Why Hawaii's Beaches, Surf, and Outdoor Culture Mean You Need to Think Differently About Hearing Protection
Jan 18, 2026
Living in Hawaii means embracing an outdoor lifestyle that most mainlanders can only dream about. Our beaches, world-class surf, year-round warm weather, and ocean-centered culture are what make these islands paradise.
But after more than three decades of providing hearing care to Hawaii's families, we've learned something important: the very environment that makes Hawaii so special also creates unique challenges for your hearing health that many residents don't fully understand.
This isn't just about protecting your hearing aids from salt water; it's about understanding how Hawaii's climate, water sports culture, and outdoor lifestyle require a fundamentally different approach to hearing protection than what works on the mainland.
The Hidden Hearing Risks in Paradise
Surfer's Ear: Not Just for Cold-Water Surfers Anymore
For years, medical research focused on surfer's ear (medically known as external auditory exostosis) as primarily a cold-water problem. The thinking was simple: cold water below 66°F combined with wind exposure causes abnormal bone growth in the ear canal as the body's protective response.
But recent research has completely changed our understanding. A study of warm-water surfers in Queensland, Australia (with water temperatures ranging from 69°F in winter to 82°F in summer), found that 69.6% had exostosis, proving that even tropical waters pose significant risk.
Hawaii's water temperatures sit right in this range, and we're seeing the same patterns in our local surfing and water sports communities.
A comprehensive 2024 review found that the prevalence of surfer's ear among surfers ranged from 31% to 80%, largely depending on water temperature and geographic location. Here in Hawaii, water sport enthusiasts like surfers, swimmers, divers, paddleboarders, and kayakers might struggle with surfer’s ear.
What makes this particularly concerning is that nearly two-thirds of affected surfers experience regular symptoms, including water trapping (56%), pain (35%), and hearing loss (26%), yet only 8.7% regularly use protective equipment like earplugs.
Why Hawaii's "Warm" Water Is Still a Problem
The mechanism behind surfer's ear involves repeated irritation from cold water and wind causing the temporal bone in your ear canal to develop protective bone growths.
While Hawaii's water feels warm compared to California or Oregon, there are a few things to consider about what makes it a challenging location for surfer’s and swimmer’s ear.
Wind Chill Effect: Even in warm water, the combination of wind and moisture in your ear canal creates evaporative cooling. Water colder than 66 degrees F is associated with more frequent development of exostoses. This is why surfers, paddlers, and anyone spending extended time with wet ears in windy conditions remain at risk.
Cumulative Exposure: Hawaii's year-round outdoor culture means more total hours in the water. A mainland surfer might get 100 days a year in the ocean. A Hawaii surfer can easily log 300+ days. That cumulative exposure adds up significantly.
The Irreversible Factor: External auditory exostosis is permanent. According to the National Center for Biotechnology Information, external auditory exostoses are irreversible, and treatment generally involves medical management or surgery if symptoms become severe. Once that bone grows, it doesn't go away without surgery. The key is prevention, and that means protecting your ears from day one.
Swimmer's Ear: A Tropical Climate's Perfect Storm
While surfer's ear develops slowly over years, swimmer's ear (otitis externa) can strike after a single surf session or beach day. Cleveland Clinic defines swimmer's ear as an inflammation, irritation, or infection of the external ear canal that causes pain, redness, swelling, and itching. The ear canal skin becomes infected when water gets stuck in the outer ear canal.
Hawaii's humid, tropical climate creates ideal conditions for the bacteria and fungi that cause swimmer's ear. Combine that with our water-focused lifestyle, and you have a recipe for recurring ear infections that can sideline even the healthiest ocean enthusiasts.
The Hearing Aid Challenge: Salt, Humidity, and Technology
For those who already use hearing aids, Hawaii presents a completely different set of challenges than dry mainland climates. Our patients consistently tell us this is one of the biggest adjustments when moving to the islands.
