The most direct way to prevent surfer’s ear is to keep cold water and wind out of your ear canals every time you surf, using water-sport earplugs, and a neoprene hood when it is properly cold. Then dry your ears after each session. Surfer’s ear is slow bony growth that does not reverse, so protection works best before you notice symptoms. This guide covers when you need plugs, how to choose a pair that stays in, and what to do after you get out of the water.

TL;DR

• Surfer’s ear (external auditory exostosis) is bone growth in the ear canal caused by repeated cold water and wind exposure. It builds over years and does not shrink on its own.
• Fitted water-sport earplugs seal the canal. A hood adds warmth and slows water, but it is not watertight.
• Consistency matters more than brand: a 2021 study of 242 ears linked severity to hours in the water without protection.
• Dry your ears after every session, and never push cotton swabs into the canal.
• Pain, drainage or muffled hearing that lingers means stop surfing and see a clinician.

Table of Contents

• What surfer’s ear is, and why prevention beats treatment
• Who is really at risk
• Earplugs: the core of surfer’s ear prevention
• Hoods and caps: warmth, not a seal
• After the session: drying your ears
• When to see a doctor
• Our view on ears and beginner lessons
• Taking your first lessons in Hawaii
• A simple ear-care routine for every session
• FAQ
• Sources

What surfer’s ear is, and why prevention beats treatment

Surfer’s ear is the common name for exostoses of the external auditory canal. The NCBI clinical review describes it as a slowly progressive benign bone growth caused by chronic cold-water exposure. It is most associated with surfing but can affect anyone who spends a lot of time in cold water or wind.

The growths narrow the canal a little more each year. A narrow canal traps water and debris, which can lead to a blocked feeling, repeated infections and some hearing loss. Advanced cases are treated with surgery. That is why the useful question is how to avoid reaching that point, not how to fix it later.

How common is it?

Among people who surf regularly, very common. A 2023 systematic review of 19 studies found the condition in 2,032 of 2,997 surfers. Prevalence ranged from 53% to 90%, with a mean of 67.8%.

Those numbers describe committed surfers, not visitors. Risk depends on water temperature, wind, how long you spend in the water and how many years you have done it. A single beginner lesson on a vacation is not comparable. The numbers matter if you plan to surf regularly, especially in cold water.

Who is really at risk

The main driver is repeated cold-water exposure. The NCBI review reports that among males who had surfed regularly for 20 years or more, about one in two had significant canal obstruction, and it gives a three-in-seven figure for females. It also cites a study in which each year of cold-water exposure was associated with roughly a 12% rise in risk.

How cold is cold? Ireland’s health service, the HSE, treats regular exposure to water below 19°C (about 66°F) as higher risk and recommends water-sport earplugs. A surfing magazine’s prevention guide suggests plugs below 64°F, and wearing them more often if you want the best protection.

If you are visiting Hawaii for a week of lessons, your exostosis risk from that trip is low compared with a lifelong cold-water surfer. But you may go home and keep surfing in colder water, and the habit you build now will carry over. The other ear problem, swimmer’s ear, can affect anyone in any water temperature, so the drying advice below applies to every session.

Earplugs: the core of surfer’s ear prevention

Well-fitting water-sport earplugs are the preferred option in clinical guidance because they seal the canal. The 2021 prospective study of 242 ears found that severity correlated with hours spent in the water without protection (p<0.0001). It found no significant correlation with time spent wearing earplugs (p=0.6711). In plain terms: the problem is unprotected hours, so the goal is to cut those hours.

Why inconsistency is the real mistake

Plugs only work when they are in. The 2023 clinical review reports that only 5% of surfers who took precautions did so every time. Wearing plugs only on the coldest days leaves most of your exposure unprotected. If you decide to protect your ears, make it part of getting your board ready, like waxing it or attaching the leash.

What to look for in a pair

Use products designed for water sports, not foam plugs made for sleeping or concerts. HSE guidance also says to test the fit before you enter the water, so plugs don’t loosen when you paddle or fall. A product test such as The Inertia’s earplug review judged plugs on how well they cut water and wind and on in-ear comfort, which matters because a plug you keep fiddling with is a plug you stop wearing.

Use these criteria when comparing models:

Some people prefer custom-molded plugs made by an audiologist from an impression of the ear. Several of the pages Google ranks recommend them for heavy users. They cost more than off-the-shelf pairs, so it is reasonable to start with a well-reviewed standard pair if you surf occasionally, and consider custom ones if you surf most weeks.

Clean and dry your plugs

CDC guidance says reusable plugs must be cleaned and fully dried, because contaminated plugs can carry infection into the ear. Rinse them in fresh water after each session and let them air-dry before you store them.

Hoods and caps: warmth, not a seal

A neoprene hood keeps your head and ears warmer and reduces how much water, and how fast, reaches the ear. The clinical review describes hoods as semipermeable, though, while plugs create a seal. Hoods help, but they don’t replace plugs.

For frequent cold-water surfers the best answer is both: the hood for warmth and wind, the plugs for the seal. The wind part is worth stressing, since cold wind blowing on a wet ear is part of what drives the condition.

After the session: drying your ears

Even with plugs, finish the session with a dry-out routine. The CDC’s swimmer’s ear guidance, updated May 28, 2025, explains that swimmer’s ear is a bacterial infection of the outer ear promoted by water that stays in the canal. Children are more likely than adults to get it, though anyone can.

The routine the CDC describes:

1. Tilt your head to each side so the water can drain.
2. Towel-dry the outer ear.
3. Gently pull the earlobe in different directions to help water out.
4. If water remains, use a hair dryer several inches away, on the lowest heat and lowest speed.

