What is an ear infection?

Ear infections are a type of infection most commonly caused by bacteria or viruses.

There are several different types of ear infection, depending on which part of the ear is affected. The 2 most common types of ear infection are:

• otitis media (middle ear infection)
• otitis externa (outer ear infection)

Ear infections are common, especially in children.

What are the symptoms of an ear infection?

Symptoms of an ear infection will depend on which part of your ear is infected. Symptoms may include:

• pain or itchiness in or around your ear
• fever (a temperature of 38 ℃or higher) or headache
• pus or fluid leaking from your ear
• redness or swelling around your ear
• difficulty hearing, or a buzzing in your ear
• difficulties with balance
• nausea or vomiting

Babies and small children might:

• pull or rub their ear
• have a fever
• be irritable
• be tired or have less energy than usual
• have symptoms of a cold, such as a runny nose or sore throat

What causes an ear infection?

An ear infection can be caused by:

• bacteria
• viruses
• fungi

Factors that can increase your chance of developing an ear infection include:

• having a cold or another respiratory infection
• air pressure changes, such as when you are on a plane
• swimming in dirty water
• cleaning your ears too much with cotton buds
• having a cut in or around your ear
• not drying your ears well after swimming or bathing
• high humidity conditions

When you catch a cold, the infection can move up a tube that connects your middle ear to your throat. This is called the Eustachian tube. Middle ear infections are more common in babies and children because they have smaller Eustachian tubes.

How are ear infections diagnosed?

To diagnose an ear infection, your doctor will ask about your symptoms and examine you. This will include examining your ears with an otoscope. An otoscope is a special magnifying glass with a torch that is gently inserted into your ear canal. This allows your doctor to view the eardrum.

Further tests are not usually needed.

When should I see my doctor?

Go to your nearest emergency department if there is redness, pain or swelling of the bone behind the ear or if the ear is pushed forward. This could be a sign of a serious infection called mastoiditis.

You should see your doctor if you or your child:

• has any symptoms of an ear infection
• can't hear properly
• gets repeated ear infections

When to seek emergency care

You should get emergency care if you or your child has an ear infection as well as:

• vomiting
• sudden hearing loss
• a fever
• symptoms affecting the muscles in the face

How are ear infections treated?

Treatment for an ear infection depends on the type of infection and where the infection is.

Self-care at home

Middle ear infections usually resolve without treatment after 1 to 2 days. During this time, you should:

• avoid getting your ear wet — check with your doctor before swimming
• wear a shower cap or soft ear plugs while in the shower
• avoid touching your ear

If your symptoms haven't improved after 2 days, go back to your doctor.

Medicines for an ear infection

Your doctor may recommend:

• ear drops with antibiotics or antifungal medicine — this is most common for an outer ear infection, but may be recommended for a severe middle ear infection
• medicine for pain relief, such as paracetamol or ibuprofen
• antihistamines or anti-nausea medicine

If you are using ear drops, you should:

• lie down with your ear facing upwards while the drops are put in
• stay lying down for a few minutes, so the drops stay in your ear

Other treatment options

In some cases, your doctor may recommend other treatment options, including:

• professional cleaning of the ear canal
• a procedure called tympanocentesis — this drains the fluid from your middle ear

How can ear infections be prevented?

Here are some tips to help prevent ear infections:

• Don't try to remove the wax in your or your child's ears. The body is able to do this by itself.
• Don't put anything into your ear, not even a cotton bud. This is important even if your ear feels blocked or painful.
• Avoid smoking and exposure to cigarette smoke.
• Middle ear infections are often a result of a simple cold. Good hand hygiene can help lower your chance of catching a cold.
• Make sure that you drain water out of your ears after swimming. Use earplugs for swimming if you are prone to ear infections.

What are the complications of an ear infection?

Most ear infections will resolve without any complications.

Sometimes the build-up of fluid in the middle ear can lead to tearing of the eardrum. This is known as a burst eardrum. The eardrum usually heals by itself without treatment.

Some children develop glue ear. This is when fluid remains in the middle ear after an infection. This can affect your child's:

• hearing
• language development
• sleeping
• balance

In very rare cases, ear infections can lead to:

• Mastoiditis — this is when an ear infection spreads from the ear to the mastoid bone behind the ear.
• Facial nerve paralysis — this causes paralysis of the muscles in your face that help you smile and blink.
• Sepsis — this is a serious condition caused by the body's response to an infection. It can lead to inflammation of tissues and organs.

Some people are more likely to have complications from an ear infection, including:

• children under 6 months of age
• Aboriginal and/or Torres Strait Islander children
• people with a weakened immune system

Resources and support

Learn more about ear infections and glue ear on The Royal Children's Hospital Melbourne page.

The National Health and Medical Research Council offers a fact sheet on ear infection.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.