to dry and help prevent infection. Add a few drops of garlic oil as a natural antibiotic. Dr. Scott suggests keeping the ears as warm as possible when out of the water. Wear your Surfer® beanie when you check the surf.

If you have an earwax jam, try 3-4 drops of palm-warmed mineral oil or glycerin earwax solution for a few days to soften up the wax. Follow with gentle flushing of warm water and/or hydrogen peroxide over a basin to run the wax out. No Q-tips or pointed objects: You’ll push the wax back or even puncture your eardrum.

If the clog persists, see a surfer’s ear specialist. An ENT will be equipped with a tiny suction device with a Rosen tip. This beats the slower irrigation method discussed above that most ERs use for earwax removal.
If your knobs close up your canal you may require surgery. This will be obvious if you have repeated clogging and infection. The two surgical techniques used are drilling and chiseling. In drilling, the back of the ear may be cut and folded forward while the bone is ground down. The drill can damage hearing and scar the skin pretty badly.

Opt for the chisel technique. This technique was developed in the 1990s and since perfected by Doug Hetzler, MD of Santa Cruz, CA. The technique utilizes tiny 1mm chisels to split and chip the bone off with delicate precision. The chiseling technique only takes a few hours and causes less skin damage, leading to faster recovery times and a return to the water within weeks. The cost is no laughing matter but insurance will usually cover it. At the moment there are only a handful of docs doing this surgery.

Regrowth can occur after surgery. The jury is still out, but chiseling may cause less grow-back than drilling. Best to prevent it before it gets this far anyway. Keep ’em warmer and drier and you’ll be cold water surf-stoked for many years.