Ear pain after diving is usually ear barotrauma or swimmer’s ear. Barotrauma is a pressure injury behind the eardrum, and swimmer’s ear is an infection of the ear canal. You can prevent most of it: equalise early and gently, never dive with a blocked nose, and dry your ears after the sea.
This guide is for scuba divers and snorkellers in Sharm El Sheikh, from a first try-dive to a day at Ras Mohammed. The US CDC says middle ear barotrauma is the most common injury in divers.
Barotrauma or swimmer’s ear?
| Ear barotrauma | Swimmer’s ear | |
|---|---|---|
| What it is | A pressure injury to the middle ear, behind the eardrum | An infection of the ear canal, in the outer ear |
| When it starts | During the dive, often on the way down | After water stays in the ear canal for a long time |
| Typical signs | Fullness, muffled hearing and pain that grows as you go deeper; sometimes ringing or dizziness | Itching, pain when you pull the earlobe or press in front of the ear, redness, discharge |
| First step | Stop diving and get medical advice | Keep the ear dry and see a doctor |
How barotrauma happens
Your middle ear is a small air space behind the eardrum. A narrow tube, the Eustachian tube, links it to the back of your nose. As you go down, the water pressure rises. Air must pass up this tube into the middle ear to balance the pressure.
A cold or an allergy can block the tube. The pressure then cannot balance, the eardrum bulges inwards and the ear hurts. The pain grows as you go deeper, and the eardrum can bleed or tear.
Shallow water is not automatically safe. The air in your ears is squeezed most in the first few metres below the surface. The eardrum can be injured as shallow as about 1.2 metres. Snorkellers who dive down to the reef can hurt their ears too.
How swimmer’s ear happens
Water that stays in the ear canal wears down the protective wax and skin, so bacteria can grow. A 2017 review found that nearly half of active divers get this infection at least once. Children get it more often than adults.
After each swim or dive, tilt your head so each ear faces down, then dry the outer ear with a towel. Do not use cotton buds. Ask a pharmacist or doctor before using ear-drying drops, especially for a child. Do not use them if you have ear pain, discharge or a damaged eardrum. Our swimmer’s ear guide explains more.
How to equalise gently
Equalising means letting air into your middle ears to match the water pressure. Your dive instructor will show you the method that suits you. Divers Alert Network (DAN), a diving safety organisation, gives these tips:
- Equalise gently at the surface, before you start to go down.
- Go down slowly and feet first, using a line if there is one. A head-down position makes equalising harder.
- Equalise every metre or so in the first 3 to 5 metres, before you feel any pain.
- Swallow, yawn or move your jaw. You can also pinch your nose and gently try to breathe out through it. Never blow hard, because a forceful push can injure the inner ear.
- If your ear hurts, stop. Go up a little until the pain stops, then try again. Do not bounce up and down.
- If you still cannot equalise, end the dive.
Do not dive with ordinary earplugs. Air trapped behind the plug cannot equalise, and the ear canal can be injured. Earplugs or a swimming cap can help keep water out when you swim at the surface.
Do not dive with a cold or a blocked nose
A cold, hay fever or a blocked nose can block the Eustachian tubes. Air then cannot reach your middle ears, and you cannot equalise safely. DAN’s advice is clear: do not dive when congested.
Skip diving too if your ears still feel full, or pop and crackle, after an earlier dive. If a cold starts during your holiday, read our guide to air-con colds and sore throat.
Decongestants: ask a pharmacist or doctor first
Some divers take a decongestant tablet or nasal spray before diving. Please ask a pharmacist or doctor before you do this, for four reasons:
- It can wear off underwater. Air is then trapped in the middle ear as you come up. This is called a reverse block, and it can hurt or burst the eardrum.
- Sprays can rebound. Using a decongestant nasal spray for too long can make your nose more blocked.
- Side effects. Some decongestants cause drowsiness or restlessness. Never try a new medicine on a dive day.
- They do not suit everyone. Ask first if you take other medicines or are pregnant or breastfeeding. Ask too if you have a condition such as high blood pressure, diabetes, glaucoma, or a thyroid or heart problem. Decongestants should not be given to children under 6.
If your nose is still blocked on the day, the safest choice is not to dive.
When ear pain means stop
Pain is a signal to stop. The CDC advises divers who think they have ear barotrauma to stop diving and get medical help.
On a short holiday, it is tempting to keep diving. DAN warns that this risks permanent hearing loss or balance problems, because the inner ear may be hurt too. Stay out of the water until a doctor says your ear has healed.
Do not put drops in your ear until a doctor has checked your eardrum. For pain, a simple painkiller such as paracetamol (Adol) or ibuprofen can help. Read the leaflet or ask our pharmacist first, because some painkillers are not safe for everyone.