Don’t put cotton swabs or other objects into the canal. The CDC says they can damage it, and also advises against removing protective earwax. Ask a clinician before using drying drops, and don’t use them if you have ear tubes, a perforated eardrum, swimmer’s ear or ear drainage.

Why plugs and drying work together

Retained water breaks down the wax and skin barrier in the canal and makes a moist place for bacteria to multiply. Surfer’s ear and swimmer’s ear are different problems, but prevention overlaps. Plugs reduce exposure, and drying clears whatever got through.

What not to improvise

Cotton wool alone absorbs water and does not protect you. A petroleum-jelly barrier, which makes cotton water-resistant, appears in Mayo Clinic guidance only when a clinician has specifically recommended it for showering. It is not a substitute for fitted surf plugs, and it should not be used for children with ear tubes or a perforated eardrum.

When to see a doctor

Stop surfing and get medical advice if you notice any of the following:

• Pain when you pull on the outer ear
• Itching, redness or swelling in or around the ear
• Drainage from the ear
• Hearing that stays muffled or blocked after drying out

These are signs of swimmer’s ear or a blocked canal, and treatment commonly involves prescription ear drops. Don’t push through ear pain to catch one more wave. If you have ear tubes, a perforated eardrum or a history of recurring ear infections, ask your ENT or primary care clinician what water precautions apply to you before booking a lesson. A hospital water-precautions leaflet from the UK’s NHS lists grommets, perforations, recurring infections and exostoses among the conditions that call for them. Children with tubes need this conversation first.

An ENT specialist can also confirm whether you already have exostoses. Mild cases without symptoms are usually managed with protective measures in the water, while larger obstructions that cause infections or hearing loss may need surgery.

Our view on ears and beginner lessons

We teach beginners every day in Waikiki and on the North Shore, and ears come up less often than sunburn or sore shoulders. Warm-water lessons aren’t where surfer’s ear develops. But we see the habits that decide the long game: people who never think about their ears until they are three years into a cold-water hobby.

Our advice is practical. If you live somewhere cold and plan to keep surfing, buy water-sport plugs before you buy your second board, and learn to put them in as part of your routine. Try them on the beach first. If you are a parent, tell your instructor before the lesson if your child has ear tubes or a history of ear infections, and check with your child’s doctor in advance. Our instructors are professional surfers who put safety first, and we would rather adjust a lesson than have anyone paddle out uncomfortable.

After the session, dry your ears the way you’d rinse your board: every time, without thinking about it.

— Johann

Taking your first lessons in Hawaii

If you are planning to learn on Oahu, we run lessons in Waikiki and on the North Shore, with all equipment included. In Waikiki, group lessons are $100 per person, semi-private lessons $150 and private lessons $180. If your child needs the most individual attention, a private lesson is the easiest setting to talk through ear concerns beforehand. Prefer something different? Bodyboard lessons in Waikiki start from $90.

Thinking of surfing several days in a row? Our 3 and 5 day guided packages cost $472 and $744. If you bring your own plugs, try them before the first lesson, and tell your instructor if anything feels loose. If you are new to the sport and want to know what else to prepare for, our guide to sun protection for surfing covers your skin, and our surfing etiquette guide for beginners covers the lineup.

A simple ear-care routine for every session

Here is a routine you can follow whether you surf once a year or every weekend.

Before you paddle out

• Check the water temperature. If you surf below about 64°F to 66°F regularly, treat plugs as standard kit.
• Insert your plugs on the beach and shake your head to test the fit.
• Add a hood if it is cold or windy.

In the water

• Leave the plugs in for the whole session, not just the cold part.
• If a plug loosens, get out and reseat it. Don’t keep surfing with half a seal.

After you get out

• Tilt, towel-dry and gently pull the earlobe, as described above.
• Use a hair dryer on the lowest setting, several inches away, if water stays.
• Rinse and fully dry your plugs.
• Watch for pain, itching or drainage over the next day or two.

FAQ

Do I need earplugs for a beginner surf lesson?

Not necessarily. Surfer’s ear comes from years of repeated cold-water exposure, so one lesson in warm water carries little risk. Earplugs can still keep water out and help you avoid a swimmer’s ear infection, especially if you are prone to ear problems. If you have ear tubes or a perforated eardrum, ask your doctor before any water activity.

Can surfer’s ear be reversed?

No. The bone growth is progressive and does not shrink on its own, which is why prevention matters. If you already have symptoms such as blockage, recurrent infections or hearing loss, see an ENT clinician, who can assess whether protection is enough or surgery is needed.

Are hoods enough to prevent surfer’s ear?

A hood helps by adding warmth and slowing water, but the clinical review describes hoods as semipermeable. Plugs create the seal. For regular cold-water surfing, using both gives the best protection.

How do I get water out of my ears after surfing?

Tilt your head to each side, towel-dry the outer ear and gently pull the earlobe in different directions. If water remains, the CDC suggests a hair dryer several inches away on the lowest heat and speed. Don’t use cotton swabs, and see a clinician if pain or drainage appears.

Sources

• Surfer’s Ear, NCBI clinical review
• External auditory exostosis among surfers: a systematic review, PubMed
• Impact of ear protection on occurrence of exostosis in surfers, Springer
• Surfer’s ear, HSE (Ireland)
• How To Prevent Surfer’s Ear, Surfer magazine
• The Best Earplugs for Surfing, The Inertia
• Preventing Swimmer’s Ear, CDC
• Swimmer’s ear, Mayo Clinic
• Water precautions for ears, Royal Devon NHS

Recommended

• Sun Protection for Surfing: Your Complete Skin Safety Guide
• Supervising Children at the Surf Beach: A Parent’s Guide
• Breath Training for Surfing: What Works and What’s Risky