Ear infections

What is an ear infection?

Air usually passes up from behind the nose, through a tube (called the Eustachian tube) to the middle ear (a small space behind the eardrum), which is kept well-ventilated, clean and dry. If not enough fresh air can pass through (for example, if the Eustachian tube is blocked or clogged), the inner ear can become prone to bacterial and viral infections known as ear infections.

Ear infections can also affect the outer ear, where the skin leading from the outside of the ear to the eardrum becomes inflamed, swollen or discharges pus.

Ear infections can affect both children and adults and are very common.

Ear infection symptoms

The most common ear infection symptoms are:

• Pain inside the ear

• A high temperature (above 38C)

• Vomiting

• Feeling lethargic (having a lack of energy)

• Hearing difficulties

• Ear discharge

• A feeling of fullness or pressure inside the ear

• Itching and irritation in and around the ear

• The skin in and around the ear feeling scaly

If babies or young children have an ear infection, they may also have the following symptoms:

• Pulling or rubbing their ear

• Not reacting to some sounds

• Irritability

• Restlessness

• Lack of appetite

• Poor balance

Ear infection symptoms usually develop quickly and often get better on their own within 3 days. In some cases, symptoms can last up to a week, and you should go and see a GP if you have a long-term medical condition (like diabetes or a heart, lung, kidney or neurological disease), a weakened immune system and also experience any of the following:

• Feeling hot and shivery

• Swelling of the ear

• Hearing loss

• A severe sore throat

• Dizziness

• Ear infections that occur regularly

Can an ear infection cause a sore throat?

Ear infections can cause a sore throat in some cases due to bacteria or a virus spreading from the ear into the throat. You can also get pain when you swallow because of a build-up of pressure in the blocked Eustachian tube.

Ear infection causes

There are two types of ear infections:

• An acute ear infection is a single, isolated case

• Recurrent ear infections occur if the condition has cleared up but returns up to 3 times in 6 months, or 4 times in a year

With recurrent ear infections, it’s likely the Eustachian tube isn't working as it should be. Upper respiratory viral infections like a cold or the flu are the most common ear infection causes, as they can make the Eustachian tube swell which prevents airflow.

Allergic reactions to dust, pollen or animal dander can also cause ear infections, especially if bacteria can get into the middle ear and cause inflammation and fever due to poor ventilation.

Reducing your risk of ear infections

Research has found that you’re more likely to suffer recurrent middle ear infections if:

• You’re male

• You have a family history of ear infections

• Your baby is fed formula milk from a bottle

• Your child goes to nursery

• You live with a smoker

• You have palate abnormalities, like cleft palate

• You have a poor immune system or chronic respiratory diseases like cystic fibrosis or asthma

Things that you can do to prevent inner ear infections include:

• Ensuring your child is up to date with vaccinations

• Keeping your child away from smoky places

• Not giving your child a dummy after they're six months old

To prevent outer ear infections, you should:

• Avoid sticking cotton wool buds or your fingers into your ears

• Avoid using earplugs or a swimming hat when swimming

• Stop water or shampoo getting into your ears when showering or bathing

Ear infection diagnosis

If ear infection symptoms don’t go away on their own or become more severe, then you should go and see a GP.

They will do a physical examination of your ear or your child’s ear using a small light called an otoscope.

Ear infection treatment

If you or your child has an ear infection, you can ease the pain and discomfort by taking painkillers like paracetamol or ibuprofen (children under 16 should not take aspirin), placing a warm or cold flannel on the ear or using cotton wool to remove any discharge.

How to get rid of ear infections

Depending on the cause of the ear infection, a GP may prescribe:

• Ear infection antibiotics for inner ear infections that haven’t cleared up after three days, are causing fluid to come out of the ear or if you or your child has cystic fibrosis

• Steroid, antibiotic or antifungal ear drops for outer ear infections (depending on the cause of the ear infection) to reduce swelling and treat bacterial or fungal infections