Do I Have an Ear Infection?

You may assume that only children get ear infections. After all, it’s one of the most common reasons for trips to the pediatrician. But adults can get ear infections too.

Here’s what you need to know about this surprisingly common problem.

Ear Infection in Adults

If you have an earache that doesn’t go away in a day or so, it’s possible you have an ear infection. Infections can happen in different parts of the ear. Middle and outer ear infections occur for different reasons, and mostly in different age groups.

Babies, toddlers, and younger children tend to get middle ear infections. They occur when inflammation causes fluid to build up behind the eardrum, creating a perfect environment for germs to flourish. These infections cause pain, fever, and trouble sleeping.

Middle ear infections are less common in adults. Adults have more immunity to bacteria and viruses. Also, the drainage (eustachian) tubes in their ears are bigger, so fluid is less likely to collect in their ears.

Adults are more likely to get outer ear infections. An outer ear infection (otitis externa) is a painful condition in the outer ear canal. It can also occur in the part of the ear you can see.

According to the National Institutes of Health, one in every 10 adults will have an outer ear infection during their lifetime.

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What Causes Ear Infection in Adults?

The most common cause of an outer ear infection is when water gets trapped in the ear canal. Bacteria that already live on the skin in ear canal begin to multiply, causing infection. It’s a common problem for swimmers, so outer ear infections are sometimes known as swimmer’s ear.

Other causes of outer ear infections include:

  • Viral illnesses, like the flu or a certain type of shingles called Zoster oticus.
  • Fungi, especially if you live in a warm climate.
  • Allergies to a certain shampoo, soap, or hair product.

Risk Factors for Ear Infection in Adults

You are more susceptible to ear infections if bacteria can enter the skin of your outer ear and ear canal. Risk factors for outer ear infection in adults include:

  • Spending a lot of time swimming.
  • Spending time in hot tubs or polluted water, where more bacteria might be present.
  • Using cotton swabs to clean your ears. Vigorous cleaning can lead to breaks in the delicate ear canal skin, letting more bacteria in.
  • Using harsh chemicals near your ears, such as hair dye or hair spray.
  • Irrigating with too much force when trying to remove earwax.
  • Wearing headphones that sit inside your ears.
  • Wearing hearing aids.
  • Having previous ear infections.
  • Having eczema, psoriasis, or seborrheic dermatitis (dandruff), which can lead to dry, cracked skin.
  • Having diabetes. Poor blood flow in the ears makes people with diabetes more susceptible to ear infections.

Symptoms of Ear Infections in Adults

Signs and symptoms of an outer ear infection can include:

  • Itchiness and pain inside the ear.
  • Redness or swelling of the skin around the ear.
  • Pain that gets worse when you tug on the outer ear.
  • A blocked or full feeling in the ear.
  • Drainage from the ear.
  • Fever.
  • Diminished hearing.
  • Pain that spreads to the face, neck, or side of the head.
  • Swollen lymph nodes around the ear or in the upper neck.

Complications of Ear Infection in Adults

While outer ear infections are easily treated, they can lead to complications if you ignore them. These include:

  • Hearing loss. When the ear infection clears up, your hearing should return to normal. But without treatment, infections can persist — and you may lose some hearing.
  • Bone and cartilage damage. Untreated ear infections can spread to the base of your skull, brain, or cranial nerves. Older people and those with weakened immune systems or diabetes are at higher risk.
  • Tears to the eardrum. Untreated, chronic ear infections can lead to a buildup of pus and eventually cause damage to the eardrum.

How to Treat an Ear Infection

If your symptoms are mild, you can treat your ear infection at home. Use over-the-counter (OTC) eardrops — or make your own using a 50/50 mix of rubbing alcohol and vinegar.

You can use OTC pain relievers and warm compresses to ease the discomfort of an ear infection.

You should see a doctor if symptoms become worse. Call your doctor if you have:

  • A fever.
  • An earache that doesn’t get better after three days.
  • Swelling around the ear.
  • Fluid coming from the ear.
  • Hearing loss or a change in hearing.
  • Dizziness.
  • An earache plus a weakened immune system.
  • An earache with a chronic health condition like diabetes, kidney disease, or heart disease.

Your doctor will clean the ear canal and examine it to make sure you don’t have a perforated eardrum. They may prescribe one or more of the following:

  • Eardrops to reduce inflammation and slow bacterial or fungal growth.
  • Antibiotics to apply directly to the ear.
  • Oral antibiotics if the infection has moved beyond the skin of the ear canal.
  • Pain medication.

With proper treatment, most outer ear infections clear up within a week to 10 days.

Preventing Ear Infection in Adults

Fortunately, there are ways to help prevent ear infections from happening in the first place. The most important thing is to keep your ears as dry as you can, especially after swimming or showering. In addition:

  • Never put a pointed object in your ear canal.
  • Never clean your ears with cotton swabs. Your ears do a good job cleaning themselves by producing earwax.
  • If you have excessive earwax, ask your doctor to clean it out for you, especially if you do a lot of swimming.
  • When swimming, wear a snug-fitting bathing cap.
  • Try to avoid getting water in your ears when showering or bathing.
  • If you get water in your ears, gently tilt your head to the side to let it flow out. Pulling on your earlobe may help. You can also try drying out your ear using a hairdryer set on low.
  • If you are prone to ear infections, be careful using anything that goes in your ears. That includes earplugs, ear buds, and hearing aids. Look for ones that fit over, rather than inside, your ears.
  • American Academy of Otolaryngology-Head and Neck Surgery, Swimmer's Ear (Otitis Externa), Link
  • American Academy of Otolaryngology-Head and Neck Surgery, Earaches, Link
  • National Library of Medicine, Outer ear infection: Overview, Link
  • NHS, Ear infections, Link
  • CDC, Ear Infections, Link

About Ear Nose and Throat

The experts in the UPMC Department of Otolaryngology treat a variety of ear, nose, and throat (ENT) conditions in both children and adults. Our team includes board-certified physicians and highly skilled speech-language pathologists and audiologists. We provide both surgical and nonsurgical treatment options. Our research and clinical trials help to advance care for our patients. Find an ENT expert near you.