The Triple Threat to Hearing Aids
1. Humidity and Moisture
Hawaii's year-round humidity increases the risk of condensation inside hearing aids, especially near the ear canal, where sweat and body heat contribute to localized moisture.
Over time, this moisture can corrode metal components and interfere with electronic connections. Even small amounts of moisture can dramatically affect performance.
For someone with hearing loss, reduced volume can mean the difference between following a conversation and missing it entirely.
2. Salt Air Corrosion
Salt air carried by ocean breezes contains microscopic particles that can settle into device openings. Salt is corrosive and can damage microphones, battery terminals, and other metal parts, sometimes without immediate symptoms.
Living near the ocean (even if you're not going in the water) means your hearing aids are constantly exposed to salt-laden air. Many of our patients who live mauka (inland) have fewer moisture-related repairs than those living makai (near the ocean).
3. Sweat and Outdoor Activity
Hawaii's outdoor lifestyle means you're likely more active than your mainland counterparts. Beach walks, hiking, yard work, and simply being outside in our warm, humid climate mean more perspiration. Sweat contains both moisture and salt, making it a double threat to hearing technology.
What Hawaii Residents Need to Know About Modern Hearing Aids
The good news is that hearing aid technology has evolved significantly. Most modern devices now carry IP68 ratings, which indicate resistance to dust (6) and water immersion at depths up to 1.5 meters for up to 30 minutes (8).
However, this doesn't mean they're suitable for swimming or extended water exposure.
Salt water can leave behind crystals that may damage the device even if the initial water exposure doesn't cause problems. There have been countless cases where someone gets splashed at the beach, thinks everything is fine, and then discovers corrosion damage weeks later.
Practical Protection Strategies for Hawaii's Lifestyle
After 35 years serving Hawaii's communities, here's what actually works for you in our unique environment:
Custom Water Protection: While universal earplugs provide some protection, custom-molded earplugs designed specifically for water sports offer the best combination of water blocking and sound transmission.
Custom earplugs sit in your ear canal with no pressure points compared to conventional universal earplugs, providing maximum comfort for hours of prolonged use. Modern water sport earplugs use specialized membrane technology that keeps water out while allowing you to hear conversations, warnings, and your surroundings, which is critical for safety in the ocean.
Know Your Risk Level: Consider your typical water activities:
Surfing, bodyboarding, or diving: High risk due to constant submersion and wave impact
Stand-up paddleboarding, kayaking: Moderate to high risk from splashing and wind exposure
Swimming, snorkeling: Moderate risk, especially in choppy conditions
Beach activities, occasional swimming: Lower risk but still worth protecting against swimmer's ear
Start Protection Early: Don't wait until symptoms appear. Research shows that among surfers aware of prevention methods, only about one-third actually use any form of protection, with the most common being earplugs at just 26%. Those who start early avoid problems entirely.
For Hearing Aid Users in Hawaii
Make sure to wipe down your devices with a soft, dry cloth immediately after any outdoor activity. Using a hearing aid dehumidifier nightly (not just occasionally) in Hawaii's climate is essential, not optional!
Also, never store hearing aids near open windows, in bathrooms, or anywhere with high humidity.
Keep waterproof storage cases in your beach bag, car, and anywhere you might be near water, and remove your hearing aids before any water activity, even if you don't plan to get in. Consider having a backup pair if your lifestyle involves frequent ocean exposure.
Regular professional cleanings go beyond what home maintenance can achieve. You can rest easy knowing that our team can remove salt residue, check for early corrosion, and ensure seals remain intact.
For Everyone: General Island Living
Protective Equipment for Outdoor Work: Landscaping, construction, and other outdoor occupations in Hawaii mean exposure to both noise and moisture. Combining hearing protection with moisture resistance is crucial.
Always have dry storage available when near water; consider hooded rash guards for extended ocean time (they protect ears from wind and sun). Be mindful of sand exposure, which can scratch and damage hearing devices even without water contact.
