Ear infections in adults: signs, causes and treatment
Ear infections are less common in adults than in children, but they are painful when they happen. Most clear within a few days, often without antibiotics. Here is how to tell the types apart, what helps, and when you need a doctor.
Where the infection is changes everything.
The ear has three parts, and infections behave differently in each. An outer ear infection, otitis externa, affects the skin of the ear canal. A middle ear infection, otitis media, affects the air-filled space behind the eardrum. Inflammation of the inner ear, such as labyrinthitis, mainly causes dizziness rather than pain.
In adults, outer ear infections are the most common, often after swimming or from scratching the ear canal. Middle ear infections in adults usually follow a cold or a sinus infection, when the Eustachian tube is blocked and fluid behind the eardrum becomes infected.
Pain when you touch or pull the ear, sometimes with discharge. Often called swimmer's ear.
Pressure, muffled hearing and sometimes a temperature. If the eardrum bursts, the pain often eases as fluid drains out.
Signs of an ear infection.
Start with a pharmacist, who can advise on pain relief and ear drops, or your GP. Once the infection has cleared, a hearing test checks that your hearing has fully returned.
Why adults get ear infections.
Swimming and showering soften the skin of the canal and let bacteria in. The classic cause of outer ear infections.
Read about swimmer's earA blocked Eustachian tube traps fluid behind the eardrum, where it can become infected.
Read about Eustachian tube dysfunctionSmall scratches in the canal skin are an easy way in for bacteria.
Eczema, psoriasis and seborrhoeic dermatitis make the ear canal more vulnerable.
Devices that sit in the ear trap warmth and moisture. Clean them regularly and give your ears a rest.
These raise the risk of an infection becoming more serious, so seek advice early.
How ear infections are treated.
Many middle ear infections clear by themselves within three days, and most within a week. Paracetamol or ibuprofen help with pain and temperature, and a warm or cold flannel held against the ear can be soothing. Antibiotics are not usually needed unless symptoms are severe or not improving.
Outer ear infections are usually treated with ear drops, which may contain an antibiotic, a steroid, an acidic solution or an antifungal. A pharmacist can advise and may be able to supply them, and your GP can prescribe stronger drops if needed. Keep the ear dry while it heals.
Do not put anything into an infected ear, including cotton buds or oils, unless a pharmacist or doctor has advised it, and leave earwax removal until the infection has cleared.
After the infection, check your hearing.
We do not treat infections ourselves, but we can help you understand what is going on, and make sure your hearing recovers.
If you are not sure whether your problem is wax, an infection or something else, we can take a look and advise who to see.
If we see signs of infection, a perforation or anything else that needs treatment, we write to your GP with what we found.
Muffled hearing after an infection usually recovers within a few weeks. A test confirms it has, or shows if anything has changed.
We can look at the fit and material of your ear moulds, and your cleaning routine.
Get urgent medical help if
- You have a very high temperature or feel very unwell
- There is redness, swelling or pain behind the ear
- You have a severe headache, a stiff neck, confusion or drowsiness
- Your face feels weak or droops on one side
- You have sudden hearing loss or severe dizziness
These can be signs that an infection has spread, which is rare but serious. Call NHS 111, or 999 in an emergency.
Frequently asked questions.
Most do. Middle ear infections usually clear within three days to a week. Outer ear infections often need ear drops, but usually settle within a week or so of starting treatment.
Yes, usually temporarily. Fluid behind the eardrum or a swollen ear canal muffles sound. Hearing normally returns within a few weeks of the infection clearing. If it does not, have your hearing tested.
Earwax removal is not usually done while an ear is actively infected. Treat the infection first, with advice from your pharmacist or GP, then book in once it has settled.
Common reasons are water getting into the ears, scratching or cotton bud use, skin conditions in the ear canal, and hearing aids or earbuds that trap moisture. Repeated middle ear infections in adults should be reviewed by your GP.
No. Ear infections themselves are not passed from person to person, although the cold that led to one can be.
Once it has cleared, check your hearing.
A free hearing test in our Birmingham clinic, or a home visit across the West Midlands.
Written and clinically reviewed by our HCPC registered audiologists. Last reviewed: 15 October 2026. This page is general information, not a diagnosis. If you are worried about your hearing or your ears, book an appointment or speak to your GP.