Surfer's ear is the common name for an exostosis or abnormal bone growth within the ear canal. Surfer's ear is not the same as swimmer's ear, although infection can result as a side effect. Irritation from cold wind and water exposure causes the bone surrounding the ear canal to develop lumps of new bony growth which constrict the ear canal. Where the ear canal is actually blocked by this condition, water and wax can become trapped and give rise to infection. The condition is so named due to its prevalence among cold water surfers. Warm water surfers are also at risk for exostosis due to the evaporative cooling caused by wind and the presence of water in the ear canal. Most avid surfers have at least some mild bone growths (exostoses), causing little to no problems. The condition is progressive, making it important to take preventive measures early, preferably whenever surfing. The condition is not limited to surfing and can occur in any activity with cold, wet, windy conditions such as windsurfing, kayaking, sailing, jet skiing, kitesurfing, and diving. Signs and symptoms In general, one ear will be somewhat worse than the other due to the prevailing wind direction of the area surfed or the side that most often strikes the wave first. Decreased hearing or hearing loss, temporary or ongoing Increased prevalence of ear infections, causing ear pain Difficulty evacuating debris or water from the ear causing a plugging sensation Cause The majority of patients present in their mid-30s to late 40s. This is likely due to a combination of the slow growth of the bone and the decreased participation in activities associated with surfer's ear past the 30s. However, surfer's ear is possible at any age and is directly proportional to the amount of time spent in cold, wet, windy weather without adequate protection. The normal ear canal is approximately 7 mm in diameter and has a volume of approximately 0.8 ml (approximately one-sixth of a teaspoon). As the condition progresses, the diameter narrows and can even close completely if untreated, although people generally seek help once the passage has constricted to 0.5–2 mm due to the noticeable hearing impairment. While not necessarily harmful in and of itself, constriction of the ear canal from these growths can trap debris, leading to painful and difficult to treat infections. Prevention The widespread use of wetsuits has allowed people to surf