The most effective way to prevent surfer’s ear is to keep cold water and wind out of your ear canals, primarily by wearing earplugs every time you surf in water below 19°C (66°F). Surfer’s ear is a slow, cumulative condition where bony growths narrow the ear canal over years of cold water exposure. The good news: it’s almost entirely preventable if you start protecting your ears early and stay consistent.
What Causes the Bone to Grow
When cold water repeatedly enters your ear canal, it irritates the thin layer of tissue covering the bone. That irritation triggers the bone underneath to produce new growth, slowly narrowing the canal over time. This isn’t a one-time injury. It’s the result of hundreds or thousands of sessions, each adding a microscopic amount of bone. Wind chill accelerates the process, which is why surfers in windy lineups are especially vulnerable, even when water temperatures are moderate.
Water below 19°C (66°F) is the established threshold where exostosis development increases significantly. But wind chill can push the effective temperature inside your ear canal below that mark even in warmer water. Surfers in places like Northern California, the UK, Ireland, and southern Australia face the highest risk, though anyone surfing regularly in cool conditions can develop it.
How Quickly It Progresses
Surfer’s ear is a condition measured in decades, not months. A study of 307 surfers published in JAMA Otolaryngology found a clear relationship between years in the water and canal obstruction. Among surfers with 10 years or less of exposure, 44.7% still had completely normal ear canals and only 6% had severe obstruction. But among those who had surfed for more than 20 years, only 9.1% had normal canals and 16.2% were severely affected. Of surfers with severe exostoses, 82.4% had been surfing for more than 10 years.
The takeaway: you have a long window to start protecting yourself, but the longer you wait, the more irreversible narrowing accumulates. There’s no way to reverse bone growth without surgery.
Earplugs Are Your Primary Defense
Wearing earplugs while surfing is the single most important preventive step. They create a physical barrier between cold water and the bone lining of your ear canal. There are two main categories to consider.
Generic (universal) earplugs are inexpensive and widely available, but they often don’t form a reliable seal. Standard silicone or foam plugs tend to let water seep in, especially during duck dives and wipeouts. They can also work loose during a session, leaving you unprotected without realizing it.
Custom-molded earplugs, made from an impression of your ear canal, fit precisely and form a watertight seal. Medical-grade waterproof silicone versions block water completely while still allowing you to hear conversations and wave sets. They cost more upfront (typically $60 to $150 depending on the provider), but they last for years and stay in place during heavy surf. For anyone planning to surf regularly for the long term, custom plugs are the better investment.
Whichever type you choose, the key is wearing them consistently. Earplugs sitting in your glove box don’t prevent anything. Build the habit of putting them in before every session, just like applying sunscreen or waxing your board.
Hoods and Headgear for Extra Protection
A neoprene hood adds a second layer of defense, particularly against wind chill. Even if some water gets past it, the hood keeps the air temperature around your ears warmer and reduces the evaporative cooling effect that accelerates bone growth. In cold water conditions (below 15°C or roughly 59°F), most surfers already wear hoods as part of their wetsuit setup. If you’re surfing in the 15 to 20°C range where a hood feels optional, consider wearing one anyway, or at least a neoprene headband that covers your ears.
Combining a hood with earplugs gives you the best protection available. The hood blocks wind and reduces water flushing, while the earplugs seal the canal itself.
Post-Surf Ear Care
After every session, tilt your head to each side and gently pull your earlobe to drain trapped water. A quick shake or hop can help. If water tends to linger in your ears, drying drops can prevent moisture buildup and reduce infection risk.
A simple homemade solution works well: mix equal parts white vinegar and rubbing alcohol. Pour about one teaspoon (5 milliliters) into each ear, let it sit for a moment, then tilt your head to let it drain. The alcohol helps evaporate residual water while the vinegar discourages bacterial and fungal growth. Similar pre-mixed drops are available at most drugstores. Don’t use these drops if you have any suspicion of a perforated eardrum.
Post-surf drying doesn’t prevent the bone growth itself (that’s the earplug’s job), but it reduces the trapped-water infections and ear canal irritation that make an already narrowing canal worse.
Recognize the Early Signs
Surfer’s ear often progresses silently for years before you notice symptoms. The earliest signs are subtle: water getting trapped in your ear more frequently after sessions, a feeling of fullness, or mild hearing reduction that comes and goes. As the canal narrows further, you may notice recurring ear infections, increased difficulty clearing water, and more persistent hearing loss.
If you’ve been surfing for several years and notice water sitting in your ears longer than it used to, that’s worth getting checked. An ENT doctor can look into your ear canal in seconds and tell you whether bone growth has started and how advanced it is. Catching it early gives you the motivation to commit to earplugs before obstruction becomes severe enough to require surgery.
What Happens If Prevention Comes Too Late
Once the ear canal is significantly blocked, the only fix is surgical removal of the bony growths. The procedure, called canalplasty, involves carefully removing the excess bone under general anesthesia. Recovery time depends on the technique. Newer methods using a piezo saw (an ultrasonic cutting tool) allow precise bone removal while preserving the canal skin, leading to recovery within two to three weeks. Traditional approaches using a drill or chisel can take up to five weeks to heal, partly because more canal skin is lost and has to regrow on its own.
Post-operative pain from the piezo technique typically resolves within the first week. The main restriction after surgery is keeping your ears completely dry during healing. For surfers, that means weeks out of the water, which is reason enough to take prevention seriously from the start. And even after successful surgery, the bone will grow back if you return to cold water without protection.
A Simple Prevention Routine
- Before every session: Insert well-fitting earplugs. Add a neoprene hood or headband in water below 20°C or windy conditions.
- During the session: If an earplug falls out, replace it. Keep a spare in your wetsuit key pocket or car.
- After every session: Drain both ears thoroughly. Use a vinegar and alcohol drying drop if water lingers.
- Once a year: Ask your doctor to check your ear canals if you’ve been surfing regularly for more than a few years.
Surfer’s ear is one of the few chronic sports conditions that’s almost completely avoidable with a cheap, simple piece of equipment. The surfers who end up needing surgery are overwhelmingly those who spent years without ear protection. Starting now, regardless of how long you’ve been surfing, slows or stops further progression.