Ear Infection
Symptoms, Causes & Treatment
An ear infection is one of the most common reasons people seek urgent medical advice. Whether you have a painful outer ear infection (otitis externa) or a middle ear infection (otitis media), a licensed UK clinician can assess your symptoms online and, where clinically appropriate, prescribe treatment without you needing to attend a surgery.
An ear infection is inflammation caused by a bacterial or viral infection affecting the ear canal or middle ear — one of the most common reasons people seek urgent medical advice.
There are two main types: otitis externa (outer ear infection) affecting the ear canal, often triggered by water exposure or skin conditions; and otitis media (middle ear infection) behind the eardrum, most commonly following a cold or respiratory infection. Most ear infections resolve well with appropriate treatment.
Symptoms of an Ear Infection
Symptoms vary depending on whether the outer or middle ear is affected.
- Ear pain (ranging from mild to severe and throbbing)
- Sensation of fullness or pressure in the ear
- Reduced or muffled hearing
- Discharge from the ear (clear, yellow, or bloody)
- Itching in the ear canal
- Redness or swelling of the outer ear or canal
- Tenderness when the outer ear or jaw is touched or moved
- Facial weakness or drooping
- Severe swelling around the ear
- Sudden or significant hearing loss
- Significant dizziness or loss of balance
- High fever with ear symptoms in a child
You have facial weakness, severe swelling around the ear, or sudden significant hearing loss. Call 999 if you think you have a medical emergency.
What Causes Ear Infections?
The cause differs depending on which part of the ear is affected.
Swimming or repeated moisture trapped in the ear canal creates a favourable environment for bacterial or fungal growth — a common cause of outer ear infections.
Cotton buds, fingers, earphones, and hearing aids can break the skin barrier of the ear canal, allowing infection to take hold.
Eczema or psoriasis affecting the ear canal can disrupt the skin barrier and predispose to recurrent outer ear infections.
The most common trigger for middle ear infections. Viral infections cause swelling of the Eustachian tube and fluid build-up behind the eardrum.
More common in children due to a shorter, more horizontal tube. Also seen in adults with allergies, sinus issues, or after flying or diving.
Smoking and secondhand smoke exposure increase the risk of middle ear infections, particularly in children.
Key Risk Factors
How Is an Ear Infection Diagnosed?
Ear infections are diagnosed clinically through history and, ideally, examination of the ear canal and eardrum. During an online consultation, a clinician will explore symptoms, discharge, preceding illness, fever, and hearing changes. Some presentations require in-person examination.
How Are Ear Infections Treated?
Treatment depends on the type and severity of infection, and all prescription treatments are issued where clinically appropriate only.
Supportive Measures
Self-care is appropriate for many mild cases: keep the ear dry; avoid cotton buds; use paracetamol or ibuprofen for pain; apply a warm compress to ease discomfort.
Recurrent Ear Infections
Some people experience recurrent ear infections, particularly swimmers, hearing aid users, and those with eczema. If you have had three or more infections in six months, or are experiencing significant hearing loss, a specialist ENT referral is appropriate and can be arranged where clinically indicated.
When Should You See a Clinician?
You experience facial weakness, severe swelling around the ear, or significant dizziness — these may indicate a more serious complication.
Ear pain is severe or not improving after a few days; you have discharge; you have fever; you experience sudden hearing loss; symptoms are recurrent; or you wish to discuss prescription treatment.
Can Ear Infections Be Prevented?
Many ear infections can be reduced with simple preventive steps.
After swimming or showering, tilt your head to each side to let water drain, then gently dry the outer ear with a clean towel. Avoid inserting anything into the ear canal.
Cotton buds push wax deeper and can break the skin barrier, making infection more likely. The ear canal is largely self-cleaning — leave it alone.
If you are prone to outer ear infections, well-fitted silicone earplugs while swimming can significantly reduce moisture entering the ear canal.
Eczema or psoriasis affecting the ear canal should be managed with appropriate treatment to maintain the skin barrier and reduce the risk of infection.
Prompt treatment of upper respiratory infections and allergies reduces Eustachian tube congestion, lowering the risk of middle ear infections.
Getting Treatment for an Ear Infection Online
Our licensed UK clinicians provide fast, confidential online consultations and can prescribe antibiotic drops, oral antibiotics, or other treatment where clinically indicated.
Medical disclaimer: Information on this page is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified clinician for diagnosis and treatment. Call 999 in an emergency.
Expert clinical advice, when you need it.
Frequently Asked Questions
Most outer ear infections improve within a few days of starting treatment and fully resolve within 7–10 days. Middle ear infections often improve within 2–3 days, even without antibiotics, though where a full course is prescribed it should be completed to reduce the risk of recurrence.
Not always. Many middle ear infections, especially in older children and adults, resolve on their own with pain relief alone. A clinician will weigh up the severity of symptoms, duration, and any risk factors to decide whether antibiotic ear drops or oral antibiotics are clinically appropriate.
Swimming should be avoided until an outer ear infection has fully cleared, as water exposure can worsen or prolong it. Flying with a middle ear infection can be uncomfortable due to pressure changes and is best discussed with a clinician beforehand, as it can occasionally increase the risk of eardrum complications.
Most ear infections resolve without any lasting effect on hearing. However, frequent or poorly treated infections can occasionally lead to temporary or, rarely, permanent hearing changes. Persistent or recurrent symptoms should always be assessed by a clinician.