Earache Treatment

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Pain in the ear is very common. There are many causes of an earache, but the most common cause is an infection.

There are two types of ear infection; Otitis Externa (outer ear infection) and Otitis Media (middle ear infection). 

Otitis Media

Most middle ear infections (Otitis Media) clear up within three to five days on their own and don't need any specific treatment. Acute Otitis Media resolves in 60% of cases in 24 hours without antibiotics. They are often viral infections and so will not require antibiotics. It may be associated with other cold like symptoms and you may feel generally unwell with it. If however, you are in a lot of pain or your symptoms are showing no sign of improvement after two or three days, then you may wish to 'Start an Earache Diagnosis' or see a GP as in these circumstances antibiotic treatment may be warranted. 

Otitis Externa

Otitis Externa (outer ear infection) will often cause an earache associated with itching and irritation of the ear canal. You may have discharge coming from the ear canal. You will generally feel well in yourself with this type of infection. Otitis Externa can be treated with analgesia, acetic acid (which you can purchase from the pharmacy) or antibiotic ear drops which we can prescribe if appropriate. 

Please remember that unnecessary use of antibiotics may cause side effects and may increase the incidence of antibiotic resistance.

Treatments we may prescribe if clinically appropriate:

Please see Common Treatments below for further information.

Common Symptoms

Common Symptoms of Otitis Externa (outer ear infection)

  • an earache
  • an irritated ear canal with or without itching
  • a feeling of fullness in your ear or a pressure sensation
  • redness or swelling in the ear canal and the outer ear
  • scaly skin affecting the ear canal
  • discharge from the ear canal
  • dull hearing
  • a tender feeling in the jaw or ear on movement
  • swollen glands in the neck

Common Symptoms of Otitis Media (middle ear infection)

  • an earache
  • a fever
  • dulled hearing
  • nausea
  • lethargy
  • pressure feeling in the ear
  • other common cold symptoms such as sore throat, nasal congestion and sinus pressure.
Common Treatments

Possible treatments we prescribe for Otitis Externa if clinically appropriate:

  • Otomize antibiotic spray (5ml) - 1 spray three times a day: 7-day course  (£3.27*)
  • Sofradex antibiotic drops (10ml) - 2 drops to the affected ear three times per day (£7.50*)
  • Otosporin antibiotic drops (10ml) - 3 drops 3-4 times a day (£7.45*)

Possible treatments we prescribe for Otitis Media if clinically appropriate:

*Prices shown are cost price of the medication, taken from the British National Formulary 2018, and are given as a guideline. Pharmacies will add a dispensing fee to this which will vary considerably, so it is worthwhile phoning around to compare prices. The medication is paid for at your chosen pharmacy. 

Please click on the medication above to read the Patient Information Leaflet for important information about each drug. We use national prescribing guidelines to select which treatment would be most appropriate for your condition. 

What is Otitis Externa?

Otitis externa is relatively common, and it is estimated that around 1 in 10 people will be affected by it at some point in their lives.

Otitis externa is inflammation of the skin of the ear canal which is usually caused by a bacterial infection, but sometimes by irritation, allergy or a fungal infection. While otitis externa can clear up by itself, this can take several weeks without treatment. Medicated ear drops can speed up the recovery process. Typical symptoms may include pain, discharge, itching and reduced hearing. A warm moist environment in the ear canal, debris or any damage to the delicate lining of the ear canal increase the chances of bacteria thriving there.

People with certain long-term conditions such as eczema, asthma and allergic rhinitis are at greater risk of developing the condition. 

What is Otitis Media?

Acute otitis media is a bacterial or viral infection of the middle ear that causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum.

Anyone can develop a middle ear infection. It can often occur as a complication to the common cold. In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days on its own. 

The middle ear (small space behind the eardrum) has three bones and is usually filled with air. It is connected to the back of the throat by the Eustachian tube.

