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Earache is cited as the most common reason for parents to call a doctor out of hours for their child. It will often be the result of an ear infection.

Adults are less likely to experience earache and ear infections than children.

Earache can be a sharp, dull or burning ear pain that comes and goes or is constant. One or both ears may be affected.

When to call your GP

Call your GP if:

  • you or your child has a fever (38ºC or above)
  • you or your child has other symptoms, such as dizziness, severe headache or swelling around the ear
  • the earache does not improve within 24-48 hours

What you can do at home

You can take over-the-counter painkillers such as paracetamol or ibuprofen to relieve the pain. Children under the age of 16 should not take aspirin.

Also, try holding a cold flannel to the affected ear for about 20 minutes to relieve the pain.

Your pharmacist may be able to recommend over-the-counter eardrops for your earache, but let them know your symptoms and ask for their advice first. Eardrops or olive oil drops should not be used if the eardrum has burst, and they will not help an ear infection.

If you think you or your child has an ear infection (see below), you should avoid getting the ear wet.

Common causes of earache

The information below should not be used to self-diagnose your condition, but may give you an idea as to what is causing your earache. It does not include every possible cause, but outlines the most common reasons for earache.

These are:

  • glue ear, a build-up of fluid deep inside the ear (behind the eardrum), which mainly affects children
  • an infection in the ear canal (outer side of the eardrum)
  • a scrape or other physical damage to the inside of the ear caused by a cotton bud, stick or similar
  • a plug of earwax or other object stuck inside the ear
  • a throat infection, such as tonsillitis or quinsy, which can affect the ear

Earache caused by glue ear

Glue ear is a build-up of fluid deep inside the ear, which commonly causes some loss of hearing. The pressure of this fluid can also cause earache. Glue ear is much more common in children than adults.

Your GP will usually be able to recognise glue ear after examining the ear. It often clears up on its own without treatment.

Earache caused by an infection

If the cause of earache is an ear infection, there may be watery or pus-like fluid coming out of the ear.

In either adults or children, this may be an outer ear infection affecting the ear canal (tube leading into the ear). The whole ear canal may become inflamed and sore, or there may be a boil (an infected hair follicle) inside the ear canal, which you may be able to see.

A boil inside the ear will usually burst, drain and heal by itself after a few days, but if you are in considerable pain and discomfort and do not want to wait for this to happen, see your GP. They may be able to remove the pus using a surgical needle. 

Many ear infections clear up on their own without treatment (see treating outer ear infection), but in some cases you may be prescribed antibiotic tablets or eardrops.

Earache caused by damage to the ear

Earache may sometimes result from injury to the inside of the ear – for example, by scraping earwax from the ear canal using a cotton bud, or poking the cotton bud too far into your ear, which can puncture the eardrum (see perforated eardrum for more information).

The ear canal is very sensitive and can easily become damaged. The ear should heal on its own without treatment, but it may take six to eight weeks for a perforated eardrum to heal.

Earache caused by earwax

If your earache is due to a plug of hard earwax, do not attempt to remove this with a cotton bud, as this will only push it further inside and you may damage your eardrum.

Instead, your GP or pharmacist can prescribe eardrops to soften the wax so that it falls out naturally. In some cases, your GP will need to remove the wax (once softened with eardrops) by flushing the ear with water. 

Earache caused by a throat infection

If you find it painful to swallow and have a sore throat, it is likely that your earache is a symptom of a throat infection, such as tonsillitis or quinsy (an abscess in the back of your throat).

Some types of tonsillitis will clear up after a few days without the need for antibiotics. But if you have quinsy, you will need to see your GP as soon as possible for treatment. You should suspect quinsy if your sore throat gets worse very quickly.

More unusual causes of earache

Less commonly, earache may be caused by any of the below conditions. See your GP or dentist if you think you have any of these.

A problem with the jaw bone

You may have a problem with the joint of your jaw bone, where the jaw meets the skull. This is known as temperomandibular joint pain, and it may be caused by arthritis or teeth grinding.

A dental abscess

dental abscess is a collection of pus that can form in your teeth or gums as a result of a bacterial infection. It can cause earache, although the main symptom of a dental abscess is pain in your affected tooth, which can be intense and throbbing. Your dentist will need to remove the abscess and drain the pus.

An impacted tooth

Earache can be caused by a wisdom tooth or molar (back tooth) that has not fully broken through the skin. Have a look inside your mouth if you think this is the cause of your earache – some of the tooth will still be below the gum line. Your dentist can advise you on whether it needs to be removed. For more information, see wisdom tooth removal.

Facial nerve pain

Sometimes, ear pain can actually be trigeminal neuralgia, which is sudden, severe nerve pain in the face that is usually caused by pressure on the main nerve inside the skull. The pain is felt in the jaw, cheek or eye and can last from a few seconds to a couple of minutes. Prescription medicine can provide temporary relief from the pain.

Eczema in the ear canal

A type of eczema called seborrhoeic dermatitis can sometimes cause earache. It affects any area of skin that is naturally greasy, such as the ears, and will cause the skin to become irritated and inflamed, with red, scaly patches. Your GP will be able to prescribe eardrops containing corticosteroids to clear it.

How do I know if my child has an ear infection?

Babies with ear infections will be hot and irritable. Other signs in babies and children are:

  • pulling, tugging or rubbing their ear
  • a high temperature (38ºC or above)
  • irritability
  • poor feeding
  • restlessness at night
  • coughing
  • runny nose
  • unresponsive to quiet sounds
  • loss of balance
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