When to see a doctor and what to expect
Most ear infections clear on their own within a few days, but you should see a doctor if pain is severe, you have fluid draining from your ear, you have a fever above 102°F, or symptoms last longer than a week. A doctor will look inside your ear with an otoscope to see whether the eardrum is inflamed or fluid is present behind it. They may also ask about recent colds, swimming, or ear trauma, since these often precede infections.
If your doctor suspects a bacterial infection, they may prescribe antibiotics—usually amoxicillin or amoxicillin-clavulanate for children, or fluoroquinolone drops for swimmer's ear. Viral infections do not respond to antibiotics, so treatment focuses on managing pain and waiting for the infection to resolve. Your doctor may also recommend pain relief, decongestants, or ear drops depending on what type of infection you have and where it is located.
Key Takeaways
- Pain relief with over-the-counter acetaminophen or ibuprofen works for most ear infections while your body fights the infection.
- Warm compresses held against the ear and keeping the ear dry both reduce discomfort and help prevent the infection from worsening.
- Antibiotics only help if bacteria are causing the infection; most ear infections are viral and resolve without them.
- See a doctor if pain is severe, you have drainage or fever, or symptoms persist beyond one week.
- Prevent future infections by drying ears after swimming, avoiding inserting objects into the ear, and treating colds promptly.
Pain relief while the infection clears
Over-the-counter pain relievers are the first step for most people. Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) reduce pain and fever. Ibuprofen often works better for ear pain because it also reduces inflammation. Follow the dosing on the package based on your age and weight; do not exceed the maximum daily dose.
A warm compress held against the ear for 10 to 20 minutes several times a day eases pain without medication. You can use a heating pad on low, a warm washcloth, or a sock filled with rice and heated in the microwave. Make sure it is warm, not hot, to avoid burning the skin. Some people find that lying on the affected side helps drain fluid and reduces pressure.
Keeping your ear dry and preventing complications
Moisture in the ear canal worsens infection and slows healing. If you have drainage, gently wipe the outer ear with a clean cloth, but do not insert anything into the canal. Avoid swimming, showering, or getting water in the ear until the infection clears. When bathing, you can place a cotton ball lightly coated with petroleum jelly in the ear opening to keep water out.
Do not use cotton swabs, bobby pins, or your fingernail to clean inside the ear, even if it itches. These can scratch the canal and introduce bacteria. If itching is severe, ask your doctor about safe options. Avoid inserting earbuds or hearing aids until your doctor says the infection has cleared.
Understanding antibiotics and when they are used
Antibiotics treat bacterial infections but do nothing for viral ones, which make up the majority of ear infections. A doctor can sometimes tell the difference based on how the eardrum looks, but often they cannot know for certain without a culture—which takes time and is rarely done. Because of this, many doctors prescribe antibiotics as a precaution, especially for children under six months or people with severe symptoms.
If your doctor prescribes antibiotics, take the full course even if you feel better after a few days. Stopping early can allow bacteria to survive and cause the infection to return. Amoxicillin is the most common choice for middle ear infections in children. For swimmer's ear (infection of the outer canal), doctors usually prescribe antibiotic or antifungal ear drops instead of oral antibiotics, since the drops reach the infected area directly.
Different types of ear infection and their treatment
Middle ear infections occur behind the eardrum and are most common in children. They often follow a cold and cause ear pain, fever, and sometimes fluid drainage if the eardrum ruptures. Treatment focuses on pain relief and, if bacterial, antibiotics. Most resolve within two weeks.
Outer ear infections (swimmer's ear) affect the ear canal and cause itching, pain when you pull on the ear, and sometimes drainage. These are usually bacterial or fungal and respond well to antibiotic or antifungal ear drops. Inner ear infections are rare but cause dizziness and balance problems along with hearing loss. These require prompt medical attention and sometimes hospitalization.
When to go to urgent care or the emergency room
Seek immediate care if you have severe ear pain with facial weakness or drooping, sudden hearing loss, dizziness that prevents you from standing, or discharge that smells foul or contains blood. These can signal a serious infection spreading beyond the ear. Also go to urgent care if your child has a fever above 103°F with ear pain, or if an adult has a fever above 104°F.
If your ear has drained and the pain suddenly stops, do not assume the infection is better—this can mean the eardrum has ruptured. See a doctor to confirm the eardrum is healing properly. Untreated ruptures rarely cause permanent hearing loss, but they need monitoring.
Preventing ear infections in the future
Dry your ears thoroughly after swimming or bathing. Tilt your head to each side and gently pull the earlobe to help water drain. If you swim frequently, consider custom-fitted earplugs or a swim cap. Avoid inserting objects into your ear, including cotton swabs, which can push wax deeper and scratch the canal.
Treat colds and sinus infections promptly, since they often lead to ear infections. If you have seasonal allergies, use allergy medication or nasal sprays as directed. For children in group settings, frequent handwashing reduces the spread of the viruses that trigger ear infections. Breastfeeding infants when possible also offers some protection, as breast milk contains antibodies.
Frequently Asked Questions
Can I use over-the-counter ear drops instead of seeing a doctor?
Over-the-counter drops may help with pain and earwax, but they cannot treat an active infection. If your eardrum has ruptured, some drops can damage the middle ear. See a doctor first to confirm what type of infection you have and whether your eardrum is intact.
How long does an ear infection usually last?
Most viral ear infections resolve within one to two weeks. Bacterial infections treated with antibiotics typically improve within three to five days of starting medication, though the full course is usually 10 days. Some people have lingering fluid behind the eardrum for weeks after the infection clears.
Is it safe to fly with an ear infection?
Flying with an active ear infection can be painful because pressure changes in the cabin affect the middle ear. If you must fly, use a nasal decongestant spray before takeoff and landing, chew gum, or use the Valsalva maneuver (pinch your nose and gently blow). If possible, wait until the infection clears.
Can I get an ear infection from loud noise?
Loud noise does not cause infection, but it can damage hearing. Ear infections are caused by viruses or bacteria, usually following a cold or from water in the ear canal. Protect your hearing by wearing earplugs in loud environments.
What should I do if the infection comes back repeatedly?
Recurrent ear infections in children sometimes improve as they grow, since their Eustachian tubes become more angled. In adults, repeated infections warrant a doctor's visit to rule out underlying problems like allergies, chronic sinus disease, or a blocked Eustachian tube. Your doctor may refer you to an ear, nose, and throat specialist.