During a cold, mucus can fill the space behind the eardrum and may become infected with bacteria or viruses. The Eustachian tube can become swollen and blocked which stops the mucous draining out, resulting in pressure on the eardrum, pain and a middle ear infection (otitis media). 

The main symptoms are an earache and feeling unwell. Even though an earache is common is does not always occur. A fever and dulled hearing are also common. Sometimes due to the pressure, the eardrum may perforate. This releases the fluid and can often improve the pain. The majority of perforations are small and will heal themselves within a few weeks once the infection settles.

Your immune system will clear up most middle ear infections within a few days without any treatment. If however, you are in a lot of pain or your symptoms showing no sign of improvement after two or three days then you may wish to 'Start an Earache Diagnosis' or see a GP.

Self-help Treatments

There are certain treatments you can try at home which may help you to manage your symptoms.

1. Pain medication:

  • Paracetamol or ibuprofen can help to manage the symptoms of an earache whilst the immune system fights the infection. Please read the leaflet that comes with the medication to check its suitability for you. If you're still unsure, check with your pharmacist, GP or practice nurse. The medication can help pain and fever. 

2. Keep your ears dry as this will help the current infection to settle and can help to prevent recurrences.

  • If water gets in then tip it out. You can use a hairdryer on a low setting to dry the canal.
  • Never push the corners of a towel into your ears to dry them, as this can cause damage.
  • Use a tightly fitting cap to cover the ears when swimming.
  • Silicone earplugs may be used as long as they do not irritate your skin in the ear canal.
  • In the shower, you can use some cotton wool coated with Vaseline to prevent water or shampoo getting in.

3. Don't use cotton wool buds and avoid itching inside your ear canal with your fingers.

  • This may damage the delicate lining of the ear canal
  • This may push the wax further inside the ear. Wax will usually come out itself.
  • You can use olive oil or over-the-counter ear wax preparations to help remove the wax if necessary.

4. Remove anything from your affected ear that may cause an allergic reaction, such as earings, ear plugs or hearing aids.

5. Acidifying ear drops

  • Try using acidifying ear drops or spray (available from a pharmacy) to help keep your ears clean, particularly before and after swimming. These may help to prevent otitis externa recurring.

6. Decongestants

  • For middle ear infections decongestant nasal sprays can sometimes help. They are believed to work by reducing the pressure on the eardrum which can be contributing to the pain, by draining the Eustachian tube.
  • They can be bought over the counter from the pharmacy and should be used for a maximum of 5 days. It is important to check with a pharmacist whether this type of medication is suitable for you before using and always read the manufacturer's leaflet before use.
  • Steam inhalation may also help as a temporary decongestant, and some people find a hot shower helpful.
When to seek urgent medical advice

If you develop any of the symptoms listed below, then you must seek urgent medical advice immediately (from your GP, Out of Hours Service, Urgent care centre, NHS 111). Call an ambulance or go to A&E if the symptoms are severe.

  • drowsiness or confusion
  • difficulty in breathing or shortness of breath
  • difficulty swallowing saliva, and/or you start drooling
  • difficulty opening your mouth.
  • a severe headache
  • weakness on one side of your face
  • if you develop redness, swelling and warmth around the ear or eye
  • if you are unable to look at bright lights (photophobia)
  • chest pain
  • persistent vomiting
  • neck stiffness
  • non-blanching rash
Antibiotic Guardianship

Antibiotics should be used responsibly and only when really necessary. Overuse and misuse of antibiotics can lead to antibiotic resistance. This is where the antibiotic becomes less effective at treating certain types of bacterial infection, so they do not work when needed. 

Antibiotics should be taken as prescribed, and it is important to complete the full course, this can reduce the chance of the bacteria developing an immunity to that antibiotic. It is important not to share antibiotics, and always take unused medication to your local pharmacy for disposal.

Start an earache diagnosis

Do you think you have an ear infection that requires treatment?

We could diagnose and send you a treatment plan with a prescription, if appropriate, within an hour.