What to do if you develop an ear problem before diving

The rule: if you cannot equalise at the surface, do not dive

An ear problem before diving is not a reason to push on. Diving medical sources, including DAN and DDRC, advise against diving with a cold, sinus congestion or ear trouble.

DDRC's rule of thumb is that if you cannot equalise on the surface without medication, you should not dive. Pressing on risks ear barotrauma, which can be painful and, in some cases, cause lasting hearing loss.

This page sits in our safety and problem-solving hub and pairs with the Maldives scuba diving guide for Malaysians. It is planning information, not medical advice.

Dive or do-not-dive: a decision table

Use this table to decide what to do the evening before or the morning of a dive. When in doubt, choose the more cautious row.

The last row matters. DAN warns that decongestants can wear off during a dive, leaving air trapped on the way up, which is called a reverse block.

What to tell the dive centre

Tell the dive centre as soon as you notice a problem, ideally the evening before. They would rather reschedule than have you abort a dive halfway down.

• Which ear, and what you feel: pain, fullness, ringing or dizziness.
• Whether you have a cold, hay fever or a recent flight.
• Any medicine you have taken.
• How many dives you have booked, so they can suggest moving them.

Instructors are not doctors. If they suggest seeing the resort doctor, take that advice.

Getting medical help at a resort or local island

Many resorts have a doctor or nurse on the island, and dive centres know where to send divers. On local islands, there may be a health centre, while full hospitals are in Male and Hulhumale.

For suspected dive injuries beyond the ear, ADK Hospital in Male has had a hyperbaric unit since January 2023, and Kandima resort in Dhaalu has had one since November 2021. In an emergency, the ambulance number is 102 (UK FCDO advice, checked 12 Oct 2026).

Read how remote medical care is on a resort island for what happens if you need to reach Male.

Protecting the rest of your trip

An ear problem caught early often clears in a few days. Diving through it can stop you diving for the rest of the holiday.

• Swap to snorkelling if the doctor agrees, staying at the surface.
• Move dives later in your stay rather than cancelling outright.
• Keep paperwork: the doctor's note and dive centre messages, in case you claim on dive insurance.
• Ask about flying home after any ear injury before your return flight.

Prevention before you leave Malaysia

Avoid booking dives on the day you land. A long flight, early start and dry cabin air make equalising harder.

If you have had ear surgery, frequent ear infections or a recent perforation, get medical clearance for diving before you go. Practise gentle equalising on the plane and on the boat before the dive, never forcing it.

Common situations and what they usually mean

These are typical patterns divers report, not a diagnosis. A doctor should assess anything painful or lasting.

• Fullness after the flight that clears with swallowing: often the cabin pressure, and it usually settles within a day.
• Pain on one side after a dive where you struggled to equalise: a possible sign of middle-ear squeeze, so stop diving and get checked.
• Itchy, sore outer ear after days of swimming: often an outer ear infection, which a doctor can treat.
• Spinning, nausea or sudden hearing loss: needs urgent medical review, because the inner ear may be involved.

Write down when the symptom started, which dive it followed and what you did about it. This record helps the resort doctor, your insurer and a doctor at home if you need follow-up in Malaysia.

How dive packages handle missed days

Many Maldives dive centres sell dive packages to use during your stay. Ask before you buy whether unused dives can be refunded, credited or moved, and whether a medical note changes that.

Snorkel trips, sandbank visits and boat excursions are good alternatives while your ear settles.