Earache

Earache is common and usually not serious

Earache — pain in or around the ear — is especially common in young children. It often follows a cold and usually settles within a few days with simple pain relief. It can be distressing, particularly in babies who cannot explain what hurts.

Common causes

Middle ear infection (otitis media) — the most common cause in children. Fluid and pressure build up behind the eardrum after a cold. Causes earache, fever and temporary hearing loss.

Earwax build-up — can cause fullness, muffled hearing and discomfort without infection. Do not try to remove wax with cotton buds — this often makes it worse.

Referred pain from the throat — sore throat, tonsillitis or teething can cause pain felt in the ear even when the ear itself is healthy.

Outer ear infection (swimmer’s ear) — affects the ear canal, often after swimming. Pain may worsen when pulling the outer ear.

Air pressure changes — during flying or diving, pressure differences can cause temporary ear pain.

Earache in babies and young children

Look for:

• pulling, tugging or rubbing the ear
• irritability and crying — especially when lying down
• fever
• reduced feeding
• disturbed sleep
• not responding to quiet sounds as usual

These signs suggest earache even when the ear looks normal from outside.

Easing earache at home

• Pain relief — paracetamol or ibuprofen (age-appropriate dosing for children; check suitability if you have health conditions).
• Warm compress — a warm (not hot) flannel against the ear.
• Upright position — can reduce pressure; babies may sleep more comfortably slightly propped up.
• Fluids — especially if they have a fever.

Do not put drops, oil, cotton buds or objects into the ear unless a doctor has examined the ear and advised it.

When a GP is needed

See a GP if:

• earache lasts more than three days
• pain is severe or getting worse
• fluid, pus or blood is coming from the ear
• your child has a high temperature that will not settle
• earache keeps coming back

A GP can look in the ear, confirm whether infection is present, and decide if antibiotics are needed. Many ear infections resolve without them.

Earache and flying

If you or your child have active earache or a confirmed infection, speak to a GP before flying. Pressure changes during take-off and landing can cause significant pain and, rarely, eardrum damage.

Preventing ear infections

You cannot prevent all ear infections, but avoiding smoke exposure, keeping up with vaccinations, and treating colds promptly all help reduce risk in children.

When to seek urgent help

Call 999 for sudden complete hearing loss, severe dizziness with vomiting (possible inner ear problem), or swelling and redness around the ear with high fever (possible spread of infection beyond the ear).

Common questions

How do I know if my baby has earache?

Babies cannot say their ear hurts. Clues include pulling or rubbing the ear, irritability, crying more than usual, difficulty sleeping, fever, being off feeds, and not reacting to quiet sounds.

Does earache always mean an ear infection?

No. Earache can also be caused by earwax build-up, a sore throat or tonsillitis (pain referred to the ear), teething in babies, changes in air pressure (flying), or water trapped in the ear canal after swimming.

How can I relieve earache at home?

Paracetamol or ibuprofen for pain and fever (follow age-appropriate dosing for children). A warm flannel held against the ear may help. Keep upright — lying flat can worsen pressure. Do not insert anything into the ear canal.

Do I need antibiotics for earache?

Many ear infections are viral and get better without antibiotics. A GP decides whether antibiotics are needed based on severity, age, and how long symptoms have lasted.

Can I fly with earache?

Flying with a blocked or infected ear can be very painful due to pressure changes. See a GP before flying if you or your child have active earache or a confirmed ear infection.

Sources

• NHS — Earache