Ear infections are very common, particularly in children. You do not always need to see a GP for an ear infection as they often get better on their own within 3 days.

Check if it's an ear infection

The symptoms of an ear infection usually start quickly and include:

• pain inside the ear
• a high temperature of 38C or above
• being sick
• a lack of energy
• difficulty hearing
• discharge running out of the ear
• feeling of pressure or fullness inside the ear
• itching and irritation in and around the ear
• scaly skin in and around the ear

Young children and babies with an ear infection may also:

• rub or pull their ear
• not react to some sounds
• be irritable or restless
• be off their food
• keep losing their balance

Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.

Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.

If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.

Differences between inner, middle and outer ear infections

Inner ear infection

• can affect both children and adults
• caused by viral or bacterial infections
• affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis

Middle ear infection (otitis media)

• usually affect children
• caused by viruses like colds and flu
• affects the eustachian tube, which connects the middle ear (area behind the eardrum) to the back of the nose

Outer ear infection (otitis external):

• usually affects adults aged 45 to 75
• caused by something irritating the ear canal, such as eczema, water or wearing ear plugs
• affects the ear canal (the tube between the outer ear and the eardrum)

How to treat an ear infection yourself

To help relieve any pain and discomfort from an ear infection:

Do:

• use painkillers such as paracetamol or ibuprofen (children under 16 shouldn't take aspirin)
• place a warm or cold flannel on the ear
• remove any discharge by wiping the ear with cotton wool

Don't:

• do not put anything inside your ear to remove earwax, such as cotton buds or your finger
• do not let water or shampoo get in your ear
• do not use decongestants or antihistamines - there's no evidence they help with ear infections

A pharmacist can help with an ear infection

Speak to a pharmacist if you think you have an outer ear infection.

They can recommend acidic ear drops to help stop bacteria or fungus spreading.

Find a pharmacy

See a GP if you or your child have:

• earache that doesn't start to get better after 3 days
• regular ear infections

Get advice from 111 now if you have:

• become generally unwell
• a very high temperature or feel hot and shivery
• swelling around the ear
• fluid coming from the ear
• hearing loss or a change in hearing
• other symptoms, like being sick, a severe sore throat or dizziness
• a child under 2 with earache in both ears
• a long-term medical condition (such as diabetes or a heart, lung, kidney or neurological disease) and symptoms of an ear infection
• a weakened immune system (for example, because of chemotherapy) and symptoms of an ear infection

What happens at your appointment

Your GP will often use a small light (an otoscope) to look in the ear.

Some otoscopes blow a small puff of air into the ear. This checks for blockages, which could be a sign of an infection.

Treatment from a GP

Your GP may prescribe medicine for your ear infection, depending on what's caused it.

Infections inside the ear

Antibiotics aren't usually offered because ear infections often clear up on their own, and antibiotics make little difference to symptoms, including pain.

Antibiotics might be prescribed if:

• an ear infection doesn't start to get better after 3 days
• you or your child has any fluid coming out of their ear
• there are other factors that increase your or your child’s risk of complications, such as having a weakened immune system

They may also be prescribed if your child is less than 2 years old and has an infection in both ears.

If antibiotics are not prescribed, eardrops containing a painkiller and an anaesthetic might be prescribed.

Outer ear infections

Your GP might prescribe:

• antibiotic ear drops - to treat a bacterial infection
• steroid ear drops - to bring down swelling
• antifungal ear drops - to treat a fungal infection
• antibiotic tablets - if your bacterial infection is severe

If you have a spot or boil in your ear, your GP may pierce it with a needle to drain the pus.

Ear drops may not work if they're not used correctly.

How to use ear drops

1. Remove any visible discharge or earwax using cotton wool.
2. Hold the bottle in your hand to warm it – cold ear drops can make you feel dizzy.
3. Lie on your side with the affected ear facing up to put the drops in.
4. Gently pull and push your ear to work the drops in.
5. Stay lying down for 5 minutes so the drops don't come out.

Preventing ear infections

You can't always prevent ear infections, particularly inner ear infections caused by colds and flu.

To help avoid inner ear infections:

• make sure your child is up to date with vaccinations
• keep your child away from smoky environments
• try not to give your child a dummy after they're 6 months old

To help avoid outer ear infections:

• don't stick cotton wool buds or your fingers in your ears
• use ear plugs or a swimming hat over your ears when you swim
• try to avoid water or shampoo getting into your ears when you have a shower or bath
• treat conditions that affect your ears, such as eczema or an allergy to hearing aids