Treatment for surfer's ear depends on the severity of the bony growths and the symptoms they cause. Patients with mild narrowing of the ear canal and few or no symptoms may not require surgery. Instead, regular monitoring by an ENT specialist and periodic professional ear cleaning can help remove trapped earwax and debris, reducing the risk of blockage and infection.

When water becomes trapped behind the bony growths, recurrent episodes of swimmer's ear (otitis externa) are common. These infections are typically treated with careful cleaning of the ear canal, antibiotic ear drops, and instructions to keep the ear dry while it heals. Wearing earplugs during water activities and thoroughly drying the ears afterward can help prevent future infections.

For patients with significant narrowing of the ear canal, frequent infections, persistent water trapping, hearing loss, or symptoms that interfere with daily activities or water sports, surgery may be recommended. The procedure, called canalplasty, involves carefully removing the excess bone to widen the ear canal and restore normal drainage. Canalplasty is usually performed as an outpatient procedure under general anesthesia. After surgery, patients should keep the ear dry while it heals, attend follow-up appointments for cleaning and monitoring, and avoid water sports for several weeks until cleared by their surgeon. Most patients experience substantial improvement in symptoms and are able to return to their usual activities once healing is complete. Because continued exposure to cold water can lead to new bone growth over time, wearing protective earplugs or a neoprene hood during future water activities is recommended to help reduce the risk of recurrence.