Regular Hearing Evaluations: In Hawaii's challenging environment, annual hearing assessments are the best way to keep tabs on your hearing health, even if you don't notice problems. Early detection of changes allows for proactive intervention.
When to Seek Professional Help
Watch for these warning signs that suggest you need professional evaluation:
Water-Related Symptoms:
Persistent sensation of water trapped in your ears
Recurring ear infections, especially after ocean activities
Pain or discomfort after water exposure
Muffled hearing that doesn't clear after a few hours
Hearing Aid Concerns:
Reduced volume or sound quality
Static, crackling, or intermittent sound
Visible moisture or corrosion
Battery drains faster than usual
Long-Term Changes:
Gradual difficulty hearing in noisy environments (restaurants, beaches with surf)
Asking people to repeat themselves more frequently
Turning up TV or music volume higher than others prefer
Prevention Works, But Only If You Start Now
Hawaii offers an incredible lifestyle, and there's no reason your hearing health should limit your enjoyment of everything these islands offer. But that requires a proactive approach that accounts for our unique environment.
The audiological reality is straightforward: cumulative water exposure, salt air, humidity, and an active outdoor lifestyle all impact your hearing health and any hearing devices you use. The research is clear that these risks are real, the conditions are progressive and often irreversible, and prevention is far more effective than treatment after damage occurs.
Whether you're a lifelong resident, a recent transplant, or somewhere in between, taking hearing protection seriously from the start will pay dividends for decades to come. Custom water protection for ocean enthusiasts, proper hearing aid maintenance for device users, and regular professional evaluations for everyone (these aren't excessive measures). They're appropriate responses to living in an environment that's as challenging to hearing health as it is beautiful to experience.
Talk to Professionals Who Understand Island Living
At Hawaii Professional Audiology, we've spent over 35 years learning what hearing health angles work specifically for Hawaii residents. Mainland protocols often don't translate well to island conditions, and you can rely on approaches that account for our unique climate, lifestyle, and culture.
Whether you need a comprehensive hearing evaluation, custom water protection, hearing aid services adapted for Hawaii's environment, or simply want to talk about prevention strategies, contact us today!
Let's make sure your hearing health supports the lifestyle you love, not limits it.
Frequently Asked Questions
1. I only surf in Hawaii’s warm waters; am I really at risk for "Surfer’s Ear"?
Yes. While the name suggests a cold-water condition, research shows that tropical waters pose a massive risk.
In Hawaii, the "wind chill effect" causes evaporative cooling in your ear canal even when the ocean feels warm. Because these bone growths are permanent and irreversible without surgery, prevention must start immediately, regardless of water temperature.
2. My hearing aids are rated IP68 for water resistance; do I still need to worry about the beach?
Hawaii’s salt air contains microscopic corrosive particles that can settle into your device's microphones and battery terminals, causing "invisible" damage over time. Furthermore, salt water leaves behind crystals as it dries that can tear through seals and corrode internal electronics.
In our climate, using a hearing aid dehumidifier nightly is an essential requirement, not an optional accessory.
3. Why are custom-molded earplugs better than the cheap versions from the drugstore?
Off-the-shelf earplugs often create pressure points or fail to provide a complete seal during high-impact activities like surfing or diving.
Custom-molded protection is designed specifically for your ear anatomy, ensuring they stay put even in heavy surf. More importantly, modern custom plugs use specialized membrane technology; this allows you to hear conversations and safety warnings while keeping water out.
Considering that only about 8.7% of surfers use protection despite 26% already suffering from hearing loss, custom plugs are the most effective way to ensure you actually wear them.
Sources
National Library of Medicine: This study of surfer’s ear highlights its prevalence and what you can do to prevent it if you regularly enjoy surfing.
Stanford Medicine: A comprehensive understanding of surfer’s ear will help you best understand symptoms, what you need to do to prevent surfer’s ear, and find out how to tackle it if present.