See a doctor urgently if:
- you have severe ear pain, or pain that keeps getting worse
- your hearing suddenly drops, or you hear new ringing or buzzing
- you feel dizzy, the room spins, or you feel sick or vomit
- blood, pus or fluid comes out of your ear
- you have a high temperature, or swelling around the ear
- after a dive, you have joint pain, numbness, tingling or weakness
- after a dive, you feel unusually tired, short of breath or confused
The last two can be signs of decompression sickness. With any of these signs, stop diving and do not fly until a doctor has checked you. Call 123 for an ambulance if a diver collapses, struggles to breathe or becomes confused. DAN’s 24-hour diving emergency line is +1-919-684-9111.
Flying after diving
Flying too soon after diving raises your risk of decompression sickness, often called “the bends”. Plane cabins are pressurised to the level of about 1,800 to 2,400 metres above sea level.
DAN and the CDC advise these minimum waits before you fly:
| Your diving | Wait at least |
|---|---|
| One dive without decompression stops | 12 hours |
| Several dives in one day, or several days of diving | 18 hours |
| Dives that needed decompression stops | Much longer than 18 hours |
The CDC adds that these waits lower the risk but do not remove it, so a longer wait is safer. Plan your last dive around your flight home from Sharm.
Mountains count too. CDC advice applies to any trip higher than 610 metres above sea level. Mount Sinai rises to 2,285 metres, so wait before you join a Mount Sinai or St Catherine trip.
If you have any symptoms after diving, do not fly or travel to high ground. See a doctor first.
Plan your dive day
Going out by boat? Our Ras Mohammed and Tiran packing list covers sun, seasickness and first aid. If you need something before you sail, we offer free hotel delivery on orders from $30.
Need help in Sharm?
Ear pain after a dive? Message us on WhatsApp or call +20 120 344 2201. Our pharmacists speak English, Russian, Ukrainian and Italian, and will tell you if you need to see a doctor. Hotel delivery is free for orders from $30.
FAQ
Questions people ask
Why do my ears hurt after diving?
Ear pain after diving usually comes from barotrauma or swimmer's ear. Barotrauma happens when the pressure behind the eardrum does not match the water pressure, often because a cold or allergy blocks the Eustachian tube. Swimmer's ear is an infection of the ear canal. Stop diving, keep the ear dry and see a doctor if the pain is severe.
How long should I wait to fly after diving?
Divers Alert Network advises waiting at least 12 hours after a single dive without decompression stops. Wait at least 18 hours after several dives in a day or several days of diving, and much longer after decompression dives. A longer wait is safer. If you have any symptoms after diving, see a doctor before you fly.
Can I dive with a cold or a blocked nose?
No. A cold, hay fever or a blocked nose can stop air reaching your middle ears, so you cannot equalise safely. This can damage the eardrum or the inner ear. Divers Alert Network advises against diving when congested. Wait until your nose is clear and your ears equalise easily before you dive again.
Can I take a decongestant before diving?
Ask a pharmacist or doctor first. A decongestant can wear off underwater and trap air in your middle ear as you come up, which is called a reverse block. Using a nasal spray for too long can make congestion worse. Never try a new medicine on a dive day, and do not dive if your nose stays blocked.
How can I tell barotrauma from swimmer's ear?
Barotrauma starts during a dive, with fullness, muffled hearing and pain that grows as you go deeper. Swimmer's ear is an infection of the ear canal. It itches, and it hurts when you pull the earlobe or press in front of the ear. See a doctor if the pain is severe, or there is discharge, fever or dizziness.
Can snorkelling hurt my ears?
Yes, if you dive below the surface. The air in your ears is squeezed most in the first few metres, and the eardrum can be injured as shallow as about 1.2 metres. Equalise gently on the way down and come up if it hurts. Water left in the ear can also cause swimmer's ear, so dry your ears afterwards.
Sources and further reading (14)
- Middle-Ear Barotrauma (MEBT) — Divers Alert Network
- Middle-Ear Equalization — Divers Alert Network
- Inner-Ear Barotrauma (IEBT) — Divers Alert Network
- How to Deal with Other Ear Problems — Divers Alert Network
- Swimmer's Ear (Otitis Externa) — Divers Alert Network
- Guidelines for Flying After Diving — Divers Alert Network
- Scuba Diving: Decompression Illness and Other Dive-Related Injuries — CDC Yellow Book 2026
- Preventing Swimmer's Ear — CDC
- Ear infections (including outer ear infection) — NHS
- Perforated eardrum — NHS
- Decongestants — NHS
- Livingstone DM, Smith KA, Lange B. Scuba diving and otology: a systematic review with recommendations on diagnosis, treatment and post-operative care. Diving and Hyperbaric Medicine. 2017;47(2):97-109
- Saint Catherine Area (Mount Sinai, 2,285 m) — UNESCO World Heritage Centre
- Getting help: Egypt travel advice — GOV.UK (FCDO)
Last updated 8 October 2026. General information, not a diagnosis: always read the leaflet and ask a pharmacist or doctor.
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