Ear pain can be caused by an infection, irritation of the ear canal, pressure behind the eardrum or a problem that is not in the ear itself. Ear infections are common, particularly in children, but the location of the infection matters because assessment and treatment may differ.
Outer-ear and middle-ear infections: what is the difference?
Outer-ear infection (otitis externa) affects the skin of the ear canal. It may cause itching, pain—sometimes worse when the outer ear is moved—canal swelling or discharge. Water exposure, skin irritation or inserting objects into the ear can contribute.
Middle-ear infection (otitis media) occurs behind the eardrum and often follows a cold or respiratory infection. Ear pain, fever, a feeling of pressure and temporary hearing reduction may occur. Fluid can remain behind the eardrum after the acute infection has settled, and this can affect hearing for a time.
Symptoms overlap, and other conditions can cause similar pain. A clinician may need to examine the ear to distinguish them.
What can you do at home?
- Use an appropriate pain reliever only if it is safe for you and follow the package directions or advice from a healthcare professional.
- Keep the ear dry if an outer-ear infection is suspected and avoid swimming until symptoms have settled or a clinician advises otherwise.
- Do not insert cotton buds, fingers or other objects into the canal.
- Do not use leftover antibiotic drops or another person's medicine. Some drops are unsuitable if the eardrum is perforated or ear tubes are present.
Do ear infections always need antibiotics?
No. Treatment depends on the site, severity, age, medical history and examination findings. Some middle-ear infections improve without antibiotics, while selected bacterial infections or outer-ear infections may need prescribed treatment. Antibiotics do not treat viral infections, and the wrong drops or tablets may cause harm or delay the correct diagnosis.
When should you seek medical advice?
Arrange an assessment for worsening or persistent pain, discharge, new hearing difficulty, recurrent infections or symptoms in someone who is immunocompromised or has important ear disease or surgery history. Infants and young children may need earlier assessment depending on age, fever and overall condition.
Seek urgent care for severe illness, swelling or redness behind the ear, the ear appearing pushed outward, facial weakness, severe dizziness, significant injury, or sudden hearing loss. Sudden hearing reduction should not be attributed automatically to infection or blockage.
How can ear infections be reduced?
Not all infections can be prevented. Avoid putting objects in the ears, keep the ear canal from becoming traumatised, and seek advice if water exposure repeatedly causes symptoms. For children, follow routine vaccination recommendations and avoid exposure to tobacco smoke. Recurrent or persistent problems deserve an assessment rather than repeated self-treatment.
Common questions
Can an ear infection affect hearing? Yes. Swelling, fluid or material in the ear can reduce hearing, often temporarily, but persistent or sudden changes need evaluation.
Should I clean inside the ear to remove discharge? Avoid inserting anything into the canal. Wipe only the outside and seek advice about safe care.
Can I use ear drops I used last time? Not without advice. The cause may be different and some drops are unsuitable for certain eardrum conditions.
Sources and further reading
Educational information only; an ear examination may be needed to identify the cause and appropriate treatment.