Exostosis, or surfer's ear, occurs when bony growths form in the ear canal, typically due to repeated exposure to cold water and wind. These growths slowly narrow the ear canal, which can lead to complications if left unaddressed.

While it's most common among surfers, swimmers, and other water sports enthusiasts, anyone exposed to cold, wet conditions may be at risk. The condition develops gradually over years of repeated exposure, making it particularly prevalent in regions with cold coastal waters like the UK.

The bone growths are the body's natural response to protect the ear canal from cold water, but over time, this protective mechanism can become problematic as the growths increase in size.

The bony growths in surfer's ear develop gradually and may not cause symptoms at first. Over time, as the ear canal narrows, you might notice:

• Hearing loss: As the ear canal narrows, sound may become muffled or difficult to hear clearly
• Frequent ear infections: Trapped wax or water can lead to recurrent infections that are difficult to clear
• Ear discomfort: Pain, pressure, or a persistent feeling of fullness in the ear
• Tinnitus: Ringing, buzzing, or other sounds in the ear that aren't from external sources
• Water retention: Difficulty draining water from the ear after swimming or bathing

If you're experiencing these symptoms, especially after water activities or if you have a history of cold water exposure, consult your GP to check for exostosis and get expert advice.

Exostosis is triggered by repeated exposure to cold water and wind, which irritates the ear canal and stimulates abnormal bone growth. The condition worsens with continued exposure, particularly in chilly environments.

Primary risk factors include:

• Frequent swimming or surfing in cold climates, such as the UK's coastal waters
• Prolonged exposure to cold, windy conditions during water sports
• Lack of ear protection during water activities
• Years of consistent water sport participation without preventive measures

The condition typically develops over many years, with severity increasing proportionally to the duration and frequency of cold water exposure. Even individuals who swam regularly in their youth may develop symptoms later in life.

Prevention is the most effective approach to managing surfer's ear. You can significantly reduce the risk by:

• Wearing earplugs: Use swim-specific earplugs or custom waterproof swim molds to protect your ears from cold water. Custom-fitted options provide the best protection and comfort
• Using a wetsuit hood: For cold water activities, a neoprene hood provides additional thermal protection for your ears
• Drying ears thoroughly: Gently dry your ears with a towel after water activities and tilt your head to help water drain naturally
• Limiting exposure: Avoid prolonged time in cold water when possible, taking regular breaks to warm up
• Regular ear checks: If you're a regular water sports enthusiast, schedule periodic ear examinations to catch early signs of bone growth

For those who spend significant time in UK coastal waters, investing in quality ear protection is essential for long-term ear health.

In many cases, surfer's ear doesn't require immediate treatment unless the bony growths cause significant problems. If symptoms like hearing loss or frequent infections occur, your GP may refer you to an ear, nose, and throat (ENT) specialist.

Treatment options include:

• Monitoring: Small growths may be observed without intervention if they're not causing issues. Regular check-ups ensure any progression is tracked
• Conservative management: For mild cases, maintaining ear hygiene and preventing water retention may be sufficient
• Surgical removal (Canalplasty): Large or problematic growths can be removed surgically. This procedure involves carefully drilling away the excess bone under microscopic guidance. Recovery typically takes several weeks, and you'll need to keep your ears completely dry during healing

To support healing after surgery, keep your ears dry, avoid water activities, and follow your specialist's advice carefully. Most patients experience significant improvement in hearing and comfort following successful surgery.

For more details on managing exostosis, visit the NHS website or ENT UK for expert information.

For care home residents who may have a history of water sports or who lived in coastal areas, surfer's ear can contribute to hearing challenges, especially for those with existing ear conditions or hearing aids.

The narrowed ear canals associated with exostosis can make earwax removal more challenging and increase the risk of impaction. Residents with surfer's ear may experience more frequent blockages and require specialist care to maintain clear, comfortable ears.

At Clear Ear Cheer, our mobile ear care services offer clinical ear health checks and safe wax removal to ensure residents stay comfortable and connected. We work closely with GPs and ENT specialists to provide seamless care, bringing our expertise directly to your care home.

Our practitioners are trained to recognize exostosis and can adapt removal techniques appropriately, ensuring safe, gentle care for residents with narrowed ear